Lifestyle Modification Program for Overweight and Obese Fibromyalgia Patients

描述（由申请人提供）：这是第三次R21提交，建议对生活方式改变计划进行初步评价，以改善超重和肥胖纤维肌痛综合征（FMS）患者的体重和症状管理。文献和我们自己的数据表明，超重和肥胖在FMS中相当普遍，肥胖可能与FMS的症状严重程度、功能障碍和神经内分泌失调有关。我们的数据还表明，肥胖可能会削弱激活康复FMS的临床效益。通过改善饮食和增加日常体育活动来帮助患者采用健康生活方式的治疗努力已越来越被认为是体重管理和促进健康的可行选择。在这个项目中，我们计划招募80名超重和肥胖患者。符合条件的患者将接受为期12周（每周2小时）的计划;他们将被随机分配到1）生活方式改变计划（LMod）或2）支持性教育（SEd）。这两个项目都提供8小时的营养教育。LMod还将提供16小时的认知行为和动机增强方法，通过日常生活和应对来改善身体功能。SEd方案侧重于提供基本的FMS教育和支持性/非指导性讨论。所有患者将在治疗前、治疗后和3个月随访时接受重复评估，其中他们将接受基本体格检查和完整的自我报告清单、血液检查以及7天的日常活动和饮食习惯家庭评估。该项目将解决三个具体目标：1）评价LMod计划对日常体力活动，热量摄入，体重减轻和肥胖相关QOL的影响，2）评价LMod计划对FMS相关症状和残疾的影响，3）评价LMod计划对FMS神经内分泌和免疫脆弱性以及一般健康指标的影响。我们希望，从这个拟议的项目的结果将提供翔实的试点数据，以指导未来的临床研究，以最大限度地提高治疗效果，从康复FMS患者。 肥胖是最重要的公共卫生问题之一。纤维肌痛综合征（FMS）中的肥胖似乎为疾病的成功管理提供了进一步的并发症。该项目将帮助我们测试一个改善体重和FMS管理并促进整体健康的计划。

DESCRIPTION (provided by applicant): This is a third R21submission proposing to conduct a preliminary evaluation of a lifestyle modification program to improve weight and symptom management in overweight and obese patients with fibromyalgia syndrome (FMS). Literature and our own data suggest that overweight and obesity are quite prevalent in FMS and that obesity may be related to symptom severity, functional impairment, and neuroendocrine dysregulation in FMS. Our data also suggests that obesity may attenuate clinical benefit of activating rehabilitation for FMS. Therapeutic effort to help patients adopt the healthy lifestyle via improving diet and increase physical activities via daily routines have gained increasing recognition as a viable option for weight management and promotion of health in general. In this project, we plan to recruit 80 overweight and obese patients. Eligible patients will undergo a 12 week (2 hours weekly) program; they will be randomly assigned to either 1) Lifestyle Modification Program (LMod) or 2) Supportive Education (SEd). Both programs offer 8 hours of nutritional education. LMod will also provide 16 hours of cognitive-behavioral and motivation enhancement approaches to improve physical functioning via daily routines and coping. SEd protocol focuses on providing basic FMS education and supportive/nondirective discussions. All patients will undergo repeated assessments at pre-treatment, post-treatment and 3 month follow-up, in which they will receive a basic physical examination and complete self-report inventories, blood tests, and 7-day home assessment for daily activity and dietary habit. The project will address three specific aims: 1) To evaluate the effect of the LMod program on daily physical activity, caloric intake, weight loss, and obesity-related QOL, 2) To evaluate the effect of the LMod program on FMS-related symptoms and disability, 3) To evaluate the effect of the LMod program on the neuroendocrine and immunological vulnerability for FMS as well as on the general health indices. We expect that the results from this proposed project will provide informative pilot data to guide future clinical research to maximize treatment outcomes from rehabilitation for FMS patients. PUBLIC HEALTH RELEVANCE Obesity is one of the most significant public health concerns. Obesity in fibromyalgia syndrome (FMS) appears to present further complications for successful management of the illness. This project will help us test a program for improving weight and FMS management and promoting general health.