{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:00:00Z","timestamp":1793638800892,"version":"4.5.1"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T00:00:00Z","timestamp":1540512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01\u2010AR\u2010052528\u201001"],"award-info":[{"award-number":["R01\u2010AR\u2010052528\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30\u2010A21332"],"award-info":[{"award-number":["P30\u2010A21332"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["M01\u2010RR\u201000211"],"award-info":[{"award-number":["M01\u2010RR\u201000211"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine the dose response effect of weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis (\n                      <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a secondary analysis of the diet\u2010induced weight loss only (D) and diet\u2010induced weight loss plus exercise (D + E) groups in the Intensive Diet and Exercise for Arthritis randomized controlled clinical trial. The 240 participants were overweight and obese older community\u2010dwelling adults with pain and radiographic knee\n                      <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content>\n                      . Participants were assigned to 1 of 4 groups according to weight loss achieved over an 18\u2010month period: &lt;5% (&lt;5% group), 5\u201310% (\u22655% group), 10\u201320% (\u226510% group), and &gt;20% (\u226520% group).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were significant dose responses to weight loss for pain (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01), function (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0006), 6\u2010minute walk distance (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001), physical (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0004) and mental (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03) health\u2010related quality of life (\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL), knee joint compressive force (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001), and interleukin\u20106 (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002). Greater weight loss resulted in superior clinical and mechanstic outcomes, with the highest weight loss group (\u226520% group) distinguishing itself on all measures compared with the &lt;5% and \u22655% groups; the \u226520% group had 25% less pain and better function compared with the \u226510% group and significantly (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.006) better physical\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Long\u2010term weight loss of 10\u201319.9% of baseline body weight has substantial clinical and mechanistic benefits compared with less weight loss. The value of an additional 10% weight loss includes significantly improved physical\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL and a clinically important reduction of pain and improvement in function.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.23608","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T06:28:54Z","timestamp":1529303334000},"page":"1569-1575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":183,"title":["Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better?"],"prefix":"10.1002","volume":"70","author":[{"given":"Stephen P.","family":"Messier","sequence":"first","affiliation":[{"name":"Wake Forest University Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison E.","family":"Resnik","sequence":"additional","affiliation":[{"name":"Wake Forest University Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Beavers","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon L.","family":"Mihalko","sequence":"additional","affiliation":[{"name":"Wake Forest University Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary D.","family":"Miller","sequence":"additional","affiliation":[{"name":"Wake Forest University Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Nicklas","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"deVita","sequence":"additional","affiliation":[{"name":"East Carolina University Greenville North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-752X","authenticated-orcid":false,"given":"David J.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Royal North Shore Hospital and Institute of Bone and Joint Research University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary F.","family":"Lyles","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Paracelsus Medical University Salzburg, Austria Chondrometrics GmbH, Ainring, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Guermazi","sequence":"additional","affiliation":[{"name":"Boston University Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Loeser","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","unstructured":"OgdenCL CarrollMD McDowellMA FlegalKM.Obesity among adults in the United States: no statistically significant change since 2003\u20102004. 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