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Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a mixed methods systematic review.

Cooper, L.; Ryan, C.G.; Ells, L.J.; Hamilton, S.; Atkinson, G.; Cooper, K.; Johnson, M.I.; Kirwan, J.P.; Martin, D.

Authors

L. Cooper

C.G. Ryan

L.J. Ells

S. Hamilton

G. Atkinson

K. Cooper

M.I. Johnson

J.P. Kirwan

D. Martin

Abstract

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 01/01/90-01/0716. The review included 14 randomised controlled trials that reported weight and pain outcomes and three qualitative studies that explored perceptions of adults with co-existing overweight/obesity and CMP. The random-effects pooled mean weight-loss was 4.9kg (95%CI:2.9,6.8) greater for intervention vs control. The pooled mean reduction in pain was 7.3/100units (95%CI:4.1,10.5) greater for intervention vs control. Study heterogeneity was substantial for weight loss (I2=95%, tau={plusmn}3.5kg) and pain change (I2=67%, tau={plusmn}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, -0.09kg 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.

Journal Article Type Review
Publication Date Jun 7, 2018
Journal Obesity reviews
Print ISSN 1467-7881
Electronic ISSN 1467-789X
Publisher Wiley Open Access
Peer Reviewed Peer Reviewed
Volume 19
Issue 7
Pages 989-1007
Institution Citation COOPER, L., RYAN, C., ELLS, L.J., HAMILTON, S., ATKINSON, G., COOPER, K., JOHNSON, M.I., KIRWAN, J.P. and MARTIN, D. 2018. Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a mixed methods systematic review. Obesity reviews [online], 19(7), pages 989-1007. Available from: https://doi.org/10.1111/obr.12686
DOI https://doi.org/10.1111/obr.12686
Keywords Adults; Chronic musculoskeletal pain; Overweight; Obesity; Weight loss; Obese

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