Fat mass, but not fat-free mass, predicts increased foot pain with obesity, independent of bariatric surgery

Tom P. Walsh, Stephen J. Quinn, Angela M. Evans, Alison Yaxley, Jacob A. Chisholm, Lilian Kow, E. Michael Shanahan

Research output: Contribution to journalArticle

Abstract

Background: Foot pain is a common manifestation of obesity. Objective: To determine if bariatric surgery is associated with a reduction in foot pain and if body mass index (BMI) or body composition predict a change in foot pain. Setting: University hospital. Methods: Participants with foot pain awaiting bariatric surgery were recruited for this prospective study. Multivariable linear regression was used to determine predictors of change in foot pain between baseline and 6-month follow-up using body composition (fat mass index and fat-free mass index) or BMI, adjusting for, depression, age, sex, and group (surgery versus control). Results: Forty-five participants (38 female), mean ± standard deviation age of 45.7 ± 9.4 years, were recruited for this study. Twenty-nine participants mean ± standard deviation BMI of 44.8 ± 7.0 kg underwent bariatric surgery, while 16 participants mean ± standard deviation BMI of 47.9 ± 5.2 kg were on the waiting list (control). One participant was lost to follow-up. The treatment group lost a mean of 24.3 kg (95% confidence interval [CI] 21.1–27.5), while the control group gained 1.2 kg (95% CI −2.5 to 4.9), respectively. In multivariable analysis, bariatric surgery was significantly associated with reduced foot pain at 6-month follow-up −32.6 points (95% CI −43.8 to −21.4, P <.001), while fat mass index was significantly associated with increased pain at follow-up 1.5 points (95% CI.2 to 2.8, P =.027), after controlling for fat-free mass index, age, sex, and depression. Conclusions: Bariatric surgery was significantly associated with reduced foot pain. Higher baseline fat mass index, but not fat-free mass index or BMI, was predictive of increased foot pain at follow-up. Foot pain may be mediated by metabolic, rather than mechanical, factors in bariatric surgery candidates.

Original languageEnglish
Pages (from-to)1389-1395
Number of pages7
JournalSurgery for Obesity and Related Diseases
Volume14
Issue number9
Early online date25 Jun 2018
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • Bariatric surgery
  • Foot
  • Obesity
  • Pain

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