Prevalence of Obesity in Patients with Osteoarthritis

Berts K, Foley S, Budiman-Mak E. Prevalence of Obesity in Patients with Osteoarthritis. Paper presented at: Society of General Internal Medicine Annual Meeting; 2002 Sep 1; Chicago, IL.

Purpose: To determine the prevalence of obesity among outpatients with osteoarthritis (OA) of the knee and to identify the type and frequency of weight loss interventions provided.Participants: Patients with OA of the knee (primary diagnosis ICD9-CM code 715.06 or secondary ICD9-CM code 715.26) who attended the ambulatory care clinics June 1996 to June 1999.Method:Retrospective chart review utilizing the computerized patient record system (CPRS) to obtain demographics, weight change over time, BMI, type and frequency of nutrition intervention, and absence/presence of total knee arthroplasty (TKA). Data analysis: Descriptive statistics were used to report demographic variables, weight trends, and type/frequency of weight loss interventions. Paired t-tests were used to determine significant changes in weight and BMI over a one-year period (p < 0.05) using Microsoft Excel and Primer of Biostatics.Results: The sampling frameconsisted of331 OA patients. The majority were male (97.3%) with a mean age of 73.1 7.7 yrs (range 45-88). The mean BMI was 30.1 6.0 (n = 295 available ht/wt) and 77.3% had a BMI 27. Only 8.5% had arthroscopy with demographics similar to those without arthroscopy. Weight gain was observed in 42.7% (n = 114) with a mean weight gain of 6.9 7.2 lbs (range of .2 to 56 lbs). The average time between measured weights over one year was 9.1 3 months. Weight loss was observed in 53.2% (n = 142) with a mean weight loss of 11.8 15.3 lbs (range of .2 to 137lbs). Only 14.6% (n = 39) had substantial weight loss (losing 7% of initial recorded weight). There was a significant difference between weights at the beginning and end of the one-year time period (p < 0.001) Only 49 patients (18.3%) were counseled by a registered dietitian (RD) at least once over the course of the year with only 10% (n = 27) referred to the ambulatory care clinic RD by an MD for weight loss. Of the 39 patients with substantial weight loss, 14 patients received nutrition education with nine reporting weight loss by means of dietary behavior change, and five losing weight secondary to illness. Conclusion: A large proportion of the ambulatory care clinic patients with OA of the knee are obese and only 10% were referred for outpatient nutrition counseling. This population may likely benefit from a more aggressive approach to weight management.