The Challenges of Weight Loss With Fibromyalgia

Losing weight with fibromyalgia is especially difficult due to several aspects of the condition. At the same time, research shows that a large percentage of people with fibromyalgia are overweight, as well as studies showing that weight loss can help improve symptoms.

Thus, losing weight may be important for you as you work to manage your illness, but you'll need to overcome some extra barriers along the way.

Barriers to Weight Loss

Some of the things that complicate weight loss in fibromyalgia include:

• Problems sticking to a healthy diet
• Unpredictable and fluctuating symptoms
• Exercise intolerance
• Being sedentary, which leads to loss of strength and stamina

Problems Sticking to a Diet

Sticking to a healthy diet can be tricky for anyone. Now add pain and fatigue, which makes it hard to go grocery shopping so you have fresh food all the time.

Cooking? It's not only difficult physically, but thanks to cognitive function (a.k.a. fibro fog) and problems with short-term memory, it's hard for many of us to follow a recipe or remember where we are in the process.

Possible ways to overcome this barrier may not be possible for everyone, due to lifestyle and financial realities. Some of them include:

• Having someone else cook for you
• Subscribing to a meal-box delivery service
• Having meals or fresh groceries delivered
• Keeping simple foods on hand
• Finding ways to make cooking easier on you

Healthy snacks that don't need to be prepared may be a good option for you. These include:

• Fruits
• Vegetables
• Nuts and seeds
• Cottage cheese
• Yogurt

Unpredictable, Fluctuating Symptoms

Much of the time, fibromyalgia is an illness of flares and remissions. You'll feel not-too-bad for a while, then get knocked down by symptoms for days or weeks, then get back to feeling…well, not as horrible. (Most people with this condition experience at least some symptoms during remissions, but they're milder.)

When you're trying to exercise regularly, the ups and downs are killers. It's hard to get into a routine when, some days, you're lucky if you can take a bath and feed yourself.

What often happens is, when you're going through a good spell, you think, "I can handle a light exercise routine now, no problem!" Then, before long, you have a downturn and have to skip a few days.

Then the habit is broken. Once you're feeling better, you may just not think about it right away. Or perhaps you put it off because now you're two weeks behind on everything and have to put all your energy into catching up. You probably recognize this pattern.

It's also easy to wonder if exercise is causing your flares if every time you get a few days into an exercise routine, you have a flare.

Exercise Intolerance

Exercise intolerance is a common symptom of fibromyalgia. It should really be called "activity intolerance," because that's exactly what it is. The moment you exert yourself too much, it can trigger a flare.

And that over-exertion can be from anything: walking around the block, cleaning the house, having sex, grocery shopping, you name it. You do a little too much, and you pay for it. That kind of push-crash-push cycle does you no good at all when it comes to weight loss.

A lot of people discover exercise intolerance and decide they simply can't exercise or exert themselves at all. It's easy to become afraid of it, which is something researchers call kinesiophobia.

Refusing to exert yourself may stop the cycle, but again, it doesn't help with weight loss (or general fitness). It just makes you more out of shape—which can lead to increased pain from stiff joints and tight muscles and connective tissues.

Being Sedentary

When you're in pain, exhausted, and have exercise intolerance, you can't help but be more sedentary than you used to be. That leads to a loss of muscle strength and a drop in stamina, which make ordinary things harder to do...which leads to being more sedentary. It's a difficult cycle to break.

That means the next time you try to get an exercise routine going, you have limitations to your activity level that may even be more constraining than fibromyalgia symptoms. It can be really discouraging to realize that your muscles give out before you can do enough to trigger a flare.

This barrier can be overcome by staying as active as you can be in your day-to-day life. You have to really pay attention to your limits and know your body's warning signs that you're over-doing it.

Another possible solution is isometric exercises and simple yoga stretches that can be performed while you're lying in bed or on the couch.

What Research Shows

Numerous studies have pointed out that fibromyalgia can lead to weight gain and a sedentary lifestyle, and that extra weight can lead to more severe symptoms.

For example, research published in 2018 compared symptom severity between people assigned female at birth with fibromyalgia who were average weight, overweight, and obese based on their body-mass index. Researchers say the obese participants had:

• Higher pain levels
• More tender points (which are used to diagnose fibromyalgia)
• Higher disease activity levels
• More frequent depression

Less research has focused on why fibromites have weight problems and what to do. One of the earliest studies to do so came out in 2015.

Researchers asked obese study participants with fibromyalgia who were between 30 and 60 years old about their physical activity, weight-loss history, and symptom levels. The answers revealed several themes that likely won't surprise many people with this condition:

• A complex relationship between symptoms, daily responsibilities, and weight management
• A lot of emotion tied to the topic of weight
• Need for a weight-loss program led by someone with a lot of compassion and knowledge of fibromyalgia
• A tendency for participants to view themselves as complex, different, and needing a weight-loss program tailored to the illness

In conclusion, the researchers said these participants preferred:

"[A] weight management program for those with [fibromyalgia] that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program."

That may sound great, but is it feasible? The researchers note that it may not be. First, it could be difficult for an agency or organization to design such a program and find leaders with the qualifications to run it.

Second, it could be difficult for many people with this illness to get to that kind of program regularly because of the nature of their symptoms.

A Word From Verywell

For now, you're left with either conventional groups that aren't tailored to your specific needs, or with going it alone. However, as more research is done and more healthcare providers learn about it, better options may crop up.

Until then, it's important for us to know the proper way to approach exercise with fibromyalgia and eat a healthy diet that doesn't exacerbate symptoms.

A healthcare provider may be able to help guide you when it comes to losing weight, so make sure to have that conversation.