Obesity and the impact of chronic pain.
OBJECTIVE
To evaluate obesity as a marker for increased pain severity, disability, and psychologic distress in treatment-seeking, mixed chronic pain patients.


METHODS
Three hundred seventy-two consecutive chronic pain patients seeking evaluation at a university pain clinic were divided into 3 weight categories, based on body mass index (BMI): normal (BMI < 25 kg/m2), overweight (BMI between 25 kg/m and 30 kg/m2), and obese (BMI > or = 30 kg/m2). Patients completed questionnaires to identify pain severity, disability, depression, anxiety, and quality of life.


RESULTS
Pain severity and days per week with pain were similar among the weight groups. Disability was related to increasing weight status, with increased BMI associated with more days per week with both reduced activity and complete disability. Depressive symptoms were also related to weight category, with an average Beck Depression Inventory score of 11.81 +/- 7.55 in normal, 12.88 +/- 11.64 in overweight, and 15.78 +/- 9.88 in obese patients. Anxiety scores were similar among the weight categories. Physical function domain of quality of life was also reduced in relation to weight.


CONCLUSIONS
Weight is associated with co-morbid disability, depression, and reduced quality of life for physical function in chronic pain patients. Calculation of the BMI should become a routine part of the screening evaluation for chronic pain patients, with additional screening for disability and psychologic distress in patients with elevated BMIs.
Marcus
Dawn A
DA
Pain Medicine, Pittsburgh, PA 15206, USA. dawnpainmd@yahoo.com
D000203:Activities of Daily Living; D000328:Adult; D001007:Anxiety; D015992:Body Mass Index; D016022:Case-Control Studies; D002908:Chronic Disease; D003863:Depression; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000150:complications* / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D011788:Quality of Life / Q000523:psychology