Obesity and Joint Disease

Obesity is a risk factor for joint disease, in particular osteoarthritis, at both weight-bearing joints such as the knee, and non-weight bearing joints such as the carpometacarpal joint of the hand. Despite this, how obesity is mechanistically associated with joint disease is unclear. Both metabolic and biomechanical factors are likely to mediate the association between obesity and joint disease, although different joint tissues such as bone and cartilage are likely to differ in their response to adiposity. It may be that biomechanical factors contribute more to joint disease at weight-bearing joints such as the knee, whereas metabolic factors associated with obesity predispose joint changes at relatively non-weight bearing joints, such as those in the hand. This chapter aims to examine the evidence for a role of obesity in joint pathology using osteoarthritis as a disease paradigm.