Weight control in older adults with knee osteoarthritis: a qualitative study

Abstract

Background: Knee osteoarthritis (OA) affects mostly older adults and its primary risk factor is obesity. This study sought to understand weight-control strategies, facilitators of and barriers toward weight control in older adults with knee OA who preferred not to undergo physician-recommended total knee arthroplasty. Methods: For this qualitative descriptive study, older outpatients (N = 118) were recruited from orthopedic clinics at three hospitals. Data were collected through face-to face, individual in-depth interviews using a semi-structured interview guide and analyzed using content analysis. Results: Among participants, only 25.4% had body weight in the normal range and 55.9% reported having controlled their weight. Their most common weight-control strategies were to control diet and to exercise and control diet together. Weight control was facilitated by desiring good health, wanting to improve walking or movement, perceiving that they had gained weight, wanting to look good, and advice from healthcare providers. Common barriers to participants' weight control were perceiving that dietary control was not needed, controlling appetite was difficult, dietary control was difficult, and not eating was physically uncomfortable. Conclusions: Our findings help healthcare providers understand how older adults with knee OA perceive weight control and serve as a reference for developing weight-control programs. Health care providers can integrate these identified facilitators and barriers into a weight-control intervention program. The importance of weighing oneself every day, the meaning of body mass index, consulting with a dietician regularly to control weight, and providing appropriate knowledge about aging and weight control should also be included in any weight-control intervention program.

Outcomes addressed in randomized controlled lifestyle intervention trials in community‐dwelling older people with (sarcopenic) obesity—An evidence map

“…Pain and sleep are also determinants of quality of life, and both are associated with obesity and aging. In addition, pain is a barrier to performing everyday activities and losing body weight 107,110 . The number of medications taken is high in older people with obesity 111 .…”

“…In addition, pain is a barrier to performing everyday activities and losing body weight. 107,110 The number of medications taken is high in older people with obesity. 111 In diabetic adults with overweight and obesity, it has been shown that body weight loss is associated with a reduction in antidiabetic and antihypertensive drugs.…”

“It's the single best thing I've done in the last 10 years”: a qualitative study exploring patient and dietitian experiences with, and perceptions of, a multi-component dietary weight loss program for knee osteoarthritis

“…Despite their effectiveness, ketogenic VLCDs are underutilised 25e27 , and, to our knowledge, no previous studies have investigated their effectiveness in people with OA or other chronic musculoskeletal conditions. Such an intensive and restrictive diet may be perceived as onerous and difficult, particularly given that people with OA believe controlling appetite and diet is difficult and uncomfortable 28 and that exercise is more important than dietary change for weight management 14 . No previous studies have explored the perceived acceptability of an intensive dietary weight loss program amongst people with OA or dietitians.…”

A qualitative study to understand patients’ experiences of their post-operative outcomes following forefoot surgery

“…27 In terms of weight concern, it may be important to educate patients about healthy eating. 28 Patients undergoing an orthopaedic surgical procedure are often day cases, placing extensive responsibility to recover at home. Patients have expressed that better information about pain management would be helpful and should be delivered at multiple time points.…”