Weight Loss in Obesity: An Effect on Pain?
Study participants followed a very low calorie diet (800 kcal/day) using liquid meal replacement for 12 to 16 weeks.
Weight loss may result in improved pain, symptom severity, depression, and fibromyalgia scores in patients with obesity, according to the results of a recent study published in the Journal of Pain.
In this prospective study of 157 participants with obesity enrolled in a Weight Management Program, researchers evaluated the effect of weight loss with a very low calorie diet (800 kcal/day) using liquid meal replacement for 12 to 16 weeks.
Widespread pain was assessed with the American College of Rheumatology survey criteria for fibromyalgia, and the serum levels of inflammatory markers were measured. Changes in weight, pain, and inflammatory markers were assessed after weight loss intervention.
Participants lost a mean 16.05% of their baseline weight after the intervention, and 80% of participants lost ≥10% of their body weight. After weight loss, the mean total American College of Rheumatology score was significantly reduced from baseline by 1 point (P =.004).
Patients were also less likely after weight loss intervention to indicate that they felt pain at any point on a body map (odds ratio, 0.799; P =.022). In particular, pain was reduced from baseline in the lower legs, lower back, chest, and jaw. Similarly, mean symptom severity scores were reduced by 0.63 point (P =.002), and depressive symptoms scores were reduced by 5.62 points (P =.001).
Losing ≥10% of body weight was associated with a larger reduction in the American College of Rheumatology fibromyalgia score (P =.012) and in the depressive symptom score (P =.018). The percentage of body weight loss did not affect symptom severity. After weight loss, the levels of interleukin 10 increased (P =.002), with no significant changes detected for other cytokines.
The study authors concluded that "caloric restriction and weight loss positively affect several symptom domains that commonly affect chronic pain populations. It is therefore plausible that similar interventions could positively affect pain, affect, and somatic symptoms in clinical populations."
Schrepf A, Harte SE, Miller N, Fowler C, Nay C, Williams DA, Clauw DJ, Rothberg A. Improvement in the spatial distribution of pain, somatic symptoms, and depression after a weight loss intervention. J Pain. 2017;18(12):1542-1550