Does Obesity Make Fibromyalgia Worse?

Study after study links fibromyalgia with obesity and being out of shape. That's kind of a no-brainer when you understand that it causes severe chronic pain, fatigue, and an extreme reaction to exercise. Who isn't going to gain weight when they get sick and have to give up much—if not all—of their favorite activities?

Fibromyalgia isn't alone; research shows that obesity is common in all kinds of chronic pain conditions.

Physical symptoms as well as cognitive dysfunction can make it hard for people with this condition to regularly grocery shop and to cook, so healthy eating becomes difficult. That makes it even more likely that we'll put on some extra weight.

Several questions remain, though:

• Does being overweight/obese increase your risk of fibromyalgia?
• Does being overweight/obese make fibromyalgia symptoms worse?
• Does losing weight make fibromyalgia symptoms less severe?

So we know we're more at risk of being overweight after developing fibromyalgia, but what about the reverse? Does being overweight make you more at risk for fibromyalgia?

Some fibromyalgia experts believe it does, in fact, increase your risk. This opinion is supported by some research, including a 2017 study of obese people. Participants were tested for fibromyalgia, using both 1990 and 2011 diagnostic criteria.

Under the 1990 criteria, researchers say 34 percent tested positive for fibromyalgia. Even more—45 percent—tested positive for it under the 2011 criteria. For some perspective, only about two percent of the adult population has this condition.

Those are pretty striking numbers. However, in studies like this, it's not entirely clear what the relationship between them is. Fibromyalgia often goes undiagnosed for years, so a question that needs to be asked is how many of those people were overweight because they live with chronic pain?

Additionally, in this study, depression was more common in the participants, and depression can contribute to obesity.

Still, this study and earlier ones like it are enough to convince much of the medical community that yes, obesity does raise your risk of fibromyalgia.

Does being heavier make our symptoms worse? Once again, research suggests that it does. 

A Journal of Pain study found that obesity was linked to greater disability, increased pain sensitivity, worse sleep quality, and less strength and flexibility.

A Rheumatology International study linked obesity to increased sleepiness in fibromyalgia and showed that participants who were sleepier had gained more weight since the onset of fibromyalgia. (Again, it's not clear whether the sleepiness contributed to the weight gain or vice versa.)

A study in Pain Management Nursing comparing symptoms in normal-weight, overweight, and obese women with this illness showed no difference between those classified as overweight and obese, but did show that people in both of those categories had worse symptoms than those of normal weight when it came to:

• Pain levels
• Fatigue
• Morning tiredness
• Stiffness

Study after study points to extra weight making us feel worse, and research team after research team recommends that doctors work with us on losing weight.

If carrying more weight makes our symptoms worse, it stands to reason that losing weight should improve symptoms, right? For once, fibromyalgia appears to be logical.

A study in Clinical Rheumatology found that when obese participants with fibromyalgia lost weight, they saw significant improvements in:

• Depression
• Sleep quality
• Tender point count (indicating reduced pain sensitivity)
• Quality of life

So how do we go about losing weight, in spite of our symptoms?

In a 2015 study on unique barriers to weight management for us, researchers point out the complex relationships between fibromyalgia, diet, and exercise. They recommend a tailored weight-management program that takes our special needs into consideration.

If you want to lose weight, be sure to talk to your doctor about safe and effective ways to do it. You may benefit from seeing a nutritionist or weight-loss specialist who's knowledgeable about fibromyalgia.

While weight may increase your risk of fibromyalgia and may make your symptoms worse, that doesn't mean that it's your fault you're sick. Weight is a risk factor, not a cause; it's an exacerbating factor but not the underlying reason for your symptoms.

Some doctors may say, "You've got fibromyalgia because you're fat, so lose weight and you'll feel better," and then send you out the door without resources to help you with that. Know that those doctors are over-stating the impact of your weight and falling well short of recommendations. Healthy people struggle with weight loss, and we struggle harder. If possible, try to find a doctor who understands the problems you're facing and is willing to help you overcome them.

In the end, the most important thing is that you do what you can to improve your health. A healthy diet and appropriate level of exercise are part of that, but they're not everything. Be sure you and your health-care team are exploring multiple options for getting you better.

After all, the better you feel, the more likely it is you'll be able to do the things that help you lose weight.