Fibromyalgia, Weight Gain, and Medication

A woman standing on a set of scales
Adam Foster

Unanticipated weight gain from medication tends to increase the already excruciating difficulties of living with fibromyalgia. There are a lot of moving parts in the fibromyalgia-weight gain association, and they might make it hard to keep the weight off. In this article, I want to go through these various factors to shed light on these linkages and offer some practical recommendations.

First, we’ll take a look at how fibromyalgia can cause weight changes, specifically how metabolic changes, muscle weakness, and inactivity can all play a role. Gaining weight can be influenced by a slowed metabolism and hormonal imbalances such leptin dysregulation, and issues like hypothyroidism are more common in fibromyalgia patients, so we will also examine how this condition makes weight management even more challenging.

From there we’ll go over the most common fibromyalgia medications that can lead to weight gain, as well as how to keep an eye on your progress and discuss any concerns with your doctor if they arise.

Another important topic we will examine is the effect of weight on fibromyalgia symptoms, specifically how being overweight can make pain and inflammation much worse, making it even more difficult to manage the symptoms of fibromyalgia.

So, If you’re trying to lose weight, but are dealing with fibromyalgia, we’ll give you the lowdown on how to change your diet to make healthy eating easier, because there are a lot of moving parts when it comes to this condition. We will also go over the benefits of exercise and how to safely include it in your routine, with an emphasis on targeted therapies and exercises for symptom management and weight loss.

Fibromyalgia and Weight Changes

With an average BMI of 26.64 fibromyalgia patients are more likely to be obese than the overall population, according to the research. Several important fibromyalgia symptoms, such as sadness, sleep difficulties, neuropathic pain, and exhaustion, are all negatively correlated with a higher body mass index (BMI). However, regardless of category, persons who are obese tend to have the worst symptoms, as obesity seems to impact the severity of FM, as shown by the significant discrepancies between obese, normal-weight, and overweight patients. Obesity seemed to cause the most severe exacerbation of symptoms, while there was no statistically significant difference between normal weight and overweight people. Studies such as this one highlight the significance of controlling one’s weight as a holistic strategy for alleviating fibromyalgia symptoms.

Drugs and Extra Poundage

Whilst there is not a huge amount of research into fibromyalgia and weight gain, the few studies that do exist, show that a significant proportion of fibromyalgia patients are overweight or obese. Specifically, 67.27% of the fibromyalgia patients in one study were either overweight or obese. Is this a direct effect of fibromyalgia? probably not, it’s much more likely that it is indirect factors such as being less physically active due to pain, and indeed certain metabolic changes from common pain medication. Another issue that we find may affect these numbers, is how it’s well documented that many diagnosed with fibromyalgia, also have Hypermobility/Ehlers-Danlos syndrome, which has a very high rate of gastric disorders, these disorders, including gastroparesis, dysphagia, and functional GI diseases, which can significantly impact nutritional intake and absorption, leading to underweight conditions

It is no secret I am not a fan of the current diagnostic criteria for fibromyalgia. For me, my views are further reinforced in that the Fibromyalgia label should not be given if there is already a condition like Hypermobility or EDS present when issues such as this present. 

From the limited studies, several important findings have emerged from investigating the link between fibromyalgia weight gain and increasing pain:

Research published in “Arthritis Care & Research” indicated that fibromyalgia sufferers who were overweight or obese experienced more impairment and pain than their normal-weight counterparts.

In a similar vein, the “Journal of Pain Research” found that fibromyalgia patients’ pain severity and quality of life were both negatively impacted by their body mass index (BMI).

Researchers in the journal “Rheumatology” tracked the lives of people with fibromyalgia and discovered that when their weight increased, their pain levels and other symptoms became worse, also finding that those with fibromyalgia who lost weight had less pain and better functional state.

Additionally, “Pain” found that metabolic alterations and chronic inflammation are major contributors to the link between obesity and fibromyalgia pain.

Taken together, these studies add to the growing body of evidence suggesting fibromyalgia sufferers may find relief from their symptoms through weight loss programs. Results may vary from person to person, and a tailored strategy is frequently required for successful fibromyalgia management.

Moreover, the use of medications is very commonplace in pain management, and obesity is linked to illnesses that cause chronic pain. Because of the aforementioned elements, there is a complicated interaction that can cause pain management measures to indirectly cause weight gain and a rise in body fat percentage.

Likewise, several drugs prescribed for fibromyalgia have the potential to cause weight gain, which in turn can worsen the symptoms of the condition and lead to other health problems. 

Fibromyalgia Medications That Cause Weight Gain

One common medicine for fibro is pregabalin. Patients may have an increase in their body weight, nevertheless, Pregabalin remains one of three fibromyalgia treatments approved by the FDA, but it is well known to promote weight gain in some patients, according to a study that examined real-world dose patterns. Additional fibromyalgia drugs authorised by the FDA include duloxetine and milnacipran. Although they are more typically associated with weight gain compared to pregabalin, they can be useful tools in controlling pain and other symptoms.

Implications for Health and Symptoms

The hallmark symptoms of fibromyalgia, increasing sensitivity to pain, extreme exhaustion, and trouble sleeping, can be exacerbated by gaining weight. In addition to making fibromyalgia management more difficult, obesity can worsen co-occurring disorders including anxiety and depression.

Obesity causes a host of secondary health problems; it increases the likelihood of developing cardiovascular disease, diabetes, and metabolic syndrome, among many others. The overall health of individuals with fibromyalgia might be worsened by these illnesses, which further complicates the management of symptoms.

Anticipating and Handling Fibromyalgia Drug Interactions

The use of numerous medications at once to treat different symptoms is known as polypharmacy, and it is common for people with fibromyalgia to undergo this process. Because of the possibility of medication interactions and adverse effects, such as weight gain, this might make therapy far more difficult. Additionally, the use of several drugs together can further complicate the fibromyalgia diagnosis and personalised therapy approaches by interfering with the identification of biomarkers, according to research.

Slow Metabolism

Metabolic rate, the rate at which food is converted into energy in the body, may be slower in fibromyalgia patients. Some studies show that those with Fibromyalgia may have a metabolic rate that is lower than the general population. Because of their slowed metabolism, these people may find it harder to keep the weight off or even lose it.

When compared to healthy controls, exercise-affected individuals with fibromyalgia had lower oxygen consumption and workload, according to a study that looked at their metabolic rate, cardiac response, and aerobic capacity. This points to a decreased aerobic capacity in fibromyalgia patients, which is associated with a slower metabolic rate. Patients with fibromyalgia show changed metabolic processes, according to another study that looked at their metabolic and inflammatory profiles. The researchers found that there were substantial abnormalities in several metabolic indicators.

There are several possible explanations for why those with fibromyalgia may have a slowed metabolism. The metabolic rate might be slowed down when physical activity is reduced due to persistent pain and exhaustion. Hormonal abnormalities, which are common in fibromyalgia, might also impact metabolism. Fibromyalgia is also massively associated with poor sleep quality, which in turn has a deleterious effect on metabolic processes.

A mix of dietary changes and exercise is suggested for metabolic rate management and improvement. If you want to promote your metabolism and general health, eat a balanced diet full of nutritious foods like fruits, vegetables, lean meats, and whole grains. Vitamin D is involved in energy metabolism and muscle function, thus taking supplements could potentially help fibromyalgia patients. It is also crucial to stay hydrated to keep metabolic processes running smoothly.

Likewise, a faster metabolism is one benefit of a regular exercise routine that includes aerobics, strength training, and flexibility exercises.

Leptin Dysregulation

Pain, exhaustion, and sleep difficulties are just a few of the symptoms that people with fibromyalgia often have to contend with. Leptin dysregulation is one less well-known problem that can cause weight gain and increased hunger. If your body’s levels of the hunger hormone leptin are out of whack, you may experience extreme hunger pangs even when you’re not physically hungry. A healthy diet that includes frequent meals can help regulate leptin levels, which in turn aids in appetite suppression and promotes more effective weight management.


Research has demonstrated that people with fibromyalgia frequently have considerably elevated leptin levels when contrasted with healthy persons. Researchers found that individuals with primary fibromyalgia had significantly higher serum leptin levels compared to healthy controls when testing for growth hormone, insulin-like growth factor-1 (IGF-1), and insulin-like growth factor binding protein-3. Clinical variables like pain severity, depression scores, and illness duration were strongly linked with this higher leptin level. It appears from these results that leptin is involved in the physiopathogenesis of fibromyalgia and its symptoms and consequences.

Poor sleep quality, which as we mentioned earlier, is very prevalent in fibromyalgia, can cause metabolic dysregulation, which includes leptin. Sleep disruptions may lower levels of the hunger hormone leptin and raise levels of the hunger hormone ghrelin, according to the research. An increase in hunger and, eventually, weight gain, may be the outcome of a hormonal imbalance. Basically, when you don’t get enough sleep, your body sends confused signals regarding hunger, which might cause you to overeat and struggle with your weight.

Another complication of this multi-faceted problem is the link between leptin imbalance and depression. Research has linked abnormalities in leptin regulation to major depressive disorder. This association further confirms the link between leptin dysregulation and increased appetite in fibromyalgia, which is further supported by the fact that depression is widespread in this population. Managing the emotional and physical components of fibromyalgia is vital due to the connection between mood problems and hunger signals.

Optimal Leptin Level Control


An integrative approach to food and lifestyle is necessary to address leptin imbalance. To better regulate leptin levels and appetite, try the following:

Nutritionally Sound Eating a diet high in fresh produce, lean meats, and whole grains will help keep leptin levels in check. It is also vital to stay away from processed meals and sugars, as these might trigger fluctuations in blood sugar levels.

Additionally, maintaining constant leptin levels is easier with regular meals. Leptin imbalances, caused by skipping meals, increase the likelihood of subsequent overeating. Eat regular, well-balanced meals and snacks to stave off hunger. Raising leptin levels is one of the many benefits of getting a good night’s sleep. Avoid stimulants like caffeine in the hours leading up to bedtime, make sure your bedroom is quiet and comfortable, and stick to a regular sleep schedule. Improving one’s sleep hygiene routines can lead to more balanced hormones and greater rest.

To manage stress, it can be helpful to engage in activities that reduce tension, such yoga, meditation, or light exercise, since stress can also affect hormone balance. Reducing stress aids in regulating all bodily functions, including the signals that tell you when you’re hungry.

Hypothyroidism: A Compounding Factor

Hypothyroidism, a disorder that lowers the metabolic rate, is much more common among fibromyalgia patients. Because of the decrease in caloric expenditure, this link further complicates weight management.

No surprise, hypothyroidism and other thyroid abnormalities are more common among fibromyalgia patients, according to the research. Thyroid disorders, such as hypothyroidism or hyperthyroidism, were reported 2.5 times more often by females with fibromyalgia compared to control patients in one study. T3 uptake levels were considerably lower in the fibromyalgia group compared to the controls, suggesting thyroid dysfunction, and hypothyroidism was the most common diagnosis.

Hypothyroidism is common among fibromyalgia sufferers, according to another study that looked at the link between the two conditions. It revealed a possible association between the intensity of fibromyalgia symptoms and thyroid autoimmunity. The study also highlighted the importance of intracellular thyroid hormone levels over circulating thyroid hormones in fibromyalgia patients, suggesting that the former may not be a reliable indicator of thyroid function.

More and more research points to reduced thyroid activity as a common symptom among fibromyalgia and chronic fatigue syndrome (CFS) patients. This encompasses a wide range of thyroid dysfunctions, including primary hypothyroidism, which can be missed by routine diagnostics. Even though many fibromyalgia patients experience hypothyroidism symptoms, they are often told that their thyroid levels are normal.

For fibromyalgia sufferers, maintaining a healthy weight can be more challenging due to hypothyroidism’s effect on metabolism, which lowers the amount of calories burned. It’s also rather difficult to manage both hypothyroidism and fibromyalgia at the same time since their symptoms overlap.

So, what can you do? 

Well, research suggests that patients with fibromyalgia may find relief from their symptoms through thyroid hormone therapy, which goes beyond the usual T4 replacement. And you can help your thyroid and your health in general, by eating a diet full of healthy foods, such as fruits, vegetables, lean meats, and whole grains. Regular exercise has several health benefits, including weight management, a boosted metabolism, and relief from fibromyalgia and hypothyroidism symptoms. Ensuring that thyroid hormone levels are within the ideal range can be achieved through regular monitoring of thyroid function through blood testing. Improving symptom management and general health can be achieved by collaborating with healthcare practitioners to address hypothyroidism and fibromyalgia simultaneously.

Are there any medications for fibromyalgia that don’t cause weight gain?

For many individuals treating fibromyalgia, it’s vital to identify effective therapies that don’t cause weight gain. It is well-known that some drugs can alleviate the symptoms of fibromyalgia without having a major impact on body weight, a few of them are as follows:

A selective serotonin-norepinephrine reuptake inhibitor (SSNRI) like duloxetine, sold under the brand name Cymbalta, is a regular medication for fibromyalgia. The neurotransmitters serotonin and norepinephrine, which play a role in pain and mood regulation, are elevated, and this is how it works. Researchers have discovered that duloxetine helps fibromyalgia sufferers with pain, physical function, and quality of life. Patients who are worried about their weight may find duloxetine to be an appropriate alternative because, in most cases, it has no discernible effect on weight, either increasing it or decreasing it.

Another selective serotonin reuptake inhibitor (SSNRI) meant for fibromyalgia treatment is milnacipran, brand name Savella. Milnacipran, similar to duloxetine, aids in the management of pain and mood by balancing neurotransmitters. Clinical trials on fibromyalgia patients have shown that milnacipran significantly lessens pain and improves function. Another alternative for people who are concerned about gaining weight is milnacipran, which is deemed weight-neutral because it does not substantially affect body weight in clinical trials.

Anticonvulsant pregabalin (brand name Lyrica) blocks certain calcium channels in the central nervous system, alleviating fibromyalgia pain. Research has indicated that it can greatly alleviate pain and enhance the quality of sleep experienced by individuals with fibromyalgia. While pregabalin does its job, it has caused some people to put on a few extra pounds. It is crucial to check the amount of weight gain with your healthcare practitioner, as this side effect might vary and not everyone will experience it.

Researchers are looking at cannabinoids, which are compounds found in cannabis, to see if they can help with the symptoms of fibromyalgia. Fibromyalgia sufferers may find relief from pain and better sleep quality with the use of cannabis, according to a preliminary study. Nevertheless, these advantages require further comprehensive research. Though reactions to cannabis can vary from person to person, there is no evidence that marijuana causes weight gain. To ascertain whether this treatment is suitable for your situation, it is essential to consult with a healthcare professional.

Factors such as pharmaceutical side effects, stress, and lifestyle choices make it more difficult to manage weight gain in fibromyalgia patients. Nonetheless, if you take a focused strategy, you can achieve your weight loss and health goals far more quickly.

Weight management and symptom relief can be achieved with dietary adjustments, such as a well-rounded diet that includes anti-inflammatory foods in addition to fruits, vegetables, lean meats, and whole grains. Crucial measures also include controlling portion sizes and staying away from processed foods.

Physical Activity: Walking, swimming, or cycling are low-impact workouts that can help control weight without aggravating pain. Light strength training can also be helpful. Maintaining a routine of moderate exercise is preferable to infrequent but vigorous sessions.

Weight gain and fibromyalgia symptoms are closely associated with stress, which can be effectively reduced via the practice of mindfulness, meditation, and cognitive-behavioural therapy (CBT). A good night’s sleep is essential for stress management and general well-being.

Weight loss and symptom alleviation may be possible outcomes of taking nutritional supplements, such as 5-HTP and amino acid blends. Be cautious to check with your doctor before beginning a new supplement program.

Reviewing your medications with your healthcare practitioner regularly will help you discover the ones that are causing you to gain weight. A significant change can be achieved by modifying dosages or utilising weight-neutral substitutes.

Changes to One’s Way of Life: To better control one’s weight and alleviate its symptoms, one should establish a regimen that includes regular eating, exercise, and rest periods. In addition to offering practical advice and emotional support, support groups can be a great resource.

Despite the difficulties caused by fibromyalgia, these methods can help you manage your weight and enhance your quality of life. Finding what works for you and making adjustments that last are the most important things. Over time, even modest, regular efforts can yield big results.


Quick Questions

Does fibromyalgia make one put on extra pounds?
Fatigue, pain, sleep disruptions, and medicine side effects are just a few of the ways that fibromyalgia can cause weight gain.

When persons with fibromyalgia put on a few extra pounds, why is that?
When you’re tired, you don’t want to do as much physical exercise, which means you burn less calories.
A sedentary lifestyle is common among people with chronic pain since it hinders their ability to exercise.
Additionally, hormones that control hunger are disturbed by poor sleep, leading to overeating.
Emotional eating and lack of exercise motivation are symptoms of mental health disorders like depression and anxiety.

When taking medicine for fibromyalgia, how does it affect weight gain?
Because they alter metabolism, hunger, and energy levels, some drugs—including antidepressants, antipsychotics, and anticonvulsants—can induce weight gain.

Is there a drug for fibromyalgia that causes weight gain more often than any other?
Pregabalin is the fibromyalgia medication most commonly associated with weight gain. 


Is there a way to treat fibromyalgia without gaining weight?
Duloxetine and milnacipran are two fibromyalgia drugs that are commonly used because they are less prone to cause weight gain.

Is there a correlation between fibromyalgia fatigue and increased body fat?
Feeling tired makes people less likely to exercise, which in turn lowers their calorie expenditure and puts on weight.


Is it possible to control weight by managing fibromyalgia symptoms?
The use of medication, lifestyle modifications, and non-drug therapy to properly manage symptoms can indeed aid in weight control.

Is there anything that can help with fibromyalgia symptoms and weight management that doesn’t involve medication?
Physical Therapy: Collaborate with a physical therapist/PT’s to create individualised workout programs.
Pain relief and general health may be possible with acupuncture. A few amino acid supplements have shown promise in the management of stress-related weight gain.


In what ways does fibromyalgia-related sleep disruption lead to increased food intake?
When you don’t get enough quality sleep, the hormones that control your hunger are thrown off, and you end up gaining weight.

Can fibromyalgia medicine cause weight gain be reversed?
A good diet, frequent exercise, and a review of drugs with your doctor can help you reverse the weight gain that occurs as a result of medications.

How can I keep a good record of my weight and the symptoms of my fibromyalgia?
If you suffer from fibromyalgia, you may keep track of your symptoms using an app like FibroMapp and your nutrition and exercise habits with MyFitnessPal.