A June 2022 paper (1)  assessed the relation of obesity to opioid use in people with or at risk of knee osteoarthritis, and the extent to which this association is mediated by number of painful joints or depressive symptoms.

  • The researchers studied 2335 participants (average age 68 and considered obese). They found that people with obesity had 50% or more higher odds of opioid use than those people not considered obese.  Further: “Multi-joint pain and depressive symptoms partially explained greater opioid use among obese persons with knee osteoarthritis, demonstrating that the negative impact of obesity on knee osteoarthritis extends beyond its influence on knee pain and structural progression.”

Sarcopenic obesity increases the odds of knee osteoarthritis

A May 2024 study (2) revealed that low muscle mass index and sarcopenic obesity were associated with an increased risk of developing knee osteoarthritis especially in women. The researchers wrote: “The findings with moderate-quality evidence indicated that sarcopenic obesity increases the odds of knee osteoarthritis by approximately 90% in females. . . ”

A November 2024 study (3) looked at the impact of being overweight and obese on a single bone marrow concentrate injection patients with early stage knee osteoarthritis.

Sixty-eight patients were dived, based on their BMI into normal, overweight, and obese groups. Visual Analog Scale (VAS) for pain and Knee Injury and Osteoarthritis Outcome Score (KOOS) were the outcomes analyzed.

  • Sixty-eight patients (normal BMI = 43, overweight BMI = 15, obese BMI = 10) were enrolled in the study for analysis.
  • While significant improvement in the outcome scores was noted compared to the baseline throughout the study period in the normal BMI and overweight group, the obese group returned to baseline parameters at 3 months follow-up.
  • Patients in the normal BMI group demonstrated significant improvement in VAS  and KOOS  outcomes compared to the overweight and obese group.

1 Carlesso LC, Jafarzadeh SR, Stokes A, Felson DT, Wang N, Frey-Law L, Lewis CE, Nevitt M, Neogi T, Multicenter Osteoarthritis Study Group. Depressive Symptoms and Multi-joint Pain Partially Mediate the Relationship Between Obesity and Opioid Use in People with Knee Osteoarthritis. Osteoarthritis and Cartilage. 2022 Jun 11.
2 Wu Q, Xu Z, Ma X, Li J, Du J, Ji J, Ling X, Kan J, Zhao M. Association of low muscle mass index and sarcopenic obesity with knee osteoarthritis: a systematic review and meta-analysis. Journal of the International Society of Sports Nutrition. 2024 Dec 31;21(1):2352393. *
3 Muthu S, Thangavel P, Duraisamy S, Jha SK, Ramanathan K, Alagar Yadav S, Ranjan R. Obese Patients Do Not Benefit from Bone Marrow Aspiration Concentrate Injection for Knee Osteoarthritis: A Prospective Cohort Study of 68 Patients. Indian Journal of Orthopaedics. 2024 Nov 30:1-9.