Body mass index and response to a multidisciplinary treatment of fibromyalgia

Abstract

The purpose of this study is to determine whether there are some differences in the treatment responses to a multidisciplinary fibromyalgia (FM) treatment related with the baseline body mass index (BMI) of the participants. Inclusion criteria consisted of female sex, a diagnosis of FM (American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Baseline BMI was determined, and patients were randomly assigned to one of the two treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were pain intensity, functionality, catastrophizing, psychological distress, health-related quality of life, and sleep disturbances. One hundred thirty patients participated in the study. No statistical significant differences regarding pre-treatment outcomes were found among the different BMI subgroups, and between the two experimental conditions for each BMI category. General linear model analysis showed a significant interaction group treatment × time in pain intensity (p < .01), functionality (p < .0001), catastrophizing (p < .01), psychological distress (p < .0001), sleep index problems (p < .0001), and health-related quality of life (p < .05). No significant interactions were found in BMI × time, and in BMI × group treatment × time. There are not differences among normal weight, overweight and obese patients with FM regarding their response to a multidisciplinary treatment programme for FM which combines pharmacological treatment, education, physical therapy and cognitive behavioural therapy.

Maintenance of quality of life improvement for patients with chronic pain and obesity after interdisciplinary multimodal pain rehabilitation – A study using the Swedish Quality Registry for Pain Rehabilitation

“…There are concerns that the negative health consequences of obesity may restrict the pain rehabilitation process. However, our study supports studies that conclude that patients with different weight status benefit equally from IMMPR (Castel et al., ; Koball et al., ; Sellinger et al., ). The fact that we have used follow‐up IMMPR data and found maintenance effects on HRQoL, clearly indicates that health professionals should offer IMMPR to patients regardless of weight status.…”

“…As the comorbidity of obesity and pain is prevalent (Hitt et al., ; Narouze & Souzdalnitski, ), pain rehabilitation considers weight status. There is some indication that patients benefit from IMMPR irrespective of weight status across BMI classes (Castel et al., ; Koball, Craner, & Sperry, ). However, Koball et al.…”

“…'s study () did not investigate the sustainable improvements at follow‐up and Castel et al. 's study () included only female fibromyalgia patients. Therefore, this study aims to investigate chronic pain patients in real‐world practice settings registered in the SQRP with respect to the following research questions: Is obesity overrepresented in patients referred to specialist pain clinics in Sweden? In comparison to normal weight patients, do patients with obesity report more severe pain? Is obesity an obstacle factor for chronic pain patients to improve HRQoL and maintain improvements after IMMPR? Which factors influence HRQoL maintenance over time? …”

“…As the comorbidity of obesity and pain is prevalent (Hitt et al, 2007;Narouze & Souzdalnitski, 2015), pain rehabilitation considers weight status. There is some indication that patients benefit from IMMPR irrespective of weight status across BMI classes (Castel et al, 2015;Koball, Craner, & Sperry, 2016). However, Koball et al's study (2016) did not investigate the sustainable improvements at follow-up and Castel et al's study (2015) included only female fibromyalgia patients.…”

The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2339 patients

“…A more recent randomized controlled study has suggested that obesity has a negative impact on the efficacy of motivational interviewing (an approach aimed at modifying a number of health risk behaviours) in improving global FM symptom severity and pain [ 38 ]. However, it has also been found that the response to a multidisciplinary FM treatment programme that combines pharmacological treatment, education, physical therapy and cognitive behavioural therapy was not affected by differences in the BMI [ 39 ].…”