title: Weight loss outcomes in patients with pain.
abstract: OBJECTIVE
  To determine whether the presence or severity of pain is predictive of suboptimal weight loss outcomes in behavioral weight management programs.
  
  
  METHODS
  This is a secondary data analysis comparing weight loss among participants with overweight/obesity who participated in a 12-month randomized controlled trial. Of the 481 participants randomized, 394 (81.9%) had available pain data and were categorized by Pain Type (back pain, arthritis pain, both, or neither) and Pain Severity (no pain, moderate pain, or severe pain). Dietary and physical activity outcomes were also explored.
  
  
  RESULTS
  High rates of moderate and severe (80.2%), and back and arthritis (72.6%), pain were observed. Linear mixed models showed significant differences in % weight loss among Pain Severity, but not Pain Type, groups. Patients with severe pain lost significantly less weight (-0.1 kg, 95% CI = -1.5, -1.2) compared to those with either moderate or no pain (-1.9 kg, 95% CI = -2.5, -1.3; -2.1 kg, 95% CI = -3.3, -1.0, respectively). Patients with arthritis pain lost a significant amount of weight despite only minor improvements in walking distance.
  
  
  CONCLUSIONS
  Pain severity, but not pain type, is predictive of suboptimal weight loss outcomes.
authors.affiliation: VA Connecticut Healthcare System, West Haven, Connecticut, USA.|Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Masheb
authors.affiliation: Department of Psychology, East Carolina University, Greenville, North Carolina, USA.
authors.forename: Lesley D
authors.initials: LD
authors.lastname: Lutes
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.|Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Holleman
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Goodrich
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Janney
authors.affiliation: Office of Primary Care, VA Central Office, Washington, DC, and Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Kirsh
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Higgins
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.|Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Damschroder
mesh_terms: D000328:Adult; D001835:Body Weight; D059350:Chronic Pain / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000628:therapy*; D059408:Pain Management; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss