Weight Loss & Fibromyalgia: The Challenges

What Keeps the Weight On?

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Fibromyalgia can create barriers to weight loss. ImagesBazaar/Getty Images

How many times have you tried to lose weight? A lot of us with fibromyalgia have struggled long and hard, only to get nowhere with weight loss. A study published in late 2014 sheds some light on this and makes an interesting recommendation; but first, let's look at the problem.

We've got research showing that many of us are overweight or obese. Is that really a surprise? When you consider the number of overweight people in the general population then add that our illness(es) increase how much time we're sedentary—often by a whole lot—you have a recipe for packing on and keeping extra pounds.

That weight, according to research, makes our symptoms worse. And studies show that losing weight can make us feel better.

But what should we do about it?

Barriers to Weight Loss

I know I've found a lot of barriers to weight loss that are related to fibromyalgia.

Sticking to a healthy diet can be tricky. Pain and fatigue make it hard to get to the store for fresh food all the time. Cooking? It's not only difficult physically, but thanks to cognitive function (a.k.a. fibro fog), it's hard for many of us to follow a recipe or remember where we are in the process.

Also, it could be that fibromyalgia leads to physiological abnormalities that make weight loss harder for us. That's an area of research with few answers so far.

That brings us to exercise. Consistent exercise is a real problem for a few reasons:

  • Fluctuating symptoms
  • Exercise intolerance
  • Loss of strength and stamina due to being sedentary

Fluctuating Symptoms

Much of the time, fibromyalgia is an illness of flares and remissions.

We'll feel not-too-bad for a while, then get knocked down by symptoms for days or weeks, then get back to feeling … well, not as horrible. (Most of us experience at least some symptoms during remissions, but they're milder.)

When you're trying to exercise regularly, the ups and downs are killers. It's hard to get into a routine when, some days, you're lucky if you can take a bath and feed yourself.

What often happens to many of us is, when going through a good spell, we think, "I can handle a light exercise routine now, no problem!" Then, before long, we have a downturn and have to skip a few days.

Once we've better, perhaps we're just out of the habit and don't think about it. Or we're two weeks behind on everything and have to put all our energy there. I'm guessing you know this story well, or you wouldn't be reading this!

Also, every time I start an exercise routine and then have a flare, I have to wonder—did the exercise cause the flare?

Exercise Intolerance

Exercise intolerance is a common symptom of fibromyalgia. In my opinion, it should really be called "activity intolerance," because that's exactly what it is. The moment we exert ourselves too much, we can trigger a flare.

And that over-exertion can be from anything: walking around the block, cleaning the house, having sex, grocery shopping, you name it. We do a little too much, and we pay for it. That kind of push-crash-push cycle does us no good at all when it comes to weight loss.

A lot of people discover exercise intolerance and decide they simply can't exercise or exert themselves at all. It's easy to become afraid of it, which is something researchers call kinesiophobia. Refusing to exert yourself may stop the cycle, but again, it doesn't help with weight loss (or general fitness). It just makes us get more out of shape.

Loss of Strength & Stamina

Many of us have done this over and over: we work to build up a little strength and stamina, only to have them knocked down again by a flare or a new health problem. Some of us collect new diagnoes like other people collect stamps, meaning something else is always coming around the corner and puts us back on the couch watching Netflix for days.

That means the next time we try to get an exercise routing going, we have limitations to our activity level that are even more constraining than fibromyalgia symptoms. It can be really discouraging to realize that your muscles give out before you can do enough to trigger a flare.

Back to The Study

Now to the study I mentioned earlier. It went beyond saying that a lot of us are fat and we need to lose weight and looked into what it might take to make that happen.

Researchers asked obese women with fibromyalgia who were between 30 and 60 years old about their physical activity, weight-loss history, and symptom levels. The answers revealed several themes which likely won't surprise many people with this condition:

  • A complex relationship between symptoms, daily responsibilities, and weight management;
  • A lot of emotion tied to the topic of weight;
  • Need for a weight-loss program lead by someone with a lot of compassion and knowledge of fibromyalgia;
  • A tendency for participants to view themselves as complex, different, and needing a weight-loss program tailored to the illness.

In conclusion, the researchers said these women preferred:

…"a weight management program for women with [fibromyalgia] that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program."

That sounds great. But is it feasible? The researchers note that it may not be. First, it could be difficult for an agency or organization to design such a program and find leaders with the qualifications to run it.

Second, it could be difficult for many of us to get to that kind of program regularly because of our symptoms.

For now, we're left with either conventional groups that aren't tailored to our specific needs, or with going it alone. However, now that this research is out there, maybe, down the road, someone will come up with a better option for us.

Until then, it's important for us to know the proper way to approach exercise with fibromyalgia and eat a healthy diet that doesn't exacerbate symptoms.

Your doctor may be able to help guide you when it comes to losing weight, so make sure to have that conversation.

Sources:

Craft JM, et al. Explore. 2014 Oct 23. pii: S1550-8307(14)00208-0. Unique barriers and needs in weight management for obese women with fibromyalgia.

Senna MK, et al. Clinical rheumatology. 2012 Nov;31(11):1591-7. Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial.

Timmerman GM, Calfa NA, Stuifbergen AK. Orthopedic nursing. 2013 Mar-Apr;32(2):113-9. Correlates of body mass index in women with fibromyalgia.

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