Presurgical Weight Is Associated with Pain, Functional Impairment, and Anxiety among Gastric Bypass Surgery Patients

Abstract

Chronic pain and obesity are significant public health concerns in the United States associated with significant levels of health-care expenses and lost productivity. Previous research suggests that obesity is a risk factor for chronic pain, mainly due to excessive weight placed on the joints. However, the obesity-pain relationship appears to be complex and reciprocal. Little work to date has focused on the relationship between weight and pain among patients undergoing gastric bypass surgery for weight loss. Patients scheduled to undergo bariatric surgery for weight loss at a large southeastern academic medical center (N = 115) completed the Brief Pain Inventory (BPI), the Center for Epidemiological Studies 10-item Depression scale (CESD-10), and the Beck Anxiety Inventory (BAI). Higher presurgical weight was associated with higher pain-on-average ratings, higher functional impairment due to pain across the domains of physical activity, mood, walking ability, relationships, and enjoyment of life. Higher presurgical weight was associated with higher BAI scores, but weight was not related to depression. Findings suggest that bariatric surgery candidates report a moderate amount of pain prior to surgery and that presurgical weight is associated with higher pain, increased functional impairment due to pain, and increased anxiety. Anxiety was found to mediate the relationship between increased weight and pain.

Characterization of risk factors for adjuvant radiotherapy-associated pain in a tri-racial/ethnic breast cancer population

“…Obesity is a well-established risk factor of chronic pain in the general population and cancer patients [13; 14; 18; 20], and obese patients have elevated pain, worse functional well-being during RT, and slower improvement compared to normal weight group [13]. The molecular mechanisms of obesity in pain may be related to the nociceptive process, anxiety, or systemic inflammation [3; 36; 40]. …”

Weight-loss interventions for overweight/obese adults with chronic musculoskeletal pain

“…10 Individuals with higher BMI have been shown to have increased prevalence of chronic pain. 33 Physical activity is also used as a treatment technique for those with chronic pain; however, obesity can be a barrier to physical activity for individuals who are obese with chronic pain. 34,35 The cause and consequence relationship between obesity and chronic pain can become a vicious cycle that impacts on the function, health and wellbeing of this population.…”

“…The rising prevalence of both obesity and chronic pain is a worldwide concern, as alongside patient health and wellbeing concerns, there is an increased financial burden on healthcare and economic systems. 33,36,37 …”

“…This review should inform future interventions for the promotion of healthier lifestyles, thus increasing weight loss and decreasing chronic pain in a more sustainable manner. In addition to individual positive health outcomes, there is potential for wider societal and economic benefits, 33,37 for example, considerable savings could be made on healthcare spending on care of patients with OA knee if cases attributed to overweight/obesity (currently 26.4%) were reduced.…”

Electronically captured, patient‐reported physical function: an important vital sign in obesity medicine

“…Poorer weight management outcomes in individuals with high BMI may be explained, in part, by functional impairments. Patients who present for bariatric surgery with higher pre‐surgical weight experience less excess weight loss postoperatively and report higher pain and functional impairment levels . The stress placed on joints related to obesity can result in significant pain, making physical activity challenging.…”