Overeating during painful episodes among adults with chronic pain: A preliminary study

Introduction: A bidirectional relationship exists between obesity and chronic pain. How the two variables influence one another is unclear, especially in the context of prescription opioid use. The current study aimed to explore the phenomenon of overeating in the context of chronic pain and obesity among adults prescribed opioids.

Methods: Adults with a self-reported pain condition taking a prescription opioid completed surveys for this exploratory study. Participants provided demographic data and reported appetite changes when in pain. Chi-square analyses and analyses of variances (ANVOAs) were conducted to establish baseline comparability among body mass index (BMI) groups. Relative risk ratios were calculated to determine risk for reporting an increased appetite among BMI groups. Participants' responses to an open-ended question on appetite when in pain were analyzed using qualitative descriptive analysis.

Results: In total, 219 participants' data were analyzed. Of these, 46.8% reported eating less, 38.2% reported an unchanged appetite, and 11.9% reported eating more to feel better when in pain. Adults with obesity were over three times more likely to report an increased appetite compared to adults with normal weight. Participants reported having either a nutritional or a non-food response to painful episodes.

Conclusions: This preliminary study supports that some adults with chronic pain follow poor nutritional patterns when in pain which may make weight management difficult. Pain clinicians should assess and counsel clients for overeating or undereating risks to facilitate pain and weight management.