Meta-analysisindependent cross-checkabstract only checked I-INTC-11 standard review
Fibromyalgia and obesity
Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis.
Overview
D'Onghia M et al.. Semin Arthritis Rheum 2021 · PMID 33676126 · DOI 10.1016/j.semarthrit.2021.02.007
About one in three people with fibromyalgia has obesity; early studies suggest weight loss, including surgery, may ease symptoms.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Review FM and obesity
- How was the study done?
Systematic review and meta-analysis
- How many people, animals or samples were studied?
41 studies
- What was actually found?
Obesity common in FM; weight loss may help
- How large was the observed effect?
Obesity prevalence 35.7% (31.8-39.9%)
- What do the results mean in everyday life?
Losing weight may help fibromyalgia.
- What are the study's limitations?
High risk of bias; few weight-loss studies
- What does it say about Elawady's specific claim?
Does not support 'surgery causes fibromyalgia'
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Proof of benefit or harm from sleeve gastrectomy
Scientific in-depth review
1. Full reference
- Authors
- D'Onghia M et al.
- Journal
- Semin Arthritis Rheum
- Year
- 2021
- Identifier
- PMID 33676126 DOI 10.1016/j.semarthrit.2021.02.007
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Authors declare no competing interests.
2. Research question
What is the relationship between fibromyalgia and obesity, including the effect of weight loss?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis (41 studies)
- Population
Patients with fibromyalgia
- Country
International (higher figures in USA)
- Period
Searches to September 2020
- Sample size
41 articles
- Inclusion and exclusion criteria
MedLine, CENTRAL, Web of Science
4. Methods and endpoints
- Exposure / intervention
Obesity; weight-loss strategies (bariatric surgery, diet/exercise, behavioural)
- Comparator
Non-obese
- Endpoints
Obesity prevalence in FM; FM severity domains
- Statistical methods
Random-effects pooling of prevalence
5. Actual results
- Results
Pooled prevalence of obesity in FM 35.7% (95% CI 31.8-39.9%). Obesity associated with pain severity, tender points, stiffness, fatigue, function, sleep, cognition and quality of life (weak correlations on average). Few studies on weight loss (bariatric surgery, diet/exercise, behavioural) gave preliminary evidence of benefit for FM symptoms. Overall risk of bias high.
- Absolute risks
not applicable
- Authors' conclusion
Data support a potential interplay between obesity and FM symptoms; weight management should be encouraged.
6. Strengths
- Comprehensive search
- Meta-analysis of prevalence
7. Weaknesses
- High risk of bias in included studies
- Few weight-loss studies
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Informal judgement; authors report high risk of bias of primary studies.
9. Assessment of the statistical interpretation
Prevalence estimate fairly precise; weight-loss effect only preliminary.
10. Relevance to the specific claim
Obesity is associated with worse fibromyalgia, and weight loss including bariatric surgery shows preliminary benefit; no signal that surgery causes fibromyalgia.
11. Independent contrary findings
None identified.
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Limits the claim: the available direction of evidence is toward improvement, not causation.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | high |
| Precision of results | moderate |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Long-term FM outcomes after sleeve gastrectomy.
15. Linked fact checks
- Sleeve gastrectomy causes autoimmune diseases and fibromyalgia. – Studies contradicting or limiting the claim