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Reconsidering the Role of Weight Loss in Treatment for Chronic Pain: Knee Osteoarthritis as an Exemplar - 07/09/24

Doi : 10.1016/j.jpain.2024.104647 
KayLoni L. Olson , , Christopher Eccleston , §
 Weight Control and Diabetes Research Center, Miriam Hospital, Providence, Rhode Island 
 Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island 
 Research Department for Health, University of Bath, Bath, England 
§ Centre for Pain Research, University of Bath, Bath, England 

Address reprint requests to KayLoni L. Olson, PhD, Weight Control and Diabetes Research Center, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital, 196 Richmond Street, Room 210, Providence, RI 02903.Weight Control and Diabetes Research Center, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital196 Richmond Street, Room 210ProvidenceRI02903
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 07 September 2024

Abstract

Chronic pain is prevalent among individuals with higher body weight and associated with greater impairment. As a result, weight loss is a common recommendation for pain management among those with higher body weight. Body weight is an appealing target because it is modifiable and evidence-based treatments to produce weight loss are well-established. In the last 2 decades, there has been a growing line of scientific work investigating the application of weight loss to individuals with chronic pain. This represents an important step to integrate the conceptualization of pain and body weight and there is preliminary work suggesting treatment effects are enhanced when weight loss treatment is combined with pain coping skills. However, weight loss outcomes are variable and difficult to sustain, and access to evidence-based treatment is limited. These concerns are set against the backdrop of growing public and academic concern about the weight-centric approach to health care that dominates western medicine. This is a timely moment to reconsider the conceptualization of weight and pain, and the role of weight loss in chronic pain treatment. Using osteoarthritis as an exemplar, we review the evidence for and clinical uptake of weight loss as a chronic pain management strategy and conclude with key areas for consideration to advance the scientific understanding of these comorbid conditions and how to optimize pain management for individuals of higher body weight.

Perspective

This focus article critically considers the role of weight loss in management of chronic pain among individuals of higher body. Using knee osteoarthritis as an exemplar, the evidence and clinical uptake of weight loss for pain management is reviewed. Limitations are considered to guide future research and clinical care.

Le texte complet de cet article est disponible en PDF.

Highlights

Chronic pain is common among individuals of higher body weight.
Weight loss is often recommended for pain management.
Evidence in osteoarthritis indicates that weight loss can contribute to modest pain management.
The role of weight loss as an equitable, sustainable, and scalable treatment for pain is less clear.
Greater cross talk between pain and weight science holds promise for optimizing treatment.

Le texte complet de cet article est disponible en PDF.

Key Words : Chronic pain, osteoarthritis, obesity, weight management, pain management


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© 2024  United States Association for the Study of Pain, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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