[FIBROMYALGIA, OBESITY AND ALL THAT LIES IN BETWEEN]

Chronic pain is an issue of increasing health concern, with a negative impact on suffering patients, their families, and society since it is contributing to high health care costs and loss of productivity. Fibromyalgia is one of the most common causes of chronic pain, especially in women, and is associated with several comorbidities, leading to both increased levels of distress as well as decreased function. Obesity is another chronic disease, with increasing prevalence around the world, associated with increasing morbidity and mortality. In their study published in the present issue of Harefuah, Blokh Kerpel et al found a strong link between these two epidemics - fibromyalgia and obesity. This association contributes to our understanding regarding the epidemiology and pathogenesis of fibromyalgia. Obesity also negatively affects the course of fibromyalgia. Obese patients with fibromyalgia experience more pain, are more depressive, have reduced mobility and function and use more medications. Moreover, feasibility and efficacy of treatment interventions is challenging, especially in terms of physical activity - the mainstream of fibromyalgia treatment - which is severely reduced in obese patients. Optimal treatment for obese patients with fibromyalgia must address these issues.