"Please lose some weight."
This is a common phrase heard when visiting a hospital for knee pain. As weight increases, the burden on the knee joints naturally increases.
There is a possibility that the improvement in knee condition cannot be explained solely by weight loss. This is because research has shown that semaglutide, used in the treatment of diabetes and obesity, may affect the metabolism of joint tissues independently of weight changes.
Semaglutide is a GLP-1 (glucagon-like peptide-1) receptor agonist that promotes insulin secretion and suppresses appetite. It is the key ingredient in the diabetes treatment Ozempic and the obesity treatment Wegovy. GLP-1 receptors are proteins that detect specific signals and trigger cellular responses.
Similar Weight, Different Joint Outcomes
A research team led by Hong Yi Qin from the Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, conducted experiments using mice with obesity and osteoarthritis (a joint disease characterized by cartilage wear, pain, and inflammation).
The researchers designed the experiment to determine whether joint changes were due to weight loss or the drug's inherent effects. The experimental mice were divided into a group that received semaglutide and a group that only restricted calorie intake.
Analysis of the cartilage tissue revealed approximately 8,300 changes in protein expression. Protein expression indicates how much of a specific protein is produced within a cell. The researchers explained that this result provides molecular-level evidence that semaglutide affects the overall metabolic system of cartilage cells.
Both groups lost a similar amount of weight. However, joint changes were only observed in the group that received semaglutide. The group that only reduced calories showed almost no changes in joint condition. This suggests that it is difficult to attribute the improvement in knee condition solely to weight loss.
The results of this study were published on March 3, 2026, in the international journal 《Cell Metabolism》 under the title "Semaglutide ameliorates osteoarthritis progression through a weight loss-independent metabolic restoration mechanism."
Clue to Energy Metabolism Changes in Cartilage Cells
The study also observed changes in the GLP-1R-AMPK-PFKFB3 signaling pathway related to cellular energy metabolism (a molecular signaling system that regulates how cells produce and use energy). This indicates that the way cartilage cells produce energy has changed.
The research team explained that semaglutide could help maintain cartilage cell function even in damaged environments by activating the energy regulation mechanisms within the cells.
It was also found that GLP-1 receptors exist in cartilage cells. The researchers interpreted that semaglutide may influence the metabolic state of cartilage cells through these receptors.
Changes Observed in Preliminary Clinical Trials on Humans
The research team also conducted exploratory clinical trials involving 20 patients with obesity and knee osteoarthritis.
In the group treated with semaglutide, MRI scans showed that the thickness of the inner cartilage of the knee increased by an average of about 17% after 24 weeks.
However, the researchers noted that the small scale of the study requires caution in interpreting the results, and additional clinical research is needed to confirm the actual therapeutic effects.
Osteoarthritis May Not Be Just a Wear and Tear Disease
Osteoarthritis has long been described as a disease where joint cartilage wears down due to repetitive use, thus causing pain and inflammation, essentially a 'wear and tear disease.'
Recent studies have introduced the concept of 'metabolic osteoarthritis,' suggesting that obesity, inflammation, and metabolic abnormalities can affect joint damage.
This study is noteworthy as it shows the possibility that osteoarthritis may be related not only to simple mechanical wear but also to changes in cellular metabolism.
Research Stage for Treatment Possibilities
It is estimated that there are about 500 million osteoarthritis patients worldwide. There are currently no approved drugs to reverse cartilage damage.
Recently, GLP-1 class drugs are being researched beyond diabetes and obesity treatment, extending into various disease areas such as cardiovascular diseases and fatty liver. This study suggests that these drugs may also have positive effects on musculoskeletal diseases.
Of course, whether semaglutide can be used as a treatment for osteoarthritis will need to be confirmed through large-scale clinical studies in the future.
Joint health may ultimately be connected to the body's metabolic state.
[Knee Pain and Ozempic Related Q&A]
Q1. Does this study mean that 'weight loss is not necessary even if the knees hurt'?
A1. No, it does not. It is a clear fact that increased weight increases the load on the knee joints. Weight loss is still important for managing osteoarthritis. This study suggests the possibility that joint changes may not be solely explained by weight loss. It implies that managing metabolic health and inflammation status alongside weight management is important.
Q2. Can Ozempic or Wegovy be used for knee treatment purposes?
A2. Not at this time. Semaglutide is an approved drug for the treatment of diabetes and obesity, but it is not approved for osteoarthritis treatment. This study is only an early-stage investigation showing the possibility that the drug may affect the metabolism of joint tissues. Large-scale clinical trials will be necessary to confirm actual therapeutic effects.
Q3. What should I do first for knee joint health?
A3. Experts recommend weight management and exercises to strengthen thigh muscles as basic responses. Thigh muscles help reduce the burden on the knee joints. There is increasing research suggesting that managing metabolic health, such as blood sugar control and inflammation regulation, may also be related to joint health. If knee pain persists, it is advisable to consult an orthopedic specialist to identify the cause and develop a treatment and exercise plan.
