Research carried out by Australia-based researchers explored the effectiveness of physiotherapist-delivered diet programs for people with knee osteoarthritis (OA) who are overweight or obese, demonstrating the clinical effectiveness of using a very low energy diet (VLED) supplementary to exercise.

The study included 88 participants with knee OA and a body mass index >27kg/m2 randomly assigned either to the intervention group, who undertook exercise and a VLED including two daily meal replacements, or the control group, who undertook only exercise.

The intervention involved three phases led by a physiotherapist: intensive weight loss via VLED, substituting two meals per day with meal-replacement products and one with a low carbohydrate meal; then transitioning off VLED onto a healthy eating plan, with low GI and low carbohydrates; and finally, adopting a healthy eating plan for weight maintenance.

The intervention group lost a mean of 8.1 per cent of their total body weight, compared to one per cent in the control group.

In the intervention group, 76 per cent of participants lost ≥5 per cent of their body weight and 37 per cent lost ≥10 per cent, compared to 12 per cent and zero per cent in the control group.

While there was a statistically significant reduction in BMI and waist circumference in the intervention group compared to the control group, there were no between- group differences for waist-to-hip ratio, pain, function, quality of life, physical activity, weight self-stigma or physical performance measures.

The researchers stated that the primary outcome of the study provides evidence that physiotherapists can be upskilled to deliver a VLED intervention for people with knee OA who are overweight or obese.

The researchers believe that future studies could compare a physiotherapist-delivered VLED to a dietitian-delivered or self- managed VLED focused on weight-loss outcomes, as well as dietitians upskilling to deliver exercise alongside a VLED.

Access the research paper here.