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

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) > or =30 kg/m(2). 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.