Weight loss as Symptomatic Treatment for Knee Osteoarthritis

A research study conducted by Henning Biddal et al at the Parker Institute, Denmark whose results were published in the Annals of Rheumatic Diseases has shown that weight loss program was successful in lessening the pain in patients with Osteoarthritis.

The study was a 1-year randomized controlled trial conducted to evaluate 1-year symptomatic improvement in obese patients with knee osteoarthritis (OA) on an intensive low-energy diet (LED) maintained by frequent consultations with a dietician compared to minimal attention. The LED programme consisted of group therapy with dietary consultations and two periods of a low-calorie diet of 810 kcal/day during weeks 0–8 and weeks 32–36. The control group only received dietary instruction and attention for 2 h at baseline, and at weeks 8, 32, 36 and 52. Primary end point (total Western Ontario and McMaster Universities (WOMAC) index) was assessed as the mean group difference during and after 1 year. After 1 year, mean weight loss in the LED group was –10.9 kg (11%) versus –3.6 kg (4%) in the control group. There was no difference between the groups in total WOMAC index (p=0.11), although both groups improved. However, the LED intervention resulted in less WOMAC pain (7.7 mm), with a group mean difference of 7.2 mm. After one year 14 (32.8%) responded to LED versus 7 (15.6%) to control, with an absolute benefit of 16.3%. Continuous reinforcement of a weight loss programme can be successful over a year in obese knee OA patients. Weight loss was statistically reflected only by a reduction in pain.

Ref: Ann Rheum Dis 2011;70:1798-1803 doi:10.1136/ard.2010.142018

Bombay Hospital successfully completes surgery on patient weighing 198 kg

Bombay Hospital's bariatric surgery department has successfully treated a 32-year-old women with asthmatic attack by making her lose around 10 kg. The patient who weighed around 200 kg was brought to a stable state and made to lose around 10 kg - a precondition to operate upon her under general anaesthesia.

Since the patient weighed around 200 kg, she may not have survived another similar asthmatic attack. After repeated discussions within the bariatric (weight loss) team and her family, it was decided that the best opportunity lies in a definite procedure to get her weight down.

This patient underwent Sleeve Gastrectomy surgery in which two-thirds of the stomach is removed resulting in a banana shaped stomach. This reduces hunger and gives a feeling of fullness with small meals. This surgery is expected to bring her weight down by around 100 kg within a year.

Dr Ramen Goel, Bariatric and Weight Loss surgeon at Bombay Hospital said, “This patient was a challenge not only because she survived a life threatening episode and surgery, but also because she is mentally challenged. This has tested the effort of Bombay Hospital’s robust and proven infrastructure and team of doctors and she will continue to require our and the family’s support for long term results.”

He further added, “The safety of surgery lies in patient preparation, adequate infrastructure and experience of the entire team. Fortunately at Bombay Hospital, we have the country’s most experienced physicians, anaesthetists, dieticians, physiotherapists and other reputed doctors.”

Bombay Hospital is the first major hospital in Mumbai to start a dedicated bariatric (treatment of obesity) surgery department over nine years back under one of the most experienced bariatric surgeon. The expert multi–specialty bariatric team has been able to successfully prepare and operate many other similar patients in the past too.