Bigger is NOT Better

There is a current ad in Australia about the 10,000 tonne woman. This woman has got a bit of weight to lose this year – she is asking for our help. She has been a weight loss consultant for years, so she has seen a lot of people try to lose weight, and the difference support makes. Why are we trying to do it by ourselves? She decided to lose weight with a friend, as a team. Then other people got on board, and then she noticed that the more people shared the weight, the easier it got for everyone.

That’s why she is asking the whole country to join in. Pledge some weight, support someone on their mission, and we’re going to lose 10,000 tonnes together.

biggerI have pledged 30kgs (about 66 pounds) – yes, it’s a lot but it is the amount of weight I have gained since being on antidepressants and FM medication. It is ironic that, although many of these medications cause us to gain weight, excess weight is known to aggravate FM symptoms – such as pain sensitivity and sleep disturbances – and reduce quality of life among patients.

New research now shows, the more severe the obesity, the more severe the FM symptoms, and those who have a body mass index, or BMI, of 35 or higher experience the worst symptoms.

“I’m not surprised,” says study co-author Terry H. Oh, MD, assistant professor of physical medicine and rehabilitation at the Mayo Clinic, in Rochester, Minn. She says that earlier studies have shown that obesity increases symptoms, but there hadn’t been concrete information before this study about whether different levels of obesity affected FM symptoms differently.

In other words, is all obesity the same when it comes to FM?

Help-with-ObesityThe answer is no: Bigger definitely is worse, leading to significantly more severe symptoms. “The severely obese seemed to have the most problems,” says Dr Oh.

The study, published online in the journal Arthritis Care & Research, divided 888 adults with FM into four groups: non-obese (BMI less than 25), overweight (BMI of 25 to 29.9), moderately obese (BMI of 30 to 34.9) and severely obese (BMI equal to or greater than 35). Patients were tracked for three years, underwent a physical evaluation and were asked to fill out health surveys and the Fibromyalgia Impact Questionnaire.

The researchers found – for most symptoms, but not all – that as the BMI category increased, so did the severity of the symptoms. But trends showed most symptoms worsened with higher BMI, but for the most part, the difference in the severity of symptoms was statistically significant for the highest BMI group compared with the other groups. Patients in the highest BMI group, for example, missed work more often because of symptoms and reported more pain, stiffness and fatigue compared with those who were not obese or less obese. Also, the study found that the severely obese patients had more tender points on their bodies and worse physical functioning than the non-obese and less obese.

Why is there a relationship between BMI and the severity of symptoms? Dr Oh and her team write that multiple factors may be at work, including a higher level of pain receptors in fat tissue, elevated levels of pro-inflammatory cytokines, loss of physical fitness and an increase in mechanical loads on the body. And the higher rate of obesity in FM patients “may be caused by a vicious circle of pain and physical inactivity.”

It is important that people with fibromyalgia find a way to stay active despite the chronic pain and fatigue that come with it.

obesity“Those who are severely obese may need more help for weight-loss management,” Dr Oh says. “The basic message is that they have to stay active and exercise by starting slowly and gradually in terms of duration, intensity and frequency. It’s more than saying ‘lose weight.’ They need specific recommendations or to see a dietitian or endocrinologist or get other treatment options.”

Akiko Okifuji, PhD, a psychologist at the Pain Research and Management Center and professor at the University of Utah, in Salt Lake City, conducted earlier research on FM and obesity, which found that obese patients had more pain, less physical strength and more sleep problems.

“Both obesity and fibromyalgia are very different persistent conditions that impact overall health, physical well-being as well as quality of life,” Okifuji says.

She believes people intuitively know what Dr Oh’s study showed – that severe obesity is bad for FM patients. “But it’s good to show it scientifically,” Okifuji says. “Patients need proper nutritional education. It is difficult when you don’t move much. Sometimes food becomes a comfort. They need education on how to deal with that and how to maximize calorie burning while minimizing intake. When dealing with chronic fatigue and chronic pain, it is very difficult to do weight management. The key issue for the scientific and clinical community is to come up with an effective [weight management plan] for people who can’t move that much. It’s a tricky thing.”

Want to check your BMI?

Mine is 39 and I have decided it is time to get myself together! Anyone else with me?

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26 Comments

  1. I am with you. I had already decided to make it a priority this year to do some sort of exercise every single day, and eat healthier. I have so much to lose (about 200 lbs) that I can’t focus on that or I will just get discouraged. So I am taking things a day at a time. I would love having someone I could partner with who could encourage me and I could do the same for them.

  2. Wow this blog came at a perfect time for me, earlier this week I did a blog post on my plan to lose weight to reduce my fibro symptoms! As the article indicates I knew this intuitively, yet thanks to your blog I am just that little bit more motivated again! Thank you and feel free to have a look at my post ‘having my fairy cake and eating it! On my blog which is http://www.fairygodmotheracademy.wordpress.com

    Here’s to supporting each other

    Love and sparkles

    Lara

  3. I have been overweight my entire life and I too have decided it is time to do something about it. I am actually planning on doing weight loss surgery. I just began the process and I am not sure how long it will take. I am guessing at least 3 months to get approved. I have a lot of obesity related diseases, including fibro and horrible back problems that started this year. I am blessed that my husband has insurance that will cover it. I was told when I called to start the process is that my insurance is great for paying on the surgery. Here is to a new me by 2014.

    • Hi Kimberley,

      I’ve had gastric banding and lost 35 kilos, but then all my medications helped me put it back on. If you go ahead with it – make sure you see a dietitian regularly (I didn’t think I needed one, either) because it’s too easy to eat the food that goes straight through the band: chocolate, cheese, alcohol.

      I have just started a new thread on my forum, where maybe we can support each other: http://fibromodem.forumotion.com/t40-share-the-weight

      Whether you join or not, good luck with the surgery.

  4. Wow ! right time for me too girls ! just stopped taking steroids and refused any heavy drugs so doing it myself ‘au natural’ with MSM, Devils Claw and Gotakola herbal drops -doing 3-4 mins on small rebounder -helping and gluton free is good for me so now I’m motivated with you to do this !! Good luck to you all wherever you are -I’m in Australia -just moved here from Scotland xxx

  5. This is a great post. Thanks for sharing. Would you mind if I reblogged on my site?

  6. So well written. Thanks for sharing.

  7. I have always been overweight even as a child my dr put on my gym papers obese because i could not participate in regular gym.. I have not had a problem with my health concerning my weight at least i dont think so other than it triggering my asthma through exertion.. I did the BMI thing and i am 48.8 pounds over..I have been fluctuating between 250 and 275 pounds ever since i got sick, i was down to 225 at one point.. i was 250 when i had my last son 16 yrs ago.. i am content with my weight and none of my drs harp on me about it.. i do eat sensibly.. my boyfriend is a diabetic and overweight as well, although he has lost over 100 pounds in the last 3 yrs..he does most of the cooking and is very concious of our diet since i have gastroparesis alot of things don’t agree with me.. I support you woman of course but i can’t make a guarantee to lose anything because my weight changes from day to day mostly from water without me knowing it.. but i am behind you all..
    best of luck

  8. In May of last year I committed myself (& my husband) to a healthy life style. I am 62 & I had no exercised in years & some days needed a cane to walk. I started with an exercise class designed for arthritis & done in a warm swimming pool, 3 x a week. After 4 months I was able to add a yoga/pilates class also done in a swimming pool 2 x a week. Then last week I swapped one of my arthritis classes for water aerobics. I feel better than I have in years. My husband & I have lost over 80 lbs together (he swims for an hour 3x a week). I was able to go off 6 medications & use that $$ to pay for our YMCA membership. My diabetes is managed again & I cut my triglycerides in half. I know everyone is not able to or does not have access to an exercise program. Water is now my best friend. My husband retired in 2009 & 2 months later was diagnosed with cancer. He is now cancer free & I’m looking forward to many more years of love & happiness.

  9. I would love to lose weight. I have been thinking about how to go about that. so many weight loss plans require that you eat this or eat that. since my IBS dictates food that I can eat and can’t eat, what is a good weight loss plan for those with fibromyalgia?

    • I would start with what foods work for IBS & plan around that. Do you have access to a nutritionist? I swapped my sweets for fruits & veggies for chips. Good luck!

    • Vicki, if I knew that I would be a millionaire – all we can do is try. I’ve started on the Optislim shakes because, then, I’m not eating ANY food and my tummy doesn’t get upset. It’s not for everyone but I’m kick-starting the whole thing with that.

  10. I was fairly fit and active pre-fibro and a healthy weight, however I’ve slowly put on weight since having fibro and found it difficult to shift. The main difficulty I think for fibro sufferers is that we can’t really do a lot of exercise so the focus has to be in food intake. Many years ago (pre-fibro) I did WeightWatchers and found it really worked for me and established some good eating habits. However I initially didn’t consider doing it again because I thought my fibrofog might make tracking and counting a bit difficult and stressful. I tried Lite’n’Easy for a few months. It was during a flare up period and was definitely useful for reducing the stress and effort of grocery shopping and meal prep. However I wasn’t that diligent about not eating stuff that wasn’t in the meal packs so I didn’t lose much weight. And I was a bit over frozen dinners after a while.

    Mid last year I decided to revisit WW and discovered it had come a long way since I last did it nearly 10 years ago. The availability of online membership and a bunch of online tools and apps definitely appealed so I decided to rejoin as an online member and give it a go. I did manage to stick to it well for a few months and lost 5kg, bringing me within 2-3kg of my healthy weight range. However we had to move house unexpectedly in October and I found that completely threw my routine and eating habits. I’m still struggling to settle into a routine and over the Xmas period have regained the weight I lost. I’m finding it hard to get the mental motivation to go back to tracking. I suspect the hot weather is making my brain more foggy than normal. But it is something I need to make a priority. I know I’m not severely overweight, but it’s so easy to let it keep creeping on and I don’t want to have to lift more weight than necessary in order to move my body around.

    So yes, I’m definitely with you on this 🙂 Good luck to us all. May we be moving lighter bodies around this time next year.

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