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Obesity and metabolic syndrome represents one of the most important risk factors for both the incidence and progression of OA at weightbearing joints, such as the knee and hip, as well as for the hand. A meta-analysis found that the odds ratio for having OA in obese or overweight individuals compared with normal-weight individuals was 2.96. Evidence is accumulating that prove that dyslipidemia and type 2 diabetes are risk factors for OA independent of obesity. Body weight also influences the severity of the disease, with obese individuals experiencing more severe joint degeneration in the knees and a greater proportion requiring hip or knee joint replacement. Increased weight has been associated with early articular cartilage damage identified by MRI well before symptoms develop, suggesting a causation between obesity and OA, rather than obesity developing as a result of lifestyle changes associated with OA. As a modifiable risk factor, studies have demonstrated the implications of weight loss as an important approach for the management and prevention of OA. The effect of obesity on OA is likely to be multifactorial, possibly due to increased load on the joint, decreased muscle strength, and altered biomechanics. In addition to these physical factors, obesity is characterized by a low-grade inflammatory state, which exerts effects on the joint tissue including cartilage, synovium, and bone