Obesity | Chronic Pain

Saturday, May 09, 2009 

This study evaluated obesity as a marker for increased pain severity, disability, and psychologic distress in treatment-seeking, mixed chronicpain patients.  Three hundred seventy-two consecutive chronicpain patients seeking evaluation at a university pain clinic were divided into 3 weight categories, based on body mass index (BMI):

• normal (BMI < 25 kg/m2)
• overweight (BMI between 25 kg/m and 30 kg/m2)
• obese (BMI > or = 30 kg/m2).

 Patients completed questionnaires to identify

• painseverity
• disability
• depression
• anxiety
• quality of life.

 The findings showed: 

• Painseverity and days per week with pain were similar among the weight groups.
• Disability was related to increasing weight status, with increased BMI associated with more days per week with both reduced activity and complete disability.
• Depressive symptoms were also related to weight category, with an average Beck Depression Inventory score of 11.81 +/- 7.55 in normal, 12.88 +/- 11.64 in overweight, and 15.78 +/- 9.88 in obese patients.
• Anxiety scores were similar among the weight categories.
• Physical function domain of quality of life was also reduced in relation to weight.

 It was concluded that: 

• Weight is associated with co-morbid disability, depression, and reduced quality of life for physical function in chronicpain patients.
• Calculation of the BMI should become a routine part of the screening evaluation for chronicpain patients, with additional screening for disability and psychologic distress in patients with elevated BMIs.

(Marcus DA: Obesity and the impact of chronic pain. Clinical Journal of Pain. 20(3):186-91, 2004).

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