192 obese patients with knee osteoarthritis (OA) who underwent a rigorous 16 week exercise program were randomized to receive dietary support, knee exercise, or no further treatment in order to investigate the effect of therapy on OA disease progression. Patients were monitored over 52 additional weeks using magnetic resonance imaging (MRI). The evidence presented in this study indicated that dietary support, knee exercise, or no further treatment demonstrated similar cartilage loss, synovitis, and effusion over 52 weeks of monitoring. Dietary support patients demonstrated the least amount of weight regain and exhibited higher compliance.