Chronic pain and weight regain in a lifestyle modification trial

Objective Obesity and chronic pain often co‐occur and exert bidirectional influences on one another. How patients with obesity and chronic pain respond to weight loss treatments, however, remains unclear. This study evaluated body weight, physical activity, and diet outcomes in participants with and...

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Bibliographic Details
Published in:Obesity science & practice 2021-04, Vol.7 (2), p.192-198
Main Authors: Goessl, Cody L., Befort, Christie A., Pathak, Ram D., Ellerbeck, Edward F., VanWormer, Jeffrey J.
Format: Article
Language:English
Subjects:
Back pain
Body mass index
Body weight
Body weight loss
Chronic pain
Clinics
Codes
Cohort analysis
dietary assessment
Electronic health records
Enrollments
Gastrointestinal surgery
Lifestyles
Medical records
Metabolism
Narcotics
Obesity
Original
Patients
Physical activity
Weight control
weight loss
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Summary:Objective Obesity and chronic pain often co‐occur and exert bidirectional influences on one another. How patients with obesity and chronic pain respond to weight loss treatments, however, remains unclear. This study evaluated body weight, physical activity, and diet outcomes in participants with and without chronic pain in a 2‐year behavioral weight loss trial. Methods An analytical cohort of 397 adults was assembled from a Midwestern healthcare system that participated in the larger trial. Participants with chronic pain 1 year prior to, or during, the trial were identified using a validated medical records algorithm. Mixed models were used to estimate changes in outcomes over 24 months. Results One‐third of participants (n = 130) had chronic pain. After adjustment for age, sex, body mass index, and trial arm, weight loss was similar in both groups at 6‐months (−7.0 ± 0.8 kg with chronic pain vs. −7.7 ± 0.6 kg without). Participants with chronic pain had significantly less weight loss at 24‐months relative to those without (−3.6 ± 0.5 vs. −5.2 ± 0.4 kg; p = 0.007). Physical activity, screen time, dietary fat, fruit/vegetable consumption, and sugar‐sweetened beverage intake improved similarly in both groups over time. Conclusions Participants with chronic pain lost ∼33% less weight over 2 years, which was driven by greater weight regain after the first 6 months. Future research should test tailored weight loss maintenance strategies for individuals with chronic pain.
ISSN:2055-2238
2055-2238
DOI:10.1002/osp4.471