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Improvement in the Spatial Distribution of Pain, Somatic Symptoms, and Depression After a Weight Loss Intervention

Published:August 25, 2017DOI:https://doi.org/10.1016/j.jpain.2017.08.004

      Highlights

      • Obese patients with pain underwent a calorie-restriction weight loss intervention.
      • The spatial distribution of pain, fatigue, and depressive symptoms improved.
      • Improvement was greatest in those losing 10% or more of their body weight.
      • The anti-inflammatory cytokine interleukin-10 increased after weight loss.

      Abstract

      Weight loss is known to improve pain localized to weight-bearing joints but it is not known how weight loss affects the spatial distribution of pain and associated somatic symptoms like fatigue. We sought to determine if weight loss using a low-calorie diet improves pain, affect, and somatic symptoms commonly associated with chronic pain conditions in an observational study. We also documented changes in inflammatory markers in serum before and after weight loss. Participants were 123 obese individuals undergoing a 12- to 16-week calorie restriction weight loss intervention. The spatial distribution of pain, symptom severity (eg, fatigue, sleep difficulties), depression, and total fibromyalgia scale scores were measured before and after weight loss. Pain (P = . 022), symptom severity (P = .004), depression (P < .001), and fibromyalgia scores (P = .004) improved after weight loss; men showed greater improvement than women on somatic symptoms and fibromyalgia scores (both P < .01). Those who lost at least 10% of body weight showed greater improvement than those who lost <10%. Levels of the regulatory cytokine interleukin-10 increased after the intervention (P = .002). Weight loss may improve diffuse pain and comorbid symptoms commonly seen in chronic pain participants.

      Perspective

      This article presents the effect of a weight loss intervention on characteristics of chronic pain, including the spatial distribution of pain and comorbid somatic symptoms. Weight loss appeared to produce larger improvements in somatic symptoms for men.

      Key words

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