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ABSTRACT: Pain may interfere with daily functioning in obese persons and also with outcomes during weight loss. We examined the relationship between pain and (1) interference with daily functioning (DFi) and (2) outcomes in an obese treatment-seeking population.
Participants were 386 patients entering a residential weight loss program (body mass index, 40.7 +/- 10.12 kg/m(2)). We examined the relationships of demographic factors, pain types, and emotional status with both baseline DFi and short-term weight loss.
Regression analysis showed that overall, total pain scores significantly predicted DFi even after controlling for other confounders (p < .05). Leg pain, joint pain, and headache predicted DFi (p's < .05) among women. Among both men and women, depression severity predicted DFi (p's < .01). For the entire sample, there was an inverse bivariate relationship between total pain score and weight loss (p < .001). Joint pain and depression (among women) and age and depression (among men) predicted reduced weight loss (p's < .05).
These results highlight the value of assessing both pain and emotional status for individuals undergoing weight loss treatment since these may interfere recommendations to increase activity.
International Journal of Behavioral Medicine 04/2010; 17(2):118-24. · 2.63 Impact Factor
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ABSTRACT: In obese subjects, the liver may be differentially affected by significant weight loss depending on as yet unknown factors. We explored clinical factors associated with serum alanine aminotransferase (ALT) changes during significant weight loss in a residential weight loss program. Clinical data from 362 adults who received a comprehensive weight loss intervention (ie, diets, physical fitness, and behavioral modification) in the program were analyzed. Serum ALT was used as a surrogate marker of liver injury. The ALT changes during the program were calculated to create study outcome categories (improvement, no change, or deterioration of ALT during significant weight loss). Variables of demography, lifestyle, and comorbidities at baseline, and total/rate of weight change during the program were explored for associations with the ALT change categories using multiple logistic regression models. Variation by sex was apparent among predictors of ALT deterioration; men with rapid weight loss and women with higher initial body mass index were more likely to experience ALT deterioration, whereas men with prior alcohol consumption were less likely to experience ALT deterioration even after adjusting for baseline ALT (Ps < .03). Variation by age was apparent among predictors of ALT improvement; younger patients with current smoking and older patients with rapid weight loss, diabetes or impaired fasting glucose, or sleep apnea or who followed a reduced-carbohydrate diet were less likely to experience ALT improvement (Ps < .05). A number of clinical factors influence ALT changes during weight loss in sex- and age-specific manners. The patterns that we detected may have pathophysiologic significance beyond the practical implications of our findings in clinical practice related to underlying changes in fat metabolism.
Metabolism: clinical and experimental 09/2009; 59(2):177-85. · 2.59 Impact Factor
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ABSTRACT: The relationships between body mass index (BMI) and sleep disturbance, sleep disturbance and pain, and obesity and pain are documented; however, there is a paucity of research exploring how sleep relates to pain in obese populations.
The participants comprized 386 (234 women, 152 men) obese (BMI M=40.7) adult (age M=51.0 y) patients enrolling in a 4-week residential obesity treatment program. All information was gathered as part of the initial program evaluation.
The prevalence of patients reporting at least 1 disturbed sleep symptom was 84.8%. The prevalence of patients reporting at least 1 type of pain was 83.4%. After controlling for depression, anxiety, BMI, age, and sleep apnea treatment, regression analyses showed that daytime sleepiness, night sweats (P<0.01), difficulties falling asleep, and difficulties staying asleep (P<0.05) predicted the total number of pain symptoms reported by women. Among men, controlling for the same variables, fatigue (P<0.01), night sweats, and difficulty falling asleep (P<0.05) predicted the number of pain symptoms reported.
These results suggest that in this obese population, disturbed sleep and pain are related, and that this relationship may be different in men and women. Given the prevalence of pain and disturbed sleep in obese populations, this represents a valuable first step in better understanding this relationship.
The Clinical journal of pain 09/2009; 25(7):584-9. · 3.01 Impact Factor
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Christopher B Newgard,
Jie An,
James R Bain,
Michael J Muehlbauer,
Robert D Stevens,
Lillian F Lien,
Andrea M Haqq,
Svati H Shah,
Michelle Arlotto,
Cris A Slentz, [......],
Dianne Gallup,
Olga Ilkayeva,
Brett R Wenner,
William S Yancy, Howard Eisenson,
Gerald Musante,
Richard S Surwit,
David S Millington,
Mark D Butler,
Laura P Svetkey
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ABSTRACT: Metabolomic profiling of obese versus lean humans reveals a branched-chain amino acid (BCAA)-related metabolite signature that is suggestive of increased catabolism of BCAA and correlated with insulin resistance. To test its impact on metabolic homeostasis, we fed rats on high-fat (HF), HF with supplemented BCAA (HF/BCAA), or standard chow (SC) diets. Despite having reduced food intake and a low rate of weight gain equivalent to the SC group, HF/BCAA rats were as insulin resistant as HF rats. Pair-feeding of HF diet to match the HF/BCAA animals or BCAA addition to SC diet did not cause insulin resistance. Insulin resistance induced by HF/BCAA feeding was accompanied by chronic phosphorylation of mTOR, JNK, and IRS1Ser307 and by accumulation of multiple acylcarnitines in muscle, and it was reversed by the mTOR inhibitor, rapamycin. Our findings show that in the context of a dietary pattern that includes high fat consumption, BCAA contributes to development of obesity-associated insulin resistance.
Cell metabolism 05/2009; 9(4):311-26. · 17.35 Impact Factor
