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Musculoskeletal disorders are a leading cause of disability worldwide. 22 Hip and knee osteoarthritis (OA) and spinal pain (low back and neck pain) together have accounted for 75% of years lived with disability from musculoskeletal disorders in 2016. 22 Spinal pain has accounted for more disability than any other condition globally, totaling 86.5 million years lived with disability. 22 Hip and knee OA have accounted for over 16 million years lived with disability, and have been the 12th leading cause of disability. 22 Up to 45% of the burden from OA and spinal pain has been attributed to overweight or obesity. 8 People with OA who are overweight or obese have 3 times increased odds of worsening knee OA. 44 People who are overweight or obese and have spinal pain have up to 1.4 times increased odds of persistent back pain 52 compared to those of normal weight. There is low-quality evidence that reducing body weight by 5% is associated with meaningful improvements in pain and disability in people who are overweight and have OA. 13 Weight loss is widely recommended as a treatment approach to improve pain and disability in people with OA and spinal pain who are overweight or obese. 29,40,47 There are many weight-loss approaches for people who are overweight (including behavioral interventions targeting diet and/or physical activity and surgical and pharmaceutical interventions).U OBJECTIVE: To assess the effectiveness of weight-loss interventions on pain and disability in people with knee and hip osteoarthritis (OA) and spinal pain.

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