Abstract
ObjectiveTo quantify the influence of baseline pain levels on weight change at one-year follow-up in patients attending a National Health Service specialist weight management programme.MethodsWe compared one-year follow-up weight (body mass) change between patient sub-groups of none-to-mild, moderate, and severe pain at baseline. A mean sub-group difference in weight change of ≥5kg was considered clinically relevant.ResultsOf the 141 complete cases, n = 43 (30.5%) reported none-to-mild pain, n = 44 (31.2%) reported moderate pain, and n = 54 (38.3%) reported severe pain. Covariate-adjusted mean weight loss (95%CI) was similar for those with none-to-mild (8.1kg (4.2 to 12.0kg)) and moderate pain (8.3kg (4.9 to 11.7kg). The mean weight loss of 3.0kg (-0.4 to 6.4kg) for the severe pain group was 5.1kg (-0.6 to 10.7, p = 0.08) lower than the none-to-mild pain group and 5.3kg (0.4 to 10.2kg, p = 0.03) lower than the moderate pain group.ConclusionsPatients with severe pain upon entry to a specialist weight management service in England achieve a smaller mean weight loss at one-year follow-up than those with none-to-moderate pain. The magnitude of the difference in mean weight loss was clinically relevant, highlighting the importance of addressing severe persistent pain in obese patients undertaking weight management programmes.
Highlights
Obesity is a major public health issue affecting one in four adults in England [1]
Strategies to enhance the effectiveness of weight loss services are of national importance [2] and it is essential that the weight management services that are in place are appropriate and fit for purpose
The aim of this study was to investigate the effect of persistent pain on weight loss in individuals receiving National Health Service (NHS) specialist weight management services. This is an analysis of an NHS clinical dataset of patients who attended a specialist weight management service in the North East of England from February 2013 to November 2014
Summary
Obesity is a major public health issue affecting one in four adults in England [1]. Chronic pain affects 13% of people in the UK [3]. There is a substantial body of evidence demonstrating a link between obesity and chronic pain [4,5,6,7,8,9,10,11,12,13,14,15]. A dose response relationship exists, with the prevalence of pain increasing with progressively higher BMI [14]. The full extent of this relationship has yet to be explored, it is likely to be bi-directional and may be underpinned by a range of mechanical, physiological, psychosocial, and behavioural mechanisms [16,17]
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