Changes in widespread pain after surgical weight loss in racialized adults: A secondary analysis from a two-year longitudinal study

Abstract

Widespread pain is associated with reduced function and disability. Importantly, three-fourths of the approximately 42% of U.S. adults with obesity have widespread pain. Moreover, rates of adult obesity are higher and widespread outcomes are worse in racialized non-Hispanic Black and Hispanic/Latino/a/X groups, potentially exacerbating existing pain disparities. Bariatric surgery significantly reduces weight and improves pain. However, recurrent or unresolved pain after bariatric surgery can hinder weight loss or facilitate weight regain. The current study conducted a secondary analysis of a longitudinal study of predictors and mechanisms of weight loss after bariatric surgery to examine the point prevalence of widespread pain and pain trajectories 24 months post-surgery. Our secondary aim was to examine the association between weight loss and pain characteristics. Our exploratory aim was to longitudinally examine racial differences in pain trajectories after bariatric surgery. Our results showed that point prevalence decreased after bariatric surgery. Additionally, significant improvements in pain trajectories occurred within the first 3 months post-surgery with a pattern of pain reemergence beginning at 12 months post-surgery. Hispanic/Latino/a/X participants reported a higher number of painful anatomical sites before bariatric surgery, and the rate of change in this domain for this group was faster compared to the racialized non-Hispanic Black participants. These findings suggest that pain improvements are most evident during the early stages of surgical weight loss in racialized populations of adults with widespread pain. Thus, clinicians should routinely monitor patients’ weight changes after bariatric surgery as they are likely to correspond to changes in their pain experiences. PerspectiveThis article presents the prevalence and pain trajectories of racialized adults with widespread pain (WP) after surgical weight loss. Clinicians should evaluate changes in the magnitude and spatial distribution of pain after significant weight change in these populations so pain interventions can be prescribed with greater precision.