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Do Adults With Obesity Feel Pain More Intensely?


 

TOPLINE:

Adults with excess weight or obesity tend to experience higher levels of pain intensity than those with a normal weight, highlighting the importance of addressing obesity as part of pain management strategies.

METHODOLOGY:

  • Obesity may cause pathophysiological changes, such as increased load on joints and systemic inflammation, potentially affecting the sensation of pain. Recent studies suggest that obesity may change pain perception and worsen existing painful conditions.
  • To examine the association between overweight or obesity and self-perceived pain intensities, researchers conducted a meta-analysis of 22 studies that included 31,210 adults older than 18 years and from diverse international cohorts.
  • The participants were categorized by body mass index (BMI) as being normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥ 30). A BMI ≥ 25 was considered excess weight.
  • Pain intensity was assessed by self-report using the Visual Analog Scale, Numerical Rating Scale, and Numerical Pain Rating Scale, with the lowest value indicating “no pain” and the highest value representing “pain as bad as it could be.”
  • Researchers compared pain intensity between these patient BMI groups: Normal weight vs overweight plus obesity, normal weight vs overweight, normal weight vs obesity, and overweight vs obesity.

TAKEAWAY:

  • Compared with people with normal weight, people with excess weight (overweight or obesity; standardized mean difference [SMD], −0.15; P = .0052) or with obesity (SMD, −0.22; P = .0008) reported higher pain intensities, with a small effect size.
  • The comparison of self-report pain in people who had normal weight and overweight did not show any statistically significant difference.

IN PRACTICE:

“These findings encourage the treatment of obesity and the control of body mass index (weight loss) as key complementary interventions for pain management,” wrote the authors.

SOURCE:

This study was led by Miguel M. Garcia, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada de I+D+i al Instituto de Química Médica CSIC-URJC, Alcorcón, Spain. It was published online in Frontiers in Endocrinology.

LIMITATIONS:

The analysis did not include individuals who were underweight, potentially overlooking the associations between physical pain and malnutrition. BMI may misclassify individuals with high muscularity, as it doesn’t accurately reflect adiposity and cannot distinguish between two people with similar BMIs and different body compositions. Furthermore, the study did not consider gender-based differences while evaluating pain outcomes.

DISCLOSURES:

The study received no specific funding from any funding agency in the public, commercial, or not-for-profit sectors. The authors declared no conflicts of interest.

A version of this article appeared on Medscape.com.

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