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However, function varies among such individuals. Our objective was to evaluate the implications of obesity subtypes on longitudinal patterns of physical functioning in people with or at risk for knee OA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included participants from the Multicenter Osteoarthritis Study (MOST) with a BMI \u226530 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and dual\u2010energy x\u2010ray absorptiometry\u2013measured body composition. Three obesity subtypes were defined: (1) obesity with low muscle mass (OLM) and high fat mass; (2) obesity with cardiometabolic comorbidities (OCC) but without low muscle mass; and (3) uncomplicated obesity (UO), that is, neither OLM nor OCC. We examined the relation of these three obesity subtypes to self\u2010reported Western Ontario and McMaster Osteoarthritis Index physical function at baseline and seven years using linear regression at both time points and to their longitudinal functional trajectory patterns using multinomial logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the baseline sample (N\u00a0=\u00a01,211 individuals, 63% female, mean age 61.2\u2009\u00b1 SD\u20097.6 years, mean BMI 35.0\u2009\u00b1 SD\u20094.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), 49.1% were UO, 34.4% OLM, and 16.5% OCC. Compared to UO, the OLM and OCC groups had worse physical function at baseline. Five distinct trajectories of functioning were identified over seven years, with 23%, 38.5%, 26%, 4.5%, and 8% of the sample in groups 1 to 5, respectively. Compared to UO, OLM and OCC groups had higher odds of being in the persistent poorest functioning trajectory (odds ratio 1.9, 2.6, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Individuals with obesity and concurrent low muscle or cardiometabolic comorbidities have persistent worse functioning over a seven\u2010year period compared to those with obesity alone. Distinguishing obesity subtypes may enable personalized interventions to delay or avoid extended mobility disability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80066","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:16:51Z","timestamp":1776691011000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obesity Subtypes and Longitudinal Trajectories of Function Over Seven Years of Follow\u2010Up: Data From the Multicenter Osteoarthritis Study"],"prefix":"10.1002","author":[{"given":"Kristine","family":"Godziuk","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, School of Medicine University of California  San Francisco"},{"name":"Department of Agricultural, Food and Nutritional Science University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Tilley","sequence":"additional","affiliation":[{"name":"Chobanian &amp; Avedisian School of Medicine Boston University  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"LaValley","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Nevitt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Alabama at Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Iowa  Iowa City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-1711","authenticated-orcid":false,"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Chobanian &amp; Avedisian School of Medicine Boston University  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Multicenter Osteoarthritis Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-60587-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0075491"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2024.111962"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-019-0839-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2024.02.003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00088-8"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2015.243"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.583825"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0000000000000395"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2019.05.026"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glp159"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2020.00053"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2013.04.014"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-023-00943-z"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-024-00571-2"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2023.02.018"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu010"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-015-0638-1"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2012.20"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-019-0516-8"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/72.3.694"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3233\/s12349-013-0135-1"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-016-0880-y"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.856260"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22415"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124101029003005"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.4159\/9780674041318"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00316-4"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-2175-7"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/21514593211020700"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/1354750X.2017.1315615"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-023-00760-7"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-025-01230-y"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.113.080796"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2024.100364"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000490361"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2023.2267672"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.09.018"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2024-004733"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-022-09035-4"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064071"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.01312"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B7.BJJ-2018-1465.R1"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-020-00398-7"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2008.05.005"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-015-0355-9"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-025-00594-6"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00376-4"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40608-018-0201-9"}],"container-title":["Arthritis Care &amp; 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