Sixty-six patients with metabolic syndrome-associated osteoarthritis (MSOA) of the hip or knee were randomized to receive either a 16-week multidisciplinary lifestyle program in addition to usual care (n=32) or usual care alone (n=32). The primary outcome was change in the WOMAC total score. Secondary outcomes included WOMAC pain, stiffness, and physical function subscores, PROMIS measures, body weight, fat mass, waist circumference, inflammatory and metabolic markers. Outcomes were assessed at baseline, 8 weeks, and 16 weeks. Overall, the results of the study revealed that the intervention group achieved significantly greater improvements in WOMAC total score, pain, stiffness, and physical function, along with reductions in body weight, fat mass, waist circumference, CRP, HbA1c, fasting glucose, and LDL cholesterol compared with controls. These findings suggest that a multidisciplinary lifestyle program centered on a whole-food plant-based diet can effectively reduce symptoms and improve metabolic health in patients with MSOA.