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A questionnaire that assessed a broad range of eating-related characteristics for unselected, normal subjects was factor analyzed in a two-step process proposed by Comrey (1984). Twelve "factored homogeneous item dimensions" were identified first and yielded three primary-level factors in a second factor analysis: Predisposition to Obesity (including Dieting and Preoccupation with, and Fear Of, Gaining Weight), Uncontrollable Urges to Eat (including Eating Momentum Beyond Control, Food a Panacea and Constant Temptation, and Secret Binging), and Predisposition to Anorexia (including Insufficient Eating Obvious to Others, Food Phobia, Inability to Eat, and Vomiting After Meals). The three primary-level factors were positively intercorrelated and exhibited significant positive, though weak, correlations with a measure of trait arousability. Also, weak results tentatively indicated that individuals with more pleasant and/or more arousable temperaments were less likely to be overweight. Subjects reported sharply higher levels of food consumption when feeling "depressed" (i.e., bored, lonely, sad) than when feeling "distressed" (i.e., uncomfortable, anxious, in pain). Uncontrollable Urges to Eat correlated positively and significantly with self-reports of food consumption while depressed, showing that those lacking control over eating ate especially more while feeling bored, lonely, or sad. Predisposition to Obesity correlated negatively and significantly with self-reports of food consumption while distressed, showing that those tending more toward obesity ate less while upset or anxious.
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PMID:Measures of eating-related characteristics for the general population: relationships with temperament. 1636 30

In this exploratory study, we evaluated weight status and dietary intake patterns during painful episodes in adult patients with SCD. Specifically, we explored the relation between pain severity and body mass index (BMI), and we tested the hypothesis that dietary intake would be reduced and dietary content altered during periods of increased pain. We conducted an analysis of survey data from 62 patients involved in a longitudinal evaluation of the relationship of medical and psychosocial factors to pain. Nearly half of patients with SCD were overweight, and 20% were obese. BMI was positively related to interference associated with pain. Although BMI was not statistically associated with reported pain severity, >40% of patients reported that they perceived their pain to be affected by their weight. Less than 20% of patients reported that they perceived that their weight affected their pain. Regarding dietary patterns, the majority of patients reported eating less during episodes of pain and significantly decreasing their intake of fats and proteins. We conclude that there is a need to better understand the relation among weight, dietary patterns and pain in patients with SCD in order to provide patients with accurate education and effective treatment recommendations for managing their disease and reducing current and future risks of lifestyle and disease-related morbidities.
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PMID:Moderate chronic pain, weight and dietary intake in African-American adult patients with sickle cell disease. 1639 54

A population-based longitudinal study suggests that obesity is a strong risk factor for the development of headaches on 15 or more days per month. Little is know about the influence of weight on the response to headache preventive treatment. Herein we prospectively assessed the influence of the baseline body mass index (BMI) on the response to headache preventive treatment. We included adults with episodic or chronic migraine (ICHD-2), or transformed migraine (Silberstein and Lipton criteria) that sought care in a headache clinic. BMI was assessed in the first visit. Baseline information included headache frequency, number of days with severe headache (prospectively obtained over 1 month), and headache-related disability (HIT-6). The same information was obtained after 3 months of preventive treatment. Subjects were categorized based on BMI in: normal weight (</=24.9), overweight (25-29.9), or obese (>/=30). We contrasted the headache end-points using anova with post-test and Kruskal-Wallis with post-test. We used logistic regression to model BMI and headache parameters adjusting for covariates. Our sample consisted of 176 subjects (79.5% women, mean of 44.4 years). At baseline 40.9% had normal weight, 29.5% were overweight and 27.3% were obese. No significant differences were observed in the number of headache days at baseline. After treatment, frequency declined in the entire population, but no significant differences were found by BMI group. Regarding the number of days with severe pain per month, there were also no significant differences at baseline (normal = 6.1, overweight = 6.5, obese = 6.7), and improvement overall (P = 0.01). However, changes were greater in the obese (reduction in 2.7 days with treatment) and overweight (3.9) vs. normal (1.5, P < 0.01). Finally, HIT scores at baseline did not differ by BMI group (normal weight = 63.8, overweight = 64.1, obese = 63.6). However, compared with the normal weighted group, change in HIT scores (follow-up baseline) were greater in the obese (6.4 vs. 3.5, P < 0.05) and overweight groups (6.8 vs. 3.5, P < 0.05). In the logistic regression model, BMI did not account for changes in disability, headache frequency, or in the number of days with severe headache per month, after adjusting for covariates. Contrary to what we hypothesized, obesity at baseline does not seem to be related to follow-up refractoriness to preventive treatment.
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PMID:Headache prevention outcome and body mass index. 1655 46

Many studies report a female predominance in the prevalence of chronic musculoskeletal pain (CMP) but the mechanisms explaining these sex differences are poorly understood. Data from a random postal questionnaire survey in the Dutch general population were used to examine whether sex differences in the prevalences of CMP are due to sex differences in the distribution of known potential risk factors for CMP (exposure model) and/or to the different importance of risk factors for CMP (i.e. show different strength of association) in men and women (vulnerability model). In the present analyses, 909 men and 1178 women aged 25-65 were included. CMP was defined as pain lasting longer than 3 months and was assessed for 10 anatomical locations (neck, shoulder, higher back, elbow, wrist/hand, lower back, hip, knee, ankle, foot). Sex differences in CMP could not be explained by a different distribution of age, educational level, smoking status, overweight, physical activity, and pain catastrophizing. Having no paid job was associated with CMP, explaining part of the sex differences, but its role seems complex. Risk factors with a sex-specific association were: overweight (all pain locations) and older age (lower extremities)--both having only an effect among women--and pain catastrophizing (upper extremities), which was stronger associated with CMP among men than among women. In conclusion, sex differences in prevalence of CMP may partly be explained by sex differences in vulnerability to risk factors for CMP. Future research towards sex-specific identification of risk factors for CMP is warranted. Eventually this may lead to sex-specific prevention and management of CMP.
Pain 2006 Sep
PMID:Explaining sex differences in chronic musculoskeletal pain in a general population. 1671 17

According to the WHO, the consequences of increasing obesity in the industrialized nations represent the greatest challenge that will have to be met by the national economies in the next decade. Apart from the known comorbidities, pain is a major factor responsible for the diminishment of quality of life in the overweight patient. Pain may be due to psychological, static or metabolic consequences of obesity, and requires an individual therapeutic approach.
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PMID:[Overweight hurts]. 1673 83

Obesity is a chronic condition associated with a reduction in the quality of life and a high risk for disease and death and requiring long-term care. In Germany, 51.4% of the population is overweight, with 9 million suffering from obesity and its consequences, such as hypertension, diabetes and sleep apnea. In addition, the number of patients undergoing treatment for painful chronic-degenerative disease of the joints is on the increase. After first exhausting all conservative therapeutic options, effective surgical measures can bring about a lasting overweight reduction of up to 50%. By this means, both pain and adverse consequences of obesity can be improved.
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PMID:[Surgical treatment of obesity and its side effects is effective]. 1673 84

Chronic low back pain patients are seen in multiple practice settings and managed with a multitude of therapeutic interventions. Studies conducted by various groups have made some generalizations in the literature describing low back pain patients. However, there are no studies evaluating the demographic features of patients presenting to therapeutic interventional pain medicine programs. This prospective study was undertaken to evaluate and explore various demographic features of patients with chronic low back pain presenting to a therapeutic interventional pain medicine program. Two hundred patients were studied, with evaluation of demographic features of age, mode of onset of pain, work status, history of surgery, and pain characteristics. The results showed that, among patients presenting to an interventional pain medicine program, 17% are over 65 years of age: they are predominantly women; two thirds are either overweight or obese; the mean duration of pain is 7 years, predominantly involving multiple regions, with an average pain intensity of 7.6, significant associated psychological conditions; they have undergone multiple interventions, and were seen by, on average, six physicians; and the majority of patients were not employed, with 31% unemployed and 52% disabled or retired.
Pain Physician 2001 Apr
PMID:Characteristics of chronic low back pain in patients in an interventional pain management setting: a prospective evaluation. 1690 86

We conducted an uncontrolled pilot study to determine the effects of a weight loss and walking program on knee pain and physical function in overweight and obese (body mass index; BMI [kg/m] 25-29.9 and BMI > or = 30, respectively) postmenopausal women with knee osteoarthritis (OA). Forty-eight such women completed self-report (Western Ontario and McMaster University Osteoarthritis Index (WOMAC)) and performance-based measures of physical function ("up and go" test, 6-min walk) and enrolled in a 6-month intervention that included weekly nutrition classes and an exercise-walking program. The intervention produced an average weight loss of 5.6 +/- 4.0 kg in the 30 women who completed the program. There also were significant improvements in the 6-min walk and on VO(2max). Improvements in the timed up and go test and on the WOMAC pain and function scores, however, were restricted only to women who were classified as obese at baseline. These findings suggest that a 6-month weight loss and walking program improves measures of physical functioning and pain in overweight and obese postmenopausal women with knee OA. Among obese women, functional improvement correlated with weight loss, encouraging continued emphasis on weight loss for managing knee OA.
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PMID:Weight loss and exercise walking reduce pain and improve physical functioning in overweight postmenopausal women with knee osteoarthritis. 1703 38

This review aims to assess by meta-analysis of randomised controlled trials (RCTs) changes in pain and function when overweight patients with knee osteoarthritis (OA) achieve a weight loss. Systematic searches were performed and reference lists from the retrieved trials were searched. RCTs were enclosed in the systematic review if they explicitly stated diagnosis of knee OA and reported a weight change as the only difference in intervention from the control group. Outcome Measures for Arthritis Clinical Trials III outcome variables were considered for analysis. Effect size (ES) was calculated using RevMan, and meta-regression analyses were performed using weighted estimates from the random effects analyses. Among 35 potential trials identified, four RCTs including five intervention/control groups met our inclusion criteria and provided data from 454 patients. Pooled ES for pain and physical disability were 0.20 (95% CI 0 to 0.39) and 0.23 (0.04 to 0.42) at a weight reduction of 6.1 kg (4.7 to 7.6 kg). Meta-regression analysis showed that disability could be significantly improved when weight was reduced over 5.1%, or at the rate of >0.24% reduction per week. Clinical efficacy on pain reduction was present, although not predictable after weight loss. Meta-regression analysis indicated that physical disability of patients with knee OA and overweight diminished after a moderate weight reduction regime. The analysis supported that a weight loss of >5% should be achieved within a 20-week period--that is, 0.25% per week.
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PMID:Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. 1819 22

Obesity is considered one of the most relevant health problems of modern societies, as it constitutes a predominant risk factor in the development of various other diseases. The negative impact of obesity on the quality of life of individuals has been the subject of diverse research. The results of a test carried out at Gothenburg University in Sweden suggest that severe obesity is a debilitating factor both for health and psychosocial functioning. Research carried out in Madrid permitted identification of a profile of obese patients with impaired quality of life, which has enabled prophylactic intervention or early treatment of these cases to be considered. The results of a study carried out in the USA propose that pain would appear to be directly related with quality of life and could be considered a covariant of obesity, and should therefore be taken into account in obesity treatments. A study carried out in Oxford concluded that obese subjects or subjects with another chronic disease presented a deterioration in physical wellbeing, however only subjects with another chronic disease (without associated obesity) presented a deterioration in psychological wellbeing. The majority of studies suggest the negative influence of obesity and overweight on health and psychosocial functioning, however it is not possible to clearly define a linear relation between obesity and diminished quality of life.
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PMID:[Obesity and quality of life]. 1723 87


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