Beyond Analgesia: Preliminary Observations of Appetite and Weight Changes After Spinal Cord Stimulation

Spinal cord stimulation (SCS) is an established therapy for chronic pain, primarily used for analgesia; however, its broader physiologic effects remain poorly characterized. This retrospective observational cohort study evaluated whether SCS implantation was associated with changes in appetite and body weight in patients with chronic pain. Eighteen patients with permanent SCS implants (10 females, eight males; aged 43-75 years) were reviewed. Outcomes included weight loss, weight gain, or no change in weight, along with self-reported appetite changes following implantation. Weight loss was observed in six patients (33%), ranging from 6.8 to 22.6 kgs, all of whom reported decreased appetite. Two patients (11%) experienced weight gain, while 10 patients (56%) demonstrated no significant weight change. Overall, seven patients (39%) reported decreased appetite after SCS implantation; however, decreased appetite did not consistently translate into measurable weight loss. These findings suggest that SCS may influence appetite regulation in a subset of patients with chronic pain, potentially through central neuromodulatory mechanisms beyond analgesia. Larger prospective studies with standardized metabolic and weight assessments are needed to further evaluate this relationship and its clinical implications.