Fibromyalgia and Obesity: Is There a Link?
A new study in The Journal of Pain reports there is close association between obesity and disability in fibromyalgia patients.
Past research suggested that obesity is a common comorbidity and may be related to the severity of FM. The purpose of this study, conducted by University of Utah researchers, was to evaluate the relationship between FM and obesity in four specific FM-related domains: hyperalgesia, symptoms, physical abilities and sleep.
Study Design and Results
A total of 215 FM patients took part in the study – 47% were obese and an additional 30% were overweight. Participants completed a set of self-reported inventories to assess FM-related symptoms. They also underwent a tender point examination, physical performance testing, and a 7-day home sleep assessment.
The results showed a significant relationship between obesity and...
- greater pain sensitivity to tender-point palpation, particularly in the lower body areas.
- reduced physical strength and impaired flexibility in the lower-body.
- shorter sleep duration.
- greater restlessness during sleep.
The researchers concluded that obesity is a prevalent comorbidity of fibromyalgia and may contribute to its severity. They added that weight management may need to be part of FM treatment.
I can't say I'm surprised by the findings of this study. It just makes sense that extra weight would exacerbate the symptoms of FM. Our bodies are already painful, exhausted and hypersensitive. Carrying extra weight could only add to those problems.
What I would like to know is why obesity is so often a comorbidity of fibromyalgia. The logical answer would seem to be that the pain and fatigue leads to a decrease in physical activity and exercise. But in my experience and observation, the weight gain seems to be out of proportion to the decrease in activity.
Personally, I did not have a weight problem prior to FM. But almost immediately upon developing the first symptoms of FM, my weight began to increase rapidly – faster than could be explained by just a decrease in my activity level. And no matter little I ate or how many calories I cut, I could not lose a pound.
Based on my own experience and that of other FM patients who have related similar experiences, I have long thought there must be something about fibromyalgia that causes a change in our metabolism. Apparently I was right.
According to FM expert (and FM patient) Dr. Mark Pellegrino, research has revealed several hormone deficiencies or imbalances in fibromyalgia – such as serotonin, growth hormone, cortisol and thyroid – which can contribute to decreasing the body’s metabolism. There may also be an increased sensitivity to insulin, which would cause the body to go into a fat-storing mode.
The authors of this study suggest that weight management should be a part of FM treatment, but they don't say exactly how this weight management (or more accurately, weight loss) can be accomplished. If hormone deficiencies or imbalances are causing a metabolism slow down, wouldn't replacing those hormones be a prerequisite for a successful weight-loss program?
This study demonstrates the effects of obesity on FM. What I'd like to see now are more studies looking into the cause of the obesity and effective treatment options to combat it.
Okifuji A, et al. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep. J Pain. 2010 Dec;11(12):1329-37.
Pellegrino, M (2005). Fibromyalgia: Up Close & Personal. Anadem Publishing. See excerpt: Why Weight Gain is a Problem With Fibro and What to Do About It.