Many persons with osteoarthritis (OA) are overweight or obese, a factor known to increase pain and disability. Past work suggests that two psychosocial treatments may be beneficial for patients with OA: lifestyle behavioral weight management and pain coping skills training. We are currently conducting the first randomized clinical trial testing the separate and combined effects of these interventions in a sample of osteoarthritis patients who are overweight or obese/overweight (BMI >25<42). By the end of the current funding period we will have completed the treatment phase of this study. In this renewal application we seek funding for two studies focused on maintenance of treatment gains in this study sample. Study 1 seeks to complete 6- and 12-months follow-up data collection of patients in this study. Data analyses will examine the effects of treatment on long-term follow-up and will examine potential predictors of long-term improvements in pain, physical disability, psychological disability, joint stiffness, activity, gait, and markers of systematic inflammation. Study 2 seeks to collect data on novel patient characteristics (responsiveness of pain and distress to food intake, genetic markers of pain sensitivity) that may predict maintenance of treatment gains in this sample of overweight/obese OA patients. Our clinical observations and data from animal and human models suggest that food intake may provide acute relief from pain and distress. Although increasing food intake may provide acute relief, it likely contributes to detrimental long-term effects such as weight gain, increased pain, inflammation and disability. Study 2 will employ a case-control within subjects design patients who had participated in Study 1. This design compares levels of pain and distress that occur after eating and after control periods of the day. Participants will record their food intake and also be prompted throughout the day by programmed auditory signals to make pain and distress entries in structured diary booklets. Study 2 has two goals: 1) to examine whether food intake is related to decreases in pain and distress, and 2) to determine whether the strength of this relationship predicts pain, BMI, and other OA-related outcomes six months later. In Study 2 blood samples also will be collected and stored for later genetic analysis that will enable us to examine how markers of pain sensitivity relate to short- and long-term treatment outcomes.
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