Depression in obese patients with primary fibromyalgia: the mediating role of poor sleep and eating disorder features

Abstract

Depression is a prominent feature in fibromyalgia syndrome. Patients with fibromyalgia syndrome who are obese, with poor sleep quality, and those who have recurrent episodes of binge eating are at greater risk to develop depression. The aim of this cross-sectional study was to examine the hypothesis that the relationship between obesity and depression in patients with primary fibromyalgia syndrome is mediated by poor sleep, binge eating disorder (BED), and weight and shape concern. This study included 131 patients with primary fibromyalgia syndrome. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, Eating Disorder questionnaire, and Fibromyalgia Impact Questionnaire. Body mass index (BMI) provided the primary indicator of obesity. Sobel test showed that the conditions for complete mediation were satisfied on the weight and shape concern as mediator between BMI and depression because the association between BMI and depression score became insignificant after controlling of weight and shape concern. However, since the association between BMI and depression remained significant after BED and poor sleep score were controlled, thus for both mediators, the conditions for partial mediation on the depression were satisfied. The findings suggest that in patients with primary fibromyalgia syndrome, weight and shape concern, BED, and poor sleep quality are important mediators of the relationship between obesity and depression. We suggest that a greater focus on these mediators in depression treatment may be indicated.

Fibromyalgia and Obesity

“…17 Several studies of obesity in FM patients, have also found significant associations between depression and BMI. 11,31,43 We confirm these results in our cohort; obese FM patients reported significantly higher PHQ-9 depression scores compared with normal-weight FM patients (13.2 [6.6] vs 10.5 [6], respectively). Like our study, they did not show an increased prevalence of anxiety.…”

“…[8][9][10][11][12][13]43,47 This was surprising because we found a significant correlation between BMI and disability measured by HAQ-DI (r = 0.254; P < 0.0001) in agreement with previous reports, 32 and with data from the general population. 48,49 We did, however, find a strong correlation between HAQ-DI and FIQ physical impairment (r = 0.598, P < 0.001).…”

“…Our normal-weight FM patients had mean FIQ score of 66.7 (SD, 19.6), considered in the severe range for impairment 50 and higher than FIQ scores reported in obese FM patients in other studies, 62.1 (SD, 17.8) to 66.5 (SD, 16.4). 11,43 Our findings also suggest that HAQ-DI may be a more discriminative measure of disability in patients with severe FM and obesity, as it quantifies basic functions such as eating, grooming, reaching, dressing, and rising from a chair, rather than more complex activities such as washing clothes, doing laundry, and preparing meals in the FIQ disability index. 30,51 In addition, while BMI is associated with both upper-and lowerextremity disability, the association is strongest for the lower extremities, better reflecting items in the HAQ-DI.…”

Prevalence of Juvenile Fibromyalgia Syndrome Among Children and Adolescents and its Relationship With Academic Success, Depression and Quality of Life, Çorum Province, Turkey

“…In another study, 44.7% of FMS patients were obese and 36.8% were overweight. 37 These issues need to be investigated in JFMS.…”

The pain profile in fibromyalgia : Painomic studies of pain characteristics and proteins in blood

“…In the general adult population, the prevalence of CWP has been reported to be around 10% [15,16], and for FM the number ranges between 1-4% depending on which ACR criteria used [16][17][18]. Except for presence of widespread pain with allodynia or hyperalgesia, individuals diagnosed with CWP/FM often experience symptoms such as fatigue, sleep disturbance, depression and/or anxiety and stiffness of muscles and joints [19][20][21]. Beyond these symptoms other factors could play a role in this pain condition such as female sex, obesity and increasing age [22,23].…”