Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management.

The mechanisms by which obesity affects osteoarthritis (OA) are of great concern to osteoarthritis researchers and clinicians who manage this disease. Inflammation and joint loads are pathways commonly believed to cause or to exacerbate the disease process. This article reviews the physiologic and mechanical consequences of obesity in older adults who have knee OA, the effects of long-term exercise and weight-loss interventions, the most effective nonpharmacologic treatments for obesity, and the usefulness and feasibility of translating these results to clinical practice.