Exercise plus diet reduces weight, BMI but does little to improve hip pain

The addition of a weight-loss diet to exercise does not appear to change hip pain severity, in adults with hip osteoarthritis and overweight or obesity. However, it results in improvements in most other outcomes such as body weight and body composition.

A total of 101 adults with hip osteoarthritis and overweight or obesity participated in this superiority randomized trial. Participants were randomly allocated to the exercise group only or the very-low-calorie diet (VLCD) plus exercise group, and both received a 6-month home exercise program via five telehealth consultations. The VLCD plus exercise group also received a VLCD via six telehealth consultations.

Ninety-nine (98 percent) participants provided a 6-month primary outcome data (change in hip pain severity (11-point scale; range 0 to 10, with higher scores indicating worse pain), while 95 (94 percent) had 12-month data.

VLCD plus exercise resulted in 8.5-percent more weight loss than exercise only, but the former was not more effective in terms of change in hip pain severity (mean difference, –0.6 units, 95 percent confidence interval, –1.5 to 0.3) at 6 months.

However, other secondary outcomes were more favourable with VLCD plus exercise at 6 months, except Hip Disability and Osteoarthritis Outcome Score (HOOS) pain and function.

At month 12, VLCD plus exercise improved weight, BMI, HOOS pain and function, and overall hip pain, but not quality of life and physical activity. No serious related adverse events occurred.

“Exercise is recommended to manage hip osteoarthritis, but weight loss recommendations are conflicting,” the investigators said. 

The study was limited by its unblinded participants.