Fibromyalgia and Weight Gain

by Karen Lee Richards Patient Advocate

A particularly frustrating problem for many fibromyalgia patients is the tendency to gain weight. We eat less but notice little, if any, difference. And it's difficult to exercise more because of the pain. According to Mark Pellegrino, MD, in his book Fibromyalgia: Up Close and Personal, it's not unusual for someone to gain 25 - 30 pounds the first year after developing fibromyalgia.

The Link Between FM and Weight Gain

Why does fibromyalgia trigger weight gain in so many people? There are a number of contributing factors:

  • Lack of Sleep. One of the primary symptoms of FM is the inability to get the deep, stage 4 restorative sleep we need. Recent studies have shown that people who do not get adequate amounts of sleep are more likely to gain weight. Lack of sleep causes a reduction metabolism and an increase in appetite, particularly a craving for high-carb and high-sugar foods.

  • Neuroendocrine Abnormalities. Research has revealed several hormone deficiencies 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, causing the body to go into a fat-storing mode.

  • Decreased Activity. Because of their level of pain, most FM patients are not able to increase their exercise to the levels needed to increase metabolism rates and burn the calories required for significant weight loss.

  • Medication. A number of medications commonly given to treat the symptoms of FM -- particularly antidepressants -- have the side effect of weight gain.

Weight-loss Strategies

Since our pain makes it difficult for us to increase our exercise enough to burn more calories and our slow metabolism means eating less doesn't usually help much, what can we do to lose weight? Dr. Pellegrino has developed a food plan designed to improve our metabolism and calorie-burning abilities by providing us with the right "quality" of food. He recommends:

  • Eat a High-protein, Low-carbohydrate Diet. Focus on good proteins like lean meats, eggs, dairy products, tofu, soy meat substitutes and legumes. Limit carbohydrate intake to vegetables and fresh fruits. Include good fats, such as plant oils, fish oils, almonds and avocados. If you need a sweetener, use a natural sweetener like Stevia or Xylitol. Avoid sugar and other sweets, breads and pastas, rice, potatoes, partially hydrogenated oils, carbonated drinks, and alcohol except in moderation.

  • Eat Proteins First. Never eat carbohydrates -- even good carbs -- by themselves. Always eat a protein first. When you eat a protein first, the protein digestive enzymes are activated, which then slows the absorption of carbohydrates.

  • Eat Until You're Full. At meals, eat until you're full, but not stuffed. Eat slowly, chewing your food well. You should eat five or six times a day. It can be three regular meals and two small snacks, three small meals and two larger snacks, or five small meals. Experiment and see what works best for you. If you have irritable bowel syndrome, you may find that you do better eating small portions more frequently.

  • Give Yourself a Break. Follow this diet strictly Monday through Friday, then allow yourself to splurge a little on the weekends. Knowing you can indulge a little on weekends should make it easier to stick to the diet through the week.

Check With Your Doctor

Before starting any new diet or exercise program, it is always a good idea to check with your doctor. You might also want to talk with your doctor about testing you for things like thyroid, yeast or fungal overgrowth (Candida), hypoglycemia, and hormone deficiencies, since these things can also contribute to weight gain.

Pellegrino, M (2005). Fibromyalgia: Up Close & Personal. Anadem Publishing.
Kase, L (2007, October). Magic Power of Sleep. Reader's Digest, 110-115.

© Karen Lee Richards, 2008
Last updated: 9/30/08

Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.