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.

Abstract

Worldwide prevalence of adult overweight and obesity is a growing public health issue. Adults with overweight/obesity often have chronic musculoskeletal pain (CMP). 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 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 (I 2 =95%, tau= plus-minus 3.5kg) and pain change (I 2 =67%, tau= plus-minus 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 co-morbidity.

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

• Journal Article Type: Review
• Acceptance Date: Feb 14, 2018
• Online Publication Date: May 20, 2018
• Publication Date: Jun 7, 2018
• Deposit Date: Mar 5, 2018
• Publicly Available Date: May 21, 2019
• Journal: Obesity reviews
• Print ISSN: 1467-7881
• Electronic ISSN: 1467-789X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 7
• Pages: 989-1007
• DOI: https://doi.org/10.1111/obr.12686
• Keywords: Adults; Chronic musculoskeletal pain; Overweight; Obesity; Weight loss; Obese
• Public URL: http://hdl.handle.net/10059/2791
• Contract Date: Mar 5, 2018