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Masheb RM, Lutes LD, Kim HM, Holleman RG, Goodrich DE, Janney CA, Kirsh S, Higgins DM, Richardson CR, Damschroder LJ. Weight loss outcomes in patients with pain. Obesity (Silver Spring). 2015 Sep 1; 23(9):1778-84.
OBJECTIVE: To determine whether the presence or severity of pain is predictive of suboptimal weight loss outcomes in behavioral weight management programs. METHODS: This is a secondary data analysis comparing weight loss among participants with overweight/obesity who participated in a 12-month randomized controlled trial. Of the 481 participants randomized, 394 (81.9%) had available pain data and were categorized by Pain Type (back pain, arthritis pain, both, or neither) and Pain Severity (no pain, moderate pain, or severe pain). Dietary and physical activity outcomes were also explored. RESULTS: High rates of moderate and severe (80.2%), and back and arthritis (72.6%), pain were observed. Linear mixed models showed significant differences in % weight loss among Pain Severity, but not Pain Type, groups. Patients with severe pain lost significantly less weight (-0.1 kg, 95% CI? = -1.5, -1.2) compared to those with either moderate or no pain (-1.9 kg, 95% CI? = -2.5, -1.3; -2.1 kg, 95% CI? = -3.3, -1.0, respectively). Patients with arthritis pain lost a significant amount of weight despite only minor improvements in walking distance. CONCLUSIONS: Pain severity, but not pain type, is predictive of suboptimal weight loss outcomes.