ObjectiveOur aim was to define the association of weight change (weight loss or weight gain) with the incidence and progression of hand osteoarthritis (OA), assessed either by radiography or by pain, using data from the Osteoarthritis Initiative.MethodsAmong the 4,796 participants, we selected 4,598 subjects, excluding those with cancer or rheumatoid arthritis, or a Body Mass Index under 18.5 kg/m². We investigated the association of weight change with incidence and progression of radiographic hand OA and the development and resolution of hand pain. Utilizing multivariable logistic regression, we investigated the association of weight change from baseline to the 4‐year follow‐up with the incidence and progression of radiographic hand OA at the 4‐year follow‐up. Additionally, multivariable repeated‐measure mixed‐effects logistic regression analyzed the association of weight change with the development and resolution of hand pain across 2‐year, 4‐year, 6‐year, and 8‐year follow‐ups.ResultsNo statistically significant associations were observed between weight change and the investigated outcomes. Specifically, for each 5% weight loss, the odds ratios for the incidence and progression of radiographic hand OA were 0.90 (95%CI: 0.67‐1.23) and 0.92 (95%CI: 0.84‐1.00), respectively. Similarly, for each 5% weight loss, the odds ratios for the development and resolution of hand pain at the 8‐year follow‐up were 1.00 (95%CI: 0.92‐1.09) and 1.07 (95%CI: 0.91‐1.25), respectively.ConclusionOur study found no evidence of an association between weight change and the odds of incidence or progression of radiographic hand OA over 4 years, nor the development or resolution of hand pain over 8 years.This article is protected by copyright. All rights reserved.