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Weight Loss in OA — SCE Rheumatology MCQ

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EasyOsteoarthritisWeight Loss in OASCE Rheumatology

A 70-year-old woman with symptomatic knee osteoarthritis and a BMI of 34 kg/m² asks how much weight she should aim to lose to improve her symptoms. Which statement best reflects current NICE advice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Any loss is beneficial, but a 10% loss is likely to help more than 5%.

Explanation lettering: E = shown as A · D = shown as C · A = shown as D · C = shown as E

NICE recommends advising people with osteoarthritis who are living with overweight or obesity that weight loss improves physical function, reduces pain and improves quality of life. Any amount of weight loss is likely to be beneficial, but losing about 10% of baseline body weight is likely to provide greater benefit than losing 5%; therefore D is correct. Ten per cent should not be presented as a mandatory threshold below which no benefit occurs. Options A and E incorrectly deny benefit from smaller, achievable losses. Options B and C contradict the observed dose-response relationship: a 5% loss may help, but greater weight loss generally produces greater improvement. Weight loss does not need to be achieved surgically.

Reference: National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management (NG226), recommendation 1.3.5, 2022. https://www.nice.org.uk/guidance/ng226/chapter/recommendations