Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a mixed methods systematic review

Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a... Worldwide prevalence of adult overweight and obesity is a growing public health issue. Adults with overweight/obesity often have chronic musculoskeletal pain. Using a mixed‐methods review, we aimed to quantify the effectiveness and explore the appropriateness of weight loss interventions for this population. Electronic databases were searched for studies published between 01/01/90 and 01/07/16. The review included 14 randomized controlled trials that reported weight and pain outcomes and three qualitative studies that explored perceptions of adults with co‐existing overweight/obesity and chronic musculoskeletal pain. The random‐effects pooled mean weight loss was 4.9 kg (95%CI:2.9,6.8) greater for intervention vs control. The pooled mean reduction in pain was 7.3/100 units (95%CI:4.1,10.5) greater for intervention vs control. Study heterogeneity was substantial for weight loss (I2 = 95%, tau = ±3.5 kg) and pain change (I2 = 67%, tau = ±4.1%). Meta‐regression slopes for the predictors of study quality, mean age and baseline mean weight on mean study weight reduction were shallow and not statistically significant (P > 0.05). The meta‐regression slope between mean pain reduction and mean weight lost was shallow, and not statistically significant, −0.09 kg per unit pain score change (95%CI:−0.21,0.40, P = 0.54). Meta‐synthesis of qualitative findings resulted in two synthesized findings; the importance of healthcare professionals understanding the effects of pain on ability to control weight and developing management/education programmes that address comorbidity. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Obesity Reviews Wiley

Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a mixed methods systematic review

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Publisher
Wiley
Copyright
© 2018 World Obesity Federation
ISSN
1467-7881
eISSN
1467-789X
D.O.I.
10.1111/obr.12686
Publisher site
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Abstract

Worldwide prevalence of adult overweight and obesity is a growing public health issue. Adults with overweight/obesity often have chronic musculoskeletal pain. Using a mixed‐methods review, we aimed to quantify the effectiveness and explore the appropriateness of weight loss interventions for this population. Electronic databases were searched for studies published between 01/01/90 and 01/07/16. The review included 14 randomized controlled trials that reported weight and pain outcomes and three qualitative studies that explored perceptions of adults with co‐existing overweight/obesity and chronic musculoskeletal pain. The random‐effects pooled mean weight loss was 4.9 kg (95%CI:2.9,6.8) greater for intervention vs control. The pooled mean reduction in pain was 7.3/100 units (95%CI:4.1,10.5) greater for intervention vs control. Study heterogeneity was substantial for weight loss (I2 = 95%, tau = ±3.5 kg) and pain change (I2 = 67%, tau = ±4.1%). Meta‐regression slopes for the predictors of study quality, mean age and baseline mean weight on mean study weight reduction were shallow and not statistically significant (P > 0.05). The meta‐regression slope between mean pain reduction and mean weight lost was shallow, and not statistically significant, −0.09 kg per unit pain score change (95%CI:−0.21,0.40, P = 0.54). Meta‐synthesis of qualitative findings resulted in two synthesized findings; the importance of healthcare professionals understanding the effects of pain on ability to control weight and developing management/education programmes that address comorbidity.

Journal

Obesity Reviews – Wiley

Published: Jan 1, 2018

Keywords: ; ; ;

References

  • The Economic Burden of Obesity
    Morgan, E; Dent, M
  • The cost and burden of chronic pain
    Phillips, CJ
  • Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study
    Somers, TJ; Blumenthal, JA; Guilak, F; Kraus, VB; Schmitt, DO
  • Intensive lifestyle intervention improves physical function among obese adults with knee pain: findings from the Look AHEAD Trial
    Foy, CG; Lewis, CE; Hairston, KG
  • Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high‐field MRI and radiography
    Gudbergsen, H; Boesen, M; Lohmander, LS
  • Is there a dose response relationship between weight loss and symptom improvement in persons with knee osteoarthritis?
    Atukorala, I; Makovey, J; Lawler, L; Messier, SP; Bennell, K; Hunter, DJ
  • Obesity and overweight
  • Chronic pain and obesity in elderly people: results from the Einstein Aging Study
    McCarthy, LH; Bigal, ME; Katz, M; Derby, C; Lipton, RB
  • Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta‐analysis
    Silverwood, V; Blagojevic‐Bucknall, M; Jinks, C; Jordan, JL; Protheroe, J; Jordan, KP
  • Risk factors for the onset of knee osteoarthritis in older adults: a systematic review and meta‐analysis
    Blagojevic, M; Jinks, C; Jeffrey, A; Jordan, K
  • The association between obesity and low back pain: a meta‐analysis
    Shiri, R; Karppinen, J; Leino‐Arjas, P; Solovieva, S; Viikari‐Juntura, E
  • Understanding chronic pain in older adults: abdominal fat is where it is at
    Somers, TJ; Wren, AA; Keefe, FJ
  • Body mass index as a risk factor for developing chronic low back pain: a follow‐up in the Nord‐Trøndelag Health Study
    Heuch, I; Heuch, I; Hagen, K; Zwart, JA
  • Relationship between fibromyalgia and obesity in pain, function, mood, and sleep
    Okifuji, A; Donaldson, GW; Barck, L; Fine, PG
  • Mechanisms of association between obesity and chronic pain in the elderly
    Ray, L; Lipton, RB; Zimmerman, ME; Katz, MJ; Derby, CA
  • Does pain predict interference with daily functioning and weight loss in an obese residential treatment‐seeking population?
    Wachholtz, A; Binks, M; Eisenson, H; Kolotkin, R; Suzuki, A
  • Pain management and pain characteristics in obese and normal weight patients before joint replacement
    Thomazeau, J; Perin, J; Nizard, R
  • Overview of the relationship between pain and obesity: what do we know? Where do we go next?
    Janke, AE; Collins, A; Kozak, AT
  • Chronic pain perspectives: targeting systemic inflammation in patients with obesity‐related pain: obesity‐related pain: time for a new approach that targets systemic inflammation
    Bonakdar, RA
  • Obesity and Pain
    McVinnie, DS
  • Presurgical weight is associated with pain, functional impairment and anxiety among gastric bypass surgery patients
    Wedin, S; Byrne, K; Morgan, K
  • Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta‐analysis
    Christensen, R; Bartels, EM; Astrup, A; Bliddal, H
  • Joanna Briggs Institute Reviewers' Manual
  • Weight loss interventions for overweight/obese adults with chronic musculoskeletal pain: a mixed methods systematic review protocol
    Cooper, L; Ryan, C; Ells, LJ
  • GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
    Guyatt, GH; Oxman, AD; Vist, GE
  • Establishing confidence in the output of qualitative research synthesis: the ConQual approach
    Munn, A; Porritt, K; Lockwood, C; Aromataris, E; Pearson, A
  • Efficacy of tailored physical activity or chronic pain self‐management programme on return to work for sick‐listed citizens: a 3‐month randomised controlled trial
    Andersen, LN; Juul‐Kristensen, B; Sørensen, TL; Herborg, LG; Roessler, KK; Søgaard, K
  • Effect of milnacipran on body weight in patients with fibromyalgia
    Arnold, LM; Palmer, RH; Hufford, MR; Chen, W
  • Aquatic therapy improves pain, disability, quality of life, body composition and fitness in sedentary adults with chronic low back pain. A controlled clinical trial
    Baena‐Beato, P
  • Health‐related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow‐up effects
    Blissmer, B; Riebe, D; Dye, G; Ruggiero, L; Greene, G; Caldwell, M
  • Efficacy of Biodanza for treating women with fibromyalgia
    Carbonell‐Baeza, A; Aparicio, VA; Martins‐Pereira, CM
  • Whole‐foods, plant‐based diet alleviates the symptoms of osteoarthritis
    Clinton, CM; O'Brien, S; Law, J; Renier, CM; Wendt, MR
  • The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee
    Hopman‐Rock, M; Westhoff, MH
  • A randomized clinical trial of an integrated behavioral self‐management intervention simultaneously targeting obesity and pain: the STOP trial
    Janke, EA; Fritz, M; Hopkins, C; Haltzman, B; Sautter, JM; Ramirez, ML
  • Effects of dietary intervention and quadriceps strengthening exercises on pain and function in overweight people with knee pain: randomised controlled trial
    Jenkinson, CM; Doherty, M; Avery, AJ
  • Vegan diet alleviates fibromyalgia symptoms
    Kaartinen, K; Lammi, K; Hypen, M; Nenonen, M; Hanninen, O; Rauma, AL
  • Yoga training application in overweight control of seniors with arthritis/osteoarthritis
    Krejci, M
  • Effect of a 24‐week physical training programme (in water and on land) on pain, functional capacity, body composition and quality of life in women with fibromyalgia
    Latorre, PÁ; Santos, MA; Heredia‐Jiménez, JM
  • Effects of high‐intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial
    Lemmey, AB; Marcora, SM; Chester, K; Wilson, S; Casanova, F; Maddison, PJ
  • Are the benefits of a high‐intensity progressive resistance training program sustained in rheumatoid arthritis patients? A 3‐year followup study
    Lemmey, AB; Williams, SL; Marcora, SM; Jones, J; Maddison, PJ
  • Weight loss outcomes in patients with pain
    Masheb, RM; Lutes, LD; Kim, HM
  • Comparing two low‐energy diets for the treatment of knee osteoarthritis symptoms in obese patients: a pragmatic randomized clinical trial
    Reicke, BF; Christensen, R; Christensen, P
  • The effect of multifactorial intervention programs on health behavior and symptom control among community‐dwelling overweight older adults with knee osteoarthritis
    Saraboon, Y; Aree‐Ue, S; Maruo, SJ
  • Effectiveness of a tailor‐made weight loss intervention in primary care
    Vos, BRJ; Bierma‐Zeinstra, S
  • A randomised controlled trial of a lifestyle behavioural intervention for patients with low back pain, who are overweight or obese: study protocol
    Williams, A; Wiggers, J; O'Brien, KM; Wolfenden, L; Yoong, SW; Williams, CM
  • Health beliefs before and after participation on an exercised‐based rehabilitation programme for chronic knee pain: doing is believing
    Hurley, MV; Walsh, N; Bhavnani, V; Britten, N; Stevenson, F
  • Weight stigma in physiotherapy practice: patient perceptions of interactions with physiotherapists
    Setchell, J; Watson, B; Jones, L; Gard, M
  • Preferred Reporting Items for Systematic Reviews and Meta‐Analyses: the PRISMA statement
    Moher, D; Liberati, A; Tetzlaff, J; Altman, DG
  • Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial
    Christensen, RA; Astrup, A; Bliddal, H
  • Weight loss as treatment for knee osteoarthritis symptoms in obese patients: 1‐year results from a randomised controlled trial
    Bliddal, H; Leeds, AR; Stigsgaard, L; Astrup, A; Christensen, R
  • The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity
    Huang, MH; Chen, CH; Chen, TW; Weng, MC; Wang, WT; Wang, YL
  • Predictors of weight loss in overweight veterans with knee osteoarthritis who participated in a clinical trial
    Wolf, S; Foley, S; Budiman‐Mak, E
  • Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve‐month randomized controlled trial
    Christensen, R; Henriksen, M; Leeds, AR
  • Exercise and weight loss in obese older adults with knee osteoarthritis: a preliminary study
    Messier, SP; Loeser, RF; Mitchell, MN
  • Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the arthritis, diet, and activity promotion trial
    Messier, SP; Loeser, RF; Miller, GD
  • Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial
    Messier, SP; Mihalko, SL; Legault, C
  • Intensive weight loss program improves physical function in older obese adults with knee osteoarthritis
    Miller, GD; Nicklas, BJ; Davis, C; Loeser, RF; Lenchik, L; Messier, SP
  • Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized controlled trial
    Lim, JY; Tchai, E; Jang, SN
  • A pilot study investigating dietetic weight loss interventions and 12 month functional outcomes of patients undergoing total joint replacement
    Gandler, N; Simmance, N; Keenan, J; Choong, PF; Dowsey, MM
  • Effect of a commercial hypocaloric diet in weight loss and post surgical morbidities in obese patients with chronic arthropathy, a randomized clinical trial
    Luis, DA; Izaola, O; García Alonso, M; Aller, R; Cabezas, G; Fuente, B
  • Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial
    Senna, MK; Sallam, RA; Ashour, HS; Elarman, M
  • Changes in body fat but not body weight or metabolic correlates of obesity is related to symptomatic relief in obese patients with knee osteoarthritis after a weight control program
    Toda, Y; Toda, T; Takemura, S; Wada, T; Morimoto, T; Ogawa, R
  • Structural changes in the knee during weight loss maintenance after a significant weight loss in obese patients with osteoarthritis: a report of secondary outcome analyses from a randomized controlled trial
    Henriksen, M; Christensen, R; Hunter, DJ
  • Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis
    Messier, SP; Gutekunst, DJ; Davis, C; DeVita, P
  • Exercise, self‐efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis
    Focht, BC; Rejeski, WJ; Ambrosius, WT; Katula, JA; Messier, SP
  • Is serum leptin related to physical function and is it modifiable through weight loss and exercise in older adults with knee osteoarthritis?
    Miller, GD; Nicklas, BJ; Davis, CC; Ambrosius, WT; Loeser, RF; Messier, SP
  • Diet‐induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial
    Nicklas, BJ; Ambrosius, W; Messier, SP
  • Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life
    Rejeski, WJ; Focht, BC; Messier, SP; Morgan, T; Pahor, M; Penninx, B
  • Cost‐effectiveness of exercise and diet in overweight and obese adults with knee osteoarthritis
    Sevick, MA; Miller, GD; Loeser, RF; Williamson, JD; Messier, SP
  • The independent and combined effects of intensive weight‐loss and exercise training on bone mineral density in overweight and obese older adults with osteoarthritis
    Beavers, D; Beavers, K; Loeser, R
  • Effects of total and regional fat loss on plasma CRP and IL‐6 in overweight and obese, older adults with knee osteoarthritis
    Beavers, KM; Beavers, DP; Newman, JJ
  • The Intensive Diet and Exercise for Arthritis (IDEA) trial: 18‐month radiographic and MRI outcomes
    Hunter, DJ; Beavers, DP; Eckstein, F
  • Radiographs and low field MRI (0.2T) as predictors of efficacy in a weight loss trial in obese women with knee osteoarthritis
    Gudbergsen, H; Boesen, M; Christensen, R; Astrup, A; Bliddal, H
  • Inflammatory biomarkers and physical function in older, obese adults with knee pain and self‐reported osteoarthritis after intensive weight‐loss therapy
    Miller, GD; Nicklas, BJ; Loeser, RF
  • Influence of weight loss, body composition, and lifestyle behaviors on plasma adipokines: a randomized weight loss trial in older men and women with symptomatic knee osteoarthritis
    Miller, GD; Jenks, MZ; Vendela, M; Norris, JL; Muday, GK
  • Knee strength maintained despite loss of lean body mass during weight loss in older obese adults with knee osteoarthritis
    Wang, X; Miller, GD; Messier, SP; Nicklas, BJ
  • “The more pain I have, the more I want to eat”: obesity in the context of chronic pain
    Janke, AE; Kozak, AT
  • Patient's experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity
    Janke, EA; Ramirez, ML; Haltzman, B; Fritz, M; Kozak, AT
  • Unique barriers and needs in weight management for obese women with fibromyalgia
    Craft, JM; Ridgeway, JL; Vickers, KS; Hathaway, JC; Vincent, A; , OTH
  • “......I've found one the weight had gone off, I've had a few twinges, but nothing like before”. Exploring weight and self‐management of knee pain
    Morden, A; Jinks, C; Nio Ong, B
  • Chronic pain management strategies used by low‐income overweight Latinos
    Rutledge, DN; Cantero, PJ; Ruiz, JE
  • Optimal strategies for reporting pain in clinical trials and systematic reviews: recommendations from an OMERACT 12 workshop
    Busse, JW; Bartlett, S; Dougados, M; Johnston, BC; Guyatt, GH
  • The association between baseline persistent pain and weight change in patients attending a specialist weight management service
    Ryan, C; Viayaraman, A; Denny, V
  • AHA/ACC/TOS guideline for the management of overweight and obesity in adults
    Jensen, MD; Ryan, DH; Apovian, CM; Ard, JD; Comuzzie, AG; Donato, KA
  • Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale
    Salaffi, F; Stancati, A; Silvestri, CA; Ciapetti, A; Grassi, W
  • Interpreting meta‐regression: application to recent controversies in antidepressants' efficacy
    Petkova, E; Tarpey, T; Huang, L; Deng, L
  • Meta-analytical methods to identify who benefits most from treatment: daft, deluded, or deft approach?
    Fisher, DJ; Carpenter, JR; Morris, TP; Freeman, SC; Tierney, JF

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