Obesity Impacts Clinical Features of Fibromyalgia: study

Fibromyalgia is quite a common condition in the general population; however, no consistently effective treatments are yet available owing to a lack of consensus regarding fibromyalgia diagnostic and classification criteria and, especially, regarding fibromyalgia aetiopathogenesis. Available evidence suggests that obesity is common in FMS. Studies report that 32%–50% of FMS patients are obese and, an additional 21–28% are overweight. For further evidence, researchers of Italy conducted a study to identify all available evidence on the relationship between fibromyalgia (FM) and obesity, including epidemiological association, impact of obesity on FM severity and effect of weight-loss strategies on FM symptoms.

It was a comprehensive systematic review and meta-analysis in which researchers searched MedLine, Cochrane Central Register of Controlled Trials and Web of Science databases up to September 2020 to identify eligible articles. After the removal of duplicate records, they reviewed 393 studies and included 41 articles for the analysis. Researchers pooled the data from studies reporting the prevalence of obesity in FM patients using a random-effects model.

Key findings of the study were:

• Upon analysis, the quality assessment revealed that the overall risk of bias was high.

• The researchers found that the overall prevalence of obesity in FM was 35.7%, with higher figures reported for the USA.

• They noted that the majority of studies included demonstrated that obesity is associated with different domains of the disorder, including composite measures of activity, pain severity, tender point count, stiffness, fatigue, physical functioning/disability, sleep, cognitive dysfunction, and quality of life; However, the strength of correlation was weak on average.

• They found inconsistent data regarding the correlation between depression and anxiety.

• They reported that only a few studies addressed the effect of therapeutic weight loss in FM, either by bariatric surgery, diet/exercise combination or behavioural weight loss, providing preliminary evidence for a potential benefit of weight loss in ameliorating FM symptoms.

The authors concluded, "Available data support a potential interplay between obesity and FM-related symptoms. Weight management should be encouraged in patients with FM."

For further information:

https://doi.org/10.1016/j.semarthrit.2021.02.007