Obesity management may positively impact patient outcomes in fibromyalgia

Fibromyalgia (FM) patients demonstrate an increased prevalence of comorbid conditions, particularly related to rheumatologic and psychiatric health, and the rates are much higher when compared to the general population. Recent research presented in Frontiers in Medicine, suggests that proactive intervention in addressing obesity may exert a profound influence on the overall outcomes for individuals grappling with FM. The study elucidates a potential pivotal link between obesity management and improved clinical outcomes in FM patients. 

The comprehensive study conducted by Rivera and colleagues, involving 411 patients diagnosed with FM, demonstrated the notable influence of several FM-associated comorbidities on outcomes post-treatment completion. Specifically, obesity exhibited a significant impact on the FM Impact Questionnaire Revised (FIQR) (P = 0.024), while hypothyroidism showed significance in the Center for Epidemiologic Studies Depression Scale (CES-D) (P = 0.023) and Pain Catastrophizing Scale (PCS) (P = 0.035). Gastroesophageal reflux disease (GERD) had a substantial effect on PCS (P < 0.001), and osteoarthritis exhibited significance in CES-D (P = 0.047). Intriguingly, despite being the most prevalent comorbidity (33.6%), headache did not significantly impact outcome domains at follow-up. Notably, obesity, present in 18.2% of the cohort, emerged as the sole FM-associated comorbidity significantly affecting all three outcome domains during the follow-up period. 

 FM has been linked to a range of comorbid conditions, spanning both medical and psychiatric disorders. In recent decades, the surge in chronic illnesses has been attributed to various factors, such as enhanced disease understanding, increased life expectancy, improved healthcare access, and the integration of electronic medical records and online patient services. The presence of comorbidities in FM cases can pose challenges, potentially leading to delayed diagnoses, misconceptions of inadequate primary disease control, erroneous treatment decisions, and an elevated risk of morbidity and mortality among affected individuals. 

The present study underscores the importance of a targeted approach by primary and specialty physicians in addressing specific comorbidities to enhance outcomes for individuals with FM. Notably, the study identifies obesity as a factor negatively influencing the effectiveness of an intensive cognitive-behavioral treatment program, warranting further investigation. This discovery holds significant implications for FM treatment, given the established links between obesity and various modifiable comorbid conditions. Healthcare providers managing FM cases should be consider the potential impact of associated comorbidities on outcomes, emphasizing the need to address and modify these factors whenever possible. 

Reference 

Rivera FA, Munipalli B, Allman ME, Hodge DO, Wieczorek MA, Wang B, et al. A retrospective analysis of the prevalence and impact of associated comorbidities on fibromyalgia outcomes in a tertiary care center. Front Med (Lausanne). 2024 Jan 15;10:1301944. 

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