The Fibromyalgia Diet (Part 1): Weight Loss
Note: This is the first article in an ongoing series. Make sure to check out the next articles after finishing this one:
Could improving fibromyalgia symptoms be as simple as achieving a healthy body weight? If so, what’s the best diet to follow?
In fibromyalgia patients, there is a greater occurrence of depression, overweight, and obesity. (1) These occur in addition to the main symptom: chronic, widespread pain.
Conventional treatment of fibromyalgia includes long-term use of anti-depressants and/or anti-epileptic medications. (2) Both of which are aimed at alleviating some of the pain experienced by fibromyalgia sufferers. While both medications indeed help manage the symptoms of fibromyalgia, neither address the underlying or root cause.
New research suggests that the food we eat plays a pivotal role in mental health. (3) More specifically, foods effect on your body weight could be of paramount importance in treating fibromyalgia.
What is a healthy weight?
Body mass index (BMI) is a measurement that is used to determine the health risk one’s weight plays in their health. While it is not a perfect metric, the BMI can be used as a general baseline. (4) You can calculate your own body mass index here.
The following measurements are used for BMI calculations:
- Underweight = <18.5
- Normal weight = 18.5–24.9
- Overweight = 25–29.9
- Obesity = BMI of 30 or greater
In one fibromyalgia study, it was shown that the higher the BMI, the higher the number of tender points found. (5) In the same study, patients with a BMI greater than 25 were also likely to have associated with greater pain sensitivity, poorer sleep quality, and reduced physical strength and flexibility. (6)
A survey found that 70% of those suffering from fibromyalgia had a BMI greater than 25. In the same survey, 43% of participants had a BMI greater than 30 — thus defining them as obese. (7)
Weight clearly has a strong connection to fibromyalgia. In any treatment plan for fibromyalgia, a comfortable weight-loss strategy needs to be put into effect.
We recommend following a paleo template for all weight-loss endeavors. This will ensure there is minimal stress to your body. For a specific outline of how to follow a paleo diet, please see this post.
Accordingly to the world health organization (WHO), the waist to hip ratio is used as a measure of obesity. Adipose or fat tissue distributed through the abdomen is a far greater health risk than adipose tissue around the hips/buttocks.
The National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) states that women with waist–hip ratios of more than 0.8, and men with more than 1.0, are at increased risk for more serious conditions. (8)
To find out your waist-hip ratio, click here.
Does weight loss help fibromyalgia sufferers?
It should come as no surprise that a healthy weight decreases pain levels. This holds true whether you have fibromyalgia or not. However, in those with fibromyalgia, maintaining a healthy body weight becomes even more important.
A study done in 2012 examined the benefits of weight loss in those with both obesity and fibromyalgia. The study lasted for 6 months. Half of the participants were put on a calorie-restricted diet (1200 calories/day). This group was instructed to obtain their calories from 20% protein, 50% carbohydrate, and 30% fat. (9)
The other participants were told to follow the above ratios of proteins, carbs, and fats but were instructed to not limit calories. intake.
The average BMI of the weight-loss group before treatment was 32.3. After the 6 months, the average BMI was 29.03. This group went from being obese to overweight it only 6 months. The BMI of the control group remained the same throughout the trial at 32.8. (10)
More importantly, the participants who were part of the weight loss group also experienced: (11)
- Decreased fibromyalgia impact questionnaire (FIQ) score
- The FIQ was developed from information gathered from patient reports, functional status instruments, and clinical observations. This instrument measures physical functioning, work status (missed days of work and job difficulty), depression, anxiety, morning tiredness, pain, stiffness, fatigue, and well-being over the past week. (12)
- Patients in the weight loss group show significantly lower levels of physical impairment, pain, fatigue, and depression when compared to the control group.
- Lower number of trigger points
- Lowered sensitivity to the trigger points (especially on the lower body)
- Better sleep quality
- Lowering of laboratory markers for inflammation
- C-reactive protein (CRP)
- Interleukin 6
So, we now know that weight loss is an important step in the treatment of fibromyalgia. But how do we comfortably lose weight? And, keep it off? The answer is not found in a fancy new diet trend.
How to lose weight comfortably (even if you have fibromyalgia)
If you’re at all familiar with my work, you know that I am not an ambassador of diets. Instead, dietary changes should be comfortable, lifestyle alterations that can remain in effect for the long term. In the management of fibromyalgia, gradual, sustainable changes make the greatest impact.
Many patients suffering from fibromyalgia have concurrent illnesses. One of the most common is adrenal fatigue. Dietary alterations need to be gradual so as not to cause additional stress to the body. It’s best to think of weight loss for fibromyalgia patients as a marathon, not a sprint.
Extreme caloric deprivation, ultra-low-carb diets, and other plans that emphasize extreme measures rarely work well for those with fibromyalgia. Often because they’re an added stress to the system.
Instead, follow the below steps. They’re gentle, sustainable dietary changes that gently guide you towards a paleo-style template. If you remember from the study I quoted above, participants were still getting half of their calories from carbohydrates. Often, these were sourced from grains. (13)
By shifting to a paleo-style template, your daily calories tend to be quite balanced between carbohydrates, proteins, and fats. Total calories from carbohydrates will only be about 30% of your daily total.
Since inflammation is one of the main drivers of fibromyalgia, it follows that diet should be low in inflammatory foods. General guidelines recommend higher overall protein intake (especially in the morning to help stabilize blood glucose throughout the day) and moderate carbohydrates are eaten mostly later in the day.
A healthy diet should provide you all the necessary vitamins and nutrients. Without requiring supplementation. For those with fibromyalgia, I recommend a diet high in the following micronutrients:
Used as an antioxidant for immune support. (14)
- Fruit sources: papaya, strawberries, pineapple, oranges, kiwi, cantaloupe, raspberries, blueberries, and cranberries
- Vegetable sources: broccoli, Brussels sprouts, cauliflower, kale, cabbage, and bok choy
Used for maintenance of gastrointestinal and immune health.
- Top sources: yogurt, kimchi, kefir, kombucha, raw sauerkraut, beet kvass.
To support muscle and skeletal weakness.
- Top sources: daily sun baths. Duration should be half the time it takes your skin to turn pink.
Low intake can cause increased renin, cholesterol, triglycerides, and all-cause mortality. Symptoms can include lethargy, nausea, and hypotension.
- Adding salt to your food (to taste) should ensure your daily sodium levels are optimized.
High levels are associated with lower blood pressure, and low levels or a deficiency is associated with hypertension, high blood sugar, and being overweight.
- Top sources: potato, halibut, plantains, rockfish, sweet potato, beet greens, bananas, sockeye salmon, acorn squash, avocado, parsnips, pumpkins, kohlrabi, duck, and mushrooms.
Calcium, zinc, and magnesium:
This multi-formulation has been shown to have stress-lowering effects.
- Calcium: sesame seeds, sardines (with bones), yogurt, collard greens, spinach, cheese, turnip greens, sockeye salmon (with bones), molasses, and mustard greens.
- Magnesium: oysters, liver, crab, lobster, beef, lamb, endive, pork, nuts, dark chocolate, and crimini mushrooms
- Zinc: dark leafy greens, nuts and seeds, fish (mackerel), avocados, dairy products (if tolerated), bananas, figs, and dark chocolate
More tips on starting a paleo diet for those with fibromyalgia
Keep it simple.
You don’t have to adopt the Paleo diet overnight. Try removing one food group at a time as you slowly work towards the Paleo template. Remember, you’re changing your lifestyle. You’re not going on a diet.
A healthy meal doesn’t have to be complicated. A protein like meat or fish, plenty of non-starchy vegetables, whole foods carbohydrates from root vegetables or fruit, and some healthy fat. Voila, a paleo dinner.
Be sure to eat enough.
For those with fibromyalgia, less food is not better when it comes to losing weight. Your body needs optimum levels of proteins, fats, carbohydrates, and the micronutrients associated with each.
Reaching for weight loss shakes or restricting calories robs your body of the nutrients it needs to overcome inflammation. Unfortunately, this ends up causing additional stress which ultimately prolongs treatment time.
Don’t worry, you’re still likely to lose weight on a Paleo diet. Even if you’re not consciously restricting calories. By following a paleo template, you end up getting more calories from proteins and fats. Gram for gram, proteins are far more satiating than carbohydrates. This means that you’ll feel full on less food. This is why weight loss tends to happen effortlessly while on a paleo diet.
Get friends and family on board
The hardest aspect of a new diet or lifestyle change is staying committed. The first couple weeks are full of ambition and energy. But as the month’s progress, staying committed becomes more challenging. This is especially true when you try to do this on your own. Or, if you’re having to cook separate meals for yourself and family.
Making major lifestyle changes without any social support is not only difficult, it’s often unsustainable. Embarking on your Paleo weight loss with friends and family will greatly increase your chances of success. Not to mention, encouragement, motivation, and even some friendly competition between your family and peers will keep these changes sustainable.
Ok, now you know the first step of an optimal fibromyalgia diet.
Next week, we discuss the types of foods known to increase inflammation in those with fibromyalgia.
Now, I want to hear from you!
How has weight reduction helped your pain levels?
Originally published at Flourish Clinic.