Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Influence of weight loss on pain, perceived disability and observed functional limitations in obese women

International Journal of Obesity volume 28, pages 269–277 (2004)Cite this article

Abstract

OBJECTIVES: To evaluate the effects of weight reduction by dieting on musculoskeletal pain, perceived disability and observed functional limitations in everyday life.

SUBJECTS: Female outpatients in weight-loss programmes at the Karolinska Hospital, who met the criteria for participating in this study: age 20–65 y and body mass index (BMI) ⩾30 kg/m2. In all, 57 entered the programme studied and 43 completed it.

INTERVENTIONS: Diet programmes for 8–12 weeks and thereafter 6688 kJ/day for >52 weeks.

MAIN OUTCOME MEASURES: Questionnaires on musculoskeletal symptoms and obesity-specific questions on basic activities of daily living (ADL), mobility, housework, occupational disability and activities outside home. Test protocol developed for observation of functional limitations in obese women. Assessments at baseline, after 12 and after 64 weeks of dieting.

RESULTS: In all, 75% completed the study. Weight loss was 14% (14.7±6.1 kg) at 12 weeks and, due to a weight relapse, 10% (10.1±8.1 kg) at 64 weeks. At the end of the study period, the proportion of current pain from lower backs and feet had normalised. Important perceived improvements were ability to rise from having fallen over, to walk up stairs and to lift heavy things. Most functional limitations improved, such as climbing onto high stools, walking up stairs with grocery bags, doing pedicure, rising from floor or low furniture. The questionnaire results partly followed the weight development, but the observed improvements were long-lasting.

CONCLUSIONS: Weight reduction had positive short-term effects on musculoskeletal pain, perceived disability and observed functional limitations. A partial weight relapse had some impact on perceived pain and disability, but not on observed limitations. The maintained improvements may be due to weight loss, but also less pain and increased physical activity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Fine JT, Colditz GA, Coakley EH, Moseley G, Manson JE, Willett WC, Kawachi I . A prospective study of weight change and health-related quality of life in women. JAMA 1999; 282: 2136–2142.

    Article  CAS  Google Scholar 

  2. Fontaine KB, Barofsky I, Andersen RE, Bartlett SJ, Wiersima L, Cheskin LJ, Franckowiak SC . Impact of weight loss on health-related quality of life. Qual Life Res 1999; 8: 275–277.

    Article  CAS  Google Scholar 

  3. Wadden TA, Steen SN, Wingate BJ, Foster GD . Psychosocial consequences of weight reduction: how much weight loss is enough? Am J Clin Nutr 1996; 63 (Suppl 3): 461–465.

    Article  Google Scholar 

  4. Foster GD, Wadden TA, Kendall PC, Stunkard AJ, Vogt RA . Psychological effects of weight loss and regain: a prospective evaluation. J Consult Clin Psychol 1996; 64: 752–757.

    Article  CAS  Google Scholar 

  5. Sullivan M, Karlsson J, Sjöström L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S, Náslund I, Olbe L, Wedel H . Swedish obese subjects (SOS)—an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord 1993; 17: 503–512.

    CAS  PubMed  Google Scholar 

  6. Skender ML, Goodrick GK, Del Junco DJ, Reeves RS, Darnell L, Gotto AM, Foreyt JP . Comparison of 2-year weight loss trends in behavioral treatments of obesity: diet, exercise, and combination interventions. J Am Diet Assoc 1996; 96: 342–346.

    Article  CAS  Google Scholar 

  7. Walsh MF, Flynn TJ . A 54-month evaluation of a popular very low calorie diet program. J Fam Pract 1995; 41: 231–236.

    CAS  PubMed  Google Scholar 

  8. Evers Larsson U, Mattsson E . Influence of weight loss programmes on walking speed and relative oxygen cost (%VO2max) in obese women during walking. J Rehabil Med 2003; 35: 1–7.

    Article  Google Scholar 

  9. Saris WH . Fit, fat and fat free: the metabolic aspects of weight control. Int J Obes Relat Metab Disord Suppl 1998; 22: 15–21.

    Google Scholar 

  10. Jakicic JM, Clark K, Coleman E, Donnelly JE, Foreyt J, Melanson E, Volek J, Volpe SL, American College of Sports Medicine. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2001; 33: 2145–2156.

    Article  CAS  Google Scholar 

  11. Blair SN, Kampert JB, Kohl HW, Barlow CE, Macera CA, Paffenberger RS, Gibbons LW . Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276: 205–210.

    Article  CAS  Google Scholar 

  12. Han TS, Tijhuis MA, Lean ME, Seidell JC . Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998; 88: 1814–1820.

    Article  CAS  Google Scholar 

  13. Lean ME, Han TS, Seidell JC . Impairment of health and quality of life in people with large waist circumference. Lancet 1998; 351: 853–856.

    Article  CAS  Google Scholar 

  14. Evers Larsson U, Mattsson E . Functional limitations linked to high body mass index, age and current pain in obese women. Int J Obes Relat Metab Disord 2001; 25: 893–899.

    Article  CAS  Google Scholar 

  15. Han TS, Schouten JS, Lean ME, Seidell JC . The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord 1997; 21: 600–607.

    Article  CAS  Google Scholar 

  16. Mattsson E, Evers Larsson U, Rössner S . Is walking for exercise too exhausting for obese women? Int J Obes Relat Metab Disord 1997; 21: 380–386.

    Article  CAS  Google Scholar 

  17. Kiernan M, King AC, Kraemer HC, Stefanick ML, Killen JD . Characteristics of successful and unsuccessful dieters: an application of signal detection methodology. Ann Behav Med 1998; 20: 1–6.

    Article  CAS  Google Scholar 

  18. Foster GD, Wadden TA, Vogt RA, Brewer G . What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol 1997; 65: 79–85.

    Article  CAS  Google Scholar 

  19. Örebroformulär 007D. FSF-METOD AB. Örebro: Sweden.

  20. Kuorinka I, Jonsson B, Kilbom Å, Vinterberg H, Biering-Sörensen F, Andersson G, Jörgensen K . Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987; 18: 233–237; (www.sciencedirect.com).

    Article  CAS  Google Scholar 

  21. Evers Larsson U, Mattsson E . Perceived disability and observed functional limitations in obese women. Int J Obes Relat Metab Disord 2001; 25: 1705–1712.

    Article  Google Scholar 

  22. Borg GAV . Borg's perceived exertion and pain scales. Human Kinetics: Leeds, 1998.

    Google Scholar 

  23. Siegel S, Castellan Jr NJ . The case of K related samples. In: Siegel S, Castellan Jr NJ (eds). Nonparametric statistics for the behavioral sciences. McGraw-Hill Book Co.: Singapore, 1998. pp 180–181.

    Google Scholar 

  24. Bruton A, Conway JH, Holgate ST . Reliability: What is it, and how is it measured? Physiotherapy 2000; 86: 94–99.

    Article  Google Scholar 

  25. Sullivan M, Karlsson J, Ware JE . The Swedish SF-36 Health Survey I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general population in Sweden. Soc Sci Med 1995; 41: 1349–1358.

    Article  CAS  Google Scholar 

  26. Sullivan M, Karlsson J, Sjöström L, Taft C . Why quality of life measures should be used in the treatment of patients with obesity. In: Björntorp P (ed). International textbook of obesity. John Wiley & Sons: Chichester, 2001.

    Google Scholar 

  27. Verbrugge LM, Jette AM . The disablement process. Soc Sci Med 1994; 38: 1–14.

    Article  CAS  Google Scholar 

  28. Fontaine KR, Bartlett SJ, Barofsky I . Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord 2000; 27: 101–105.

    Article  CAS  Google Scholar 

  29. Ljungquist T, Jensen IB, Nygren Å, Harms-Ringdahl K . Physical performance tests for people with long-term spinal pain—aspects of construct validity. J Rehabil Med 2003; 35: 69–75.

    Article  Google Scholar 

  30. Barofsky I, Fontaine KR, Cheskin LJ . Pain in the obese: impact on health-related quality-of-life. Ann Behav Med 1998; 19: 408–410.

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported by the Neurotec Department, Division of Physiotherapy, and the Committee for the Health and Caring Sciences at the Karolinska Institutet. The study was carried out at the Division of Physiotherapy and the Department of Medicine at the Karolinska Institutet. We thank Professor Stephan Rössner and his staff for generously providing patients, and we are very grateful to all these patients for spending time to participate in our study. We are much obliged to Elisabeth Berg, statistician, KI, and Tim Crosfield, linguistic reviewer, for their help.

Author information

Authors and Affiliations

  1. Neurotec Department, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden

    U Evers Larsson

Authors
  1. U Evers Larsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to U Evers Larsson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Evers Larsson, U. Influence of weight loss on pain, perceived disability and observed functional limitations in obese women. Int J Obes 28, 269–277 (2004). https://doi.org/10.1038/sj.ijo.0802534

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802534

Keywords

This article is cited by

Search

Advanced search

Quick links