Ultrasound of the Knee in Obese Patients With Knee Osteoarthritis; Weight Loss

Inclusion Criteria: * Informed consent obtained * Clinical diagnosis of knee OA (American College of Rheumatology (ACR) criteria) confirmed by radiology but restricted to definite radiographic OA at early to moderate-stages (Kellgren-Lawrence grades 1, 2, or 3) * Age ≥ 18 years and \< 75 years * Body mass index (BMI) ≥ 27 kg/m2 * Stable body weight during the previous 3 months (\< 5 kg self-reported weight change) * Motivated for weight loss Exclusion Criteria: * On-going participation, or participation within the last 3 months, in an organised weight loss programme (or within the last 3 months) * Current or history of treatment with medications that may cause significant weight gain for at least 3 months before this trial * Current use or use within three months before this trial of GLP-1 receptor agonist, pramlintide, sibutramine, orlistat, zonisamide, topiramate, or phentermine * Type 1 diabetes * Type 2 diabetes treated with glucose-lowering drugs other than metformin * Alloplasty in target knee joint (see section 6.3) * End stage disease in target knee joint (Kellgren-Lawrence grade 4) * Immuno-inflammatory disease * Chronic wide-spread pain * Pregnancy or insufficient anti-conception therapy for female fertile patients * Breast-feeding * Estimated glomerular filtration rate (eGFR) \< 60 ml/min/1.73 m2 * Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \> 3 x above upper normal range (UNR) * Surgery scheduled for the trial duration period, except for minor surgical procedures * Surgical procedures such as arthroscopy or injections into a knee within 3 months prior to enrolment * Previous surgical treatment for obesity (excluding liposuction \>1 year before trial entry) * Thyroid stimulating hormone (TSH) outside of the range of 0.4-6.0 mIU/L * Obesity secondary to endocrinologic or eating disorders or to treatment with medicinal products that may cause weight gain * Family or personal history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 * Inflammatory bowel disease * Congestive heart failure, New York Heart Association (NYHA) class III-IV * Diabetic gastroparesis * History of or current diagnosis of pancreatitis (acute and/or chronic) or pancreatic cancer * History of cancer with the exception of in-situ malignancies of the skin or cervix uteri * History of major depressive disorder, a PHQ-9 (Patient Health Questionnaire-9) score of more than 15, or a history of other severe psychiatric disorders or diagnosis of an eating disorder * Subjects with a lifetime history of a suicide attempt or history of any suicidal behaviour within the past month before entry into the trial * Inability to speak Danish fluently * A mental state impeding compliance with the program * Use of opioids or similar strong analgesics * Allergic reactions to the active ingredients of Saxenda, such as hypotension, palpitations, dyspnoea and oedema