title: Unique barriers and needs in weight management for obese women with fibromyalgia.
abstract: OBJECTIVE
  The aim of this study was to identify barriers, needs, and preferences of weight management intervention for women with fibromyalgia (FM).
  
  
  METHODS
  Obesity appears in higher rates in women with fibromyalgia compared to the population at large, and no study to date has taken a qualitative approach to better understand how these women view weight management in relation to their disease and vice versa.
  
  
  METHODS
  We designed a qualitative interview study with women patients with FM and obesity.
  
  
  BACKGROUND
  Women (N = 15) were recruited by their participation in a fibromyalgia treatment program (FTP) within the year prior.
  The women approached for the study met the following inclusion criteria: confirmed diagnosis of FM, age between 30 and 60 years (M = 51 ± 6.27), and body mass index (BMI) ≥ 30 (M = 37.88 ± 4.87).
  
  
  METHODS
  Patients completed questionnaire data prior to their participation in focus groups (N = 3), including weight loss history, physical activity data, the Revised Fibromyalgia Impact Questionnaire (FIQR), and the Patient Health Questionnaire 9-item (PHQ-9). Three focus group interviews were conducted to collect qualitative data.
  Consistent themes were revealed within and between groups. Patients expressed the complex relationships between FM symptoms, daily responsibilities, and weight management. Weight was viewed as an emotionally laden topic requiring compassionate delivery of programming from an empathetic leader who is knowledgeable about fibromyalgia. Patients view themselves as complex and different, requiring a specifically tailored weight management program for women with FM.
  
  
  RESULTS
  Women with FM identify unique barriers to weight management, including the complex interrelationships between symptoms of FM and health behaviors, such as diet and exercise. They prefer a weight management program for women with FM that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program. Feasibility may be one of the biggest barriers to such a program both from an institutional and individual perspective.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN; Current address: Department of Psychiatry and Psychology, Olmsted Medical Center, Rochester, MN.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Craft
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Ridgeway
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Vickers
authors.affiliation: Patient Education Research, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Hathaway
authors.affiliation: Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Ann
authors.initials: A
authors.lastname: Vincent
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Electronic address: oh.terry@mayo.edu.
authors.forename: Terry H
authors.initials: TH
authors.lastname: Oh
mesh_terms: D000328:Adult; D001294:Attitude to Health; D015992:Body Mass Index; D001835:Body Weight; D004032:Diet; D004644:Emotions; D015444:Exercise; D005260:Female; D005356:Fibromyalgia / Q000150:complications*; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy*; D011361:Professional Competence; D011788:Quality of Life; D011795:Surveys and Questionnaires; D061217:Weight Reduction Programs
keywords: Fibromyalgia; obesity; qualitative; weight management; women