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Because of the metabolic problems occurring in fibromyalgia and CFS, two in-house studies done in our research center showed an average 32 1/2 pound weight gain in this illness. As most of you have found, trying to lose this weight before one has addressed the underlying metabolic problems can be near impossible.

A new study in the Journal of Clinical Rheumatology1 has also noted that people with fibromyalgia are more likely to weigh more. Unfortunately, the perspective of the authors shows through even in the first line of the study where they note, "Fibromyalgia (FM) is a biopsychosocial disorder." So we will take their interpretations with a grain of salt. But the data is interesting. It showed that in fibromyalgia:
  • 0.4 percent were underweight;
  • 25.9 percent normal weight;
  • 29.9 percent overweight;
  • 43.8 percent obese.

When comparing the people with fibromyalgia who were obese with those who had normal weight, the study did find what we have often seen before as well. People suffering with obesity report higher prevalence of abuse (48 versus 33.9 percent, P = 0.016) and sexual abuse (17.3 versus 6.8 percent, P = 0.01) than those with normal weight.

My problem with the study? Although this study was well done, and I applaud the authors, their writing does reflect the general lack of understanding of this illness and the people who suffer with it. The study conclusion? "Physicians treating FM should discuss weight loss with their FM patients. Even if increasing BMI [weight] is not intrinsic to FM, it contributes to poor mood and functional outcome and should be a treatment goal."

As if most people with fibromyalgia who have weight issues haven't tried to lose weight!

So here are a few important points to keep in mind if you start hearing stuff related to this study:

  1. Our studies showed that the average 32.5 pound weight gain occurred after the fibromyalgia symptoms began. In other words, the weight gain was triggered by the illness not the other way around.
  2. The decreased metabolism likely directly contributes to the weight gain. Until this is addressed, it is unlikely that the person will be able to effectively lose weight. Just saying, "lose weight" without addressing these is setting the person up for failure. Key factors that must be addressed for the weight to be lost and the overall symptoms to improve are:

A. Optimizing thyroid function?even if the blood tests are "normal."

B. Optimizing adrenal function. Elevated cortisol can cause weight gain, and inadequate cortisol can cause sugar cravings and food cravings that trigger weight gain.

C. Optimize sleep. Sleep contributes to the production of growth hormone which increases muscle mass and lowers fat. Inadequate sleep is associated with an average 6 1/2 pound weight gain and 30 percent increased risk of obesity.

D. Treat the Candida. Candida overgrowth in the gut has clinically been shown to trigger sugar cravings, and the increased sugar intake can contribute to insulin resistance and weight gain. The sugar craving caused by low blood sugar (from adrenal fatigue) is an irritable "feed me now or I will kill you" kind of feeling. The sugar cravings from Candida are more what I characterize as "the happy Twinkie hunter," where you are happily going through the kitchen cabinets looking for something sweet. It is not uncommon in fibromyalgia to have both. When the underlying adrenal and Candida issues are addressed, not only will you feel dramatically better, but also the weight can come down and the sugar cravings resolve.

E. Begin a walking program. Many of us are afraid to exercise because of the postexertional crashing. Unfortunately, this lack of exercise results in deconditioning, which is devastating in this illness. So start a walking program, and wear a pedometer. Look to increase your walking by about 50 steps a day as able. See my article on Exercise Friend or Foe in Fibromyalgia? In the April2016 issue of TotalHealth for more information.

The free Energy Analysis Program at can analyze your symptoms, and even pertinent lab tests if available, to show you how to optimize energy production and metabolism in your case.

Please do not beat yourself up over the weight gain. It was out of your control. But now with understanding the causes, not only can you feel better, but the weight can also come down as well.



Jacob E Teitelbaum, MD

Jacob Teitelbaum, MD, is a board certified internist and Medical Director of the national Fibromyalgia and Fatigue Centers and Chronicity. He is author of the popular free iPhone application "Cures A-Z," and author of the best-selling books

Dr. Teitelbaum knows CFS/fibromyalgia as an insider — he contracted CFS when he was in medical school and had to drop out for a year to recover. In the ensuing 25 years, he has dedicated his career to finding effective treatments.