A low-calorie diet likely won't directly help hip osteoarthritis pain but could still have health benefits

Embargoed until: Publicly released: 2025-08-05 07:00

Australia; NSW; VIC

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People with hip osteoarthritis alongside overweight/obesity who go on a very low-calorie diet for a year likely won't see additional improvements to their hip pain, but will likely see other health improvements compared to just doing an exercise regime, according to Australian researchers. The researchers recruited 101 adults and randomly split them into two groups; one did an exercise regime with a physiotherapist while the other group did the same exercise, but also followed a very low-calorie diet with nutritionist assistance. The researchers say those in the diet group lost more weight, but there were no clear differences in hip pain severity between the groups. However after a year, they say there were some improvements in hip function and lower pain medication use in the diet group.

Media release

From: American College of Physicians

Study suggests weight loss could help treat and manage hip osteoarthritis

A randomized controlled trial evaluated the efficacy of a weight loss diet added to exercise on the change in hip pain among adults with hip osteoarthritis. The study found that adding a weight loss diet did not change hip pain severity; however, it did benefit secondary outcomes including physical function, body weight, and other measures of pain. The results suggest that weight loss could be a potential treatment option for the management of hip osteoarthritis. The study is published in Annals of Internal Medicine.

Researchers from Sydney Musculoskeletal Health, The Kolling Institute, University of Sydney and colleagues studied data from 101 adults aged 50 or over with hip osteoarthritis, overweight or obesity, and hip pain for three or more months in Melbourne and Sydney, Australia between June 2021 and January 2023, with follow-up until January 2024.

Participants were randomly assigned to either exercise only or a very low calorie diet (VLCD) plus exercise. They were then randomly assigned a physiotherapist, and if assigned in the VLCD plus exercise, randomly assigned a dietician. Components of the exercise only group consisted of five consultations with a physiotherapist and a home strengthening exercise program. The VLCD plus exercise group underwent the same exercise components along with six consultations with a dietitian to support them undertaking a ketogenic VLCD.

The primary outcome was 6-month change in hip pain severity. Secondary outcomes were reported at 6 and 12 months and included body weight, BMI, and hip pain physical function and hip-related quality of life subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS). The researchers found that at 6 months, there was no evidence of a between-group difference in hip pain severity. Similar results were found at 12 months. All secondary outcomes, with the exception of HOOS pain and function, favored VLCD plus exercise at 6 months. However, the benefits of VLCD plus exercise for HOOS pain and function become apparent at 12 months. Additionally, 82% of VLCD plus exercise participants achieved greater than 5% body weight loss versus 16% in exercise only.

The findings stimulate further research on clinical topics including whether weight loss can reduce or delay hip joint replacement surgery.

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Other American College of Physicians, Web page Summary for patients

Journal/
conference: Annals of Internal Medicine

Research:Paper

Organisation/s: The University of Sydney, The University of Melbourne, Monash University, The University of Newcastle

Funder: Funding was provided by a National Health and Medical Research Council (NHMRC) Investigator Grant (Grant No. 1774431) and Project Grant (Grant No. 1159045).

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