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Obesity and Musculoskeletal Conditions
Osteoarthritis
➤ Weight management, physical activity, and use of assistive
devices are first-line interventions for reducing pain and
improving physical function.
➤ In individuals with obesity or overweight, weight loss of 10% can
lead to a significant reduction in pain.
➤ If nonpharmacologic measures do not control symptoms, then
first-line therapy is nonsteroidal anti-inflammatory medications
(topical or oral) at the lowest effective dose to control symptoms.
➤ If medical management is not effective, consider referring to
orthopedic surgery for total joint arthroplasty in advanced knee
and hip osteoarthritis.
Gout
➤ Recommend limiting intake of alcohol, high-purine foods,
animal proteins, high-fructose corn syrup, and sugar-sweetened
beverages.
➤ Recommend weight loss for individuals with gout and obesity or
overweight.
➤ Consider urate-lowering pharmacologic therapy for individuals
with gout and subcutaneous tophi, radiographic changes due to
gout, or two or more gout flares per year, advanced chronic kidney
disease, a serum urate concentration greater than 9 mg/dL, or a
history of urolithiasis.
➤ Allopurinol is the preferred medication to reduce urate levels.
