The Effect of Vertical Banded Gastroplasty on Glucose-Induced β-Endorphin Response

The role of excess subcutaneous fat in pain and sensory sensitivity in obesity

“…The finding that neither pain thresholds, perceived intensity of suprathreshold stimuli, nor pain tolerance, which is strongly linked to motivation (Baker and Kirsch, ), was altered in obese participants on body sites with little excess subcutaneous fat indicates that neither sensory‐discriminative nor affective‐motivational processing of pain is globally affected in obesity. This is interesting because obesity is associated with elevated levels of circulating β‐endorphin (Karayiannakis et al., ), an endogenous opioid peptide involved in pain inhibition (Hartwig, ) and altered motivation and reward processing (Van Ree et al., ), that one would predict to affect, in a global sense, pain sensitivity regardless of the region tested. In addition, the finding that indices of central pain processing, i.e., temporal summation at a spinal and HTNS at a brainstem level, were not altered in obese participants further supports the interpretation that central mechanisms are not responsible for decreased pain sensation in obesity.…”

Obesity and pain sensitivity: Why should we care?

“…Future rigorous studies that address the limitations of the current literature are needed to definitively conclude if pain sensitivity is altered in obesity. Despite this uncertainty, I propose that obesity is more likely to be associated with decreased pain sensitivity due to underlying relationships with reward processing 7,8 and inflammation. 9 So how could these relationships decrease pain sensitivity in obesity and why should we care?…”