Pain is adversely related to weight loss maintenance following bariatric surgery

Surg Obes Relat Dis. 2021 Dec;17(12):2026-2032. doi: 10.1016/j.soard.2021.08.025. Epub 2021 Sep 3.

Abstract

Background: Pain and obesity are frequently co-morbid health conditions; thus, it is unsurprising that pain is commonly experienced by individuals seeking bariatric surgery. While pain is generally reduced in the short-term after surgery, there is also variability in pain outcomes and less is known about how unresolved or recurring pain may relate to long-term weight loss and weight loss maintenance.

Objectives: This study evaluated trajectories of pain scores through 7 years following bariatric surgery and whether higher pain levels related to poorer weight loss and greater weight regain.

Setting: Data were collected from 3 university hospitals, 1 private not-for-profit research institute, and 1 community hospital.

Methods: Self-report measures of pain and weight change data were utilized for 1702 adults seeking Roux-en-Y gastric bypass surgery from the Longitudinal Assessment for Bariatric Surgery (LABS) cohort. A series of linear mixed models examined trajectories of pain scores and the concurrent predictive relationship between pain and weight outcomes from pre-surgery through 7 years post-surgery.

Results: Overall bodily-, hip-, and knee-pain improved through 2 years, deteriorated from 2-5 years, and then slightly improved from 5-7 years following surgery (P < .001). Greater pain was concurrently associated with less weight loss and greater weight regain over time (P ≤ .006).

Conclusion: Pain is evident in the long-term following bariatric surgery and associated with suboptimal weight outcomes. More research is needed to identify mechanisms underlying this relationship, which may ultimately help develop appropriate pain assessment and treatment strategies to ensure optimal post-surgery outcomes.

Keywords: Bariatric surgery; LABS; Pain; Weight loss; Weight regain.

MeSH terms

  • Adult
  • Bariatric Surgery* / adverse effects
  • Follow-Up Studies
  • Gastric Bypass* / adverse effects
  • Humans
  • Obesity, Morbid* / surgery
  • Pain
  • Weight Loss