What is the clinical effectiveness of body weight modification interventions for chronic non-cancer pain?
Three systematic reviews (that included 13 unique relevant primary studies) and two non-randomized studies were identified regarding the clinical effectiveness of body weight modification interventions (e.g., diet-only, exercise-only, combination diet and exercise) for the treatment of chronic non-cancer pain in adults with excess body weight (body mass index ≥ 25 kg/m2). No evidence regarding the clinical effectiveness of body weight modification interventions in adults with body mass index < 18.5 kg/m2 was identified.
The three systematic reviews were generally well-conducted, but there were methodological limitations in their included primary studies which provided low to moderate strength evidence. The identified literature revealed mixed conclusions regarding the clinical effectiveness of body weight modification interventions for chronic non-cancer pain for overweight adults. Specifically, in most studies, body weight modification interventions (i.e., diet or exercise) resulted in statistically significant weight reductions, and improvements in pain and physical function compared to no diet or exercise. However, in some studies, no statistically significant differences were detected in weight, pain, and physical function between diet and/or exercise groups and control groups (i.e., no diet and exercise). There were numerically more nonserious gastrointestinal issues associated with diet interventions compared to non-diet groups; however, specific numbers were not reported. Furthermore, no serious adverse events were reported for any intervention or control groups.
The limitations of the included studies (e.g., heterogeneity of interventions and outcome measures, variation in treatment durations, risk of performance bias due to unblinded participants, inconsistencies in study findings) should be taken into consideration when interpreting the findings of this report.