Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a mixed methods systematic review. (20th May 2018)

• Record Type: Journal Article
• Authors: Cooper, L.; Ryan, C. G.; Ells, L. J.; Hamilton, S.; Atkinson, G.; Cooper, K.; Johnson, M. I.; Kirwan, J. P.; Martin, D.
• Is Part Of: Obesity reviews. Volume 19:Number 7(2018)
• Page Start: 989
• Page End: 1007
• Publication Date: 2018-05-20
• Subjects: Chronic -- musculoskeletal pain -- obese -- weight loss; Obesity -- Periodicals; 616.398005
• DOI: 10.1111/obr.12686
• Languages: English
• ISSNs: 1467-7881

Abstract

Summary: Worldwide prevalence of adult overweight and obesity is a growing public health issue. Adults with overweight/obesity often have chronic musculoskeletal pain. Using a mixed‐methods review, we aimed to quantify the effectiveness and explore the appropriateness of weight loss interventions for this population. Electronic databases were searched for studies published between 01/01/90 and 01/07/16. The review included 14 randomized controlled trials that reported weight and pain outcomes and three qualitative studies that explored perceptions of adults with co‐existing overweight/obesity and chronic musculoskeletal pain. The random‐effects pooled mean weight loss was 4.9 kg (95%CI:2.9, 6.8) greater for intervention vs control. The pooled mean reduction in pain was 7.3/100 units (95%CI:4.1, 10.5) greater for intervention vs control. Study heterogeneity was substantial for weight loss (I 2 = 95%, tau = ±3.5 kg) and pain change (I 2 = 67%, tau = ±4.1%). Meta‐regression slopes for the predictors of study quality, mean age and baseline mean weight on mean study weight reduction were shallow and not statistically significant ( P > 0.05). The meta‐regression slope between mean pain reduction and mean weight lost was shallow, and not statistically significant, −0.09 kg per unit pain score change (95%CI:−0.21, 0.40, P = 0.54). Meta‐synthesis of qualitative findings resulted in two synthesized findings; the importance of healthcare professionals understanding the effects of pain on ability to control weight and developing management/education programmes that address comorbidity.