Prevalence and correlates of painful conditions and multimorbidity in national sample of overweight/obese Veterans

Abstract

Abstract-Chronic pain and overweight/obesity are prevalent public health concerns and occur at particularly high rates among Veterans. This study examined the prevalence and correlates of two common painful conditions (back pain and arthritis/ joint pain) among overweight/obese Veterans in Veterans Health Administration (VHA) care. Participants (N = 45,477) completed the MOVE!23, a survey intended to tailor treatment for Veterans in VHA's MOVE! weight-management program. Overall, 72% of the sample reported painful conditions, with 10% reporting back pain, 26% reporting arthritis/joint pain, and 35% reporting both. We used multinomial logistic regression with "no pain" as the reference category to examine the association between painful conditions and participant characteristics. After multivariable adjustment, female Veterans had higher odds of reporting arthritis/joint pain and combined back and arthritis/ joint pain than no pain. Participants with higher body mass index had higher odds of reporting arthritis/joint pain and both back and arthritis/joint pain. The likelihood of painful conditions was higher in Veterans with comorbidities (hypertension, hyperlipidemia, lung disease, depression, anxiety, or posttraumatic stress disorder) and generally increased with the number of comorbidities reported (i.e., 5 or more). Overweight/obese Veterans frequently report painful conditions and, among those with pain, often have multiple comorbidities. These factors may increase the complexity of clinical management and necessitate refinements to weight-management programs.

Weight loss outcomes in patients with pain

“…Moderate or severe pain was reported in over 80% of sample participants, and nearly three‐quarters reported back and/or arthritis pain. Consistent with our findings, other studies have reported very high rates of pain among participants with overweight/obesity [10,12], including a national VHA sample that found similar rates of back and arthritis pain .…”

“…Pain Type was assessed by administering the MOVE!23 Survey, a 23‐item self‐report instrument designed to evaluate domains related to obesity and weight management . Data on its psychometric properties have been reported , including it discriminate validity with regard to pain . Participants are asked: “Please indicate (with a check mark to the left) any of the following that apply to you.” Response items include a list of health conditions, two of which are pain‐related: back pain or spinal disc disease (BACK), and arthritis or joint pain (ARTHRITIS).…”

“…Participants are asked: “Please indicate (with a check mark to the left) any of the following that apply to you.” Response items include a list of health conditions, two of which are pain‐related: back pain or spinal disc disease (BACK), and arthritis or joint pain (ARTHRITIS). Participants who checked neither pain‐related condition were categorized as NEITHER, and those who checked both pain‐related conditions were categorized as BOTH, following a previously validated method .…”

The impact of socio-demographic features on anxiety and depression amongst navy veterans after retirement: a cross-sectional study

“…Additionally, overweightness and obesity were found to be negatively related to mental health but positively related with symptoms of sleep disturbances [22] that may indirectly affect stress levels. Further, these findings are in agreement with other studies on veterans [17,23,24]. In this context, a study concerning the associations of anxiety and depression with BMI conducted among 177047 adults in US revealed that obese and overweight people were significantly more likely to be diagnosed with anxiety during their lifetimes [25].…”

The musculoskeletal diagnosis cohort: examining pain and pain care among veterans

“…[27;32] Perhaps due to public health attention to obesity, research has also emerged with a focus on chronic pain and overweight/obesity. [19] Data from this study encourage attention to anxiety and alcohol use disorders, as well. In contrast to these observations and despite considerable focus on the misuse and abuse of prescription pain medications in the recent past, there was little evidence of a trend in the co-prevalence of drug use disorders among veterans with MSD.…”