The Relationship Between Eating Behaviors and Functional Status in Female Patients Diagnosed with Fibromyalgia
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Fibromyalgia Syndrome
Body Mass Index
Eating Behaviors
Quality Of Life

How to Cite

Mengi, A. (2023). The Relationship Between Eating Behaviors and Functional Status in Female Patients Diagnosed with Fibromyalgia. Galician Medical Journal, 30(2), E202323.


Aim. To evaluate whether eating behaviors of female patients with fibromyalgia syndrome differ from those of the healthy population, what factors affect these behaviors, and whether eating behaviors are effective on patients’ life quality and functional status.

Materials and Methods. This cross-sectional and observational study included 55 female fibromyalgia patients and 55 healthy female volunteers. All participants were assessed using demographic data, body mass index (BMI), and the Three-Factor Eating Questionnaire (TFEQ) (Uncontrolled Eating, Cognitive Restraint, Emotional Eating, and Hunger Susceptibility). Fibromyalgia patients were assessed using the Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ).

Results. BMI, Uncontrolled Eating, and Hunger Susceptibility scores differed significantly between fibromyalgia patients and healthy volunteers (p < 0.05). In fibromyalgia patients, the TFEQ subscores were not correlated with the FIQ (p > 0.05). There was a positive correlation between the Cognitive Restraint score and age, rest and night pain scores in fibromyalgia patients (p< 0.05). Increasing age was an independent predictor of Cognitive Restraint in fibromyalgia patients (p=0.003).

Conclusions. The proportion of overweight/obese patients, BMI, Uncontrolled Eating, and Hunger Susceptibility were significantly higher among fibromyalgia patients. Fibromyalgia patients’ eating behaviors were not associated with their quality of life and functional status. Increasing age appeared to be a predictor of Cognitive Restraint degree.
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Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nature Reviews Rheumatology. 2020;16(11):645–660. Available from:

Siracusa R, Paola RD, Cuzzocrea S, Impellizzeri D. Fibromyalgia: Pathogenesis, mechanisms, diagnosis and treatment options update. International Journal of Molecular Sciences. 2021;22(8):3891. Available from:

Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, et al. EULAR revised recommendations for the management of fibromyalgia. Annals of the Rheumatic Diseases. 2016;76(2):318–328. Available from:

Galvez-Sánchez CM, Reyes del Paso GA. Diagnostic criteria for fibromyalgia: critical review and future perspectives. Journal of Clinical Medicine. 2020;9(4):1219. Available from:

Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskeletal Disorders. 2007;8:27. Available from:

Correa-Rodríguez M, El Mansouri-Yachou J, Casas-Barragán A, Molina F, Rueda-Medina B, Aguilar-Ferrándiz ME. The association of body mass index and body composition with pain, disease activity, fatigue, sleep and anxiety in women with fibromyalgia. Nutrients. 2019;11(5):1193. Available from:

Okifuji A, Donaldson GW, Barck L, Fine PG. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep. The Journal of Pain. 2010;11(12):1329–1337. Available from:

Elkfury JL, Antune LC, Angoleri L dal M, Sipmann RB, de Souza A, da Silva Torres IL, et al. Dysfunctional eating behavior in fibromyalgia and its association with serum biomarkers of brain plasticity (BDNF and S100B): an exploratory study. Archives of Endocrinology and Metabolism. 2021;65(6):713–732 Available from:

Javaras KN, Pope HG, Lalonde JK, Roberts JL, Nillni YI, Laird NM, et al. Co-occurrence of binge eating disorder with psychiatric and medical disorders. The Journal of Clinical Psychiatry. 2008;69(2):266–273. Available from:

Senna MK, Ahmad HS, Fathi W. Depression in obese patients with primary fibromyalgia: the mediating role of poor sleep and eating disorder features. Clinical Rheumatology. 2012;32(3):369–375. Available from:

da Silva SGL, Sarni ROS, de Souza FIS, Molina J, Terreri MTRA, Hilário MOE, et al. Assessment of nutritional status and eating disorders in female adolescents with fibromyalgia. Journal of Adolescent Health. 2012;51(5):524–527. Available from:

López-Rodríguez MM, Granero Molina J, Fernández Medina IM, Fernández Sola C, Ruiz Muelle A. Patterns of food avoidance and eating behavior in women with fibromyalgia. Endocrinología, Diabetes y Nutrición. 2017;64(9):480–90. Available from:

Almirall M, Martínez-Mateu SH, Alegre C, Collado A, Ojeda B, Arias A, et al. Dietary habits in patients with fibromyalgia: a cross-sectional study. Clinical and Experimental Rheumatology. 2021;39(3):170–173. Available from:

Bennett RM, Friend R, Marcus D, Bernstein C, Han BK, Yachoui R, et al. Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 Preliminary American College of Rheumatology Criteria and the development of alternative criteria. Arthritis Care & Research. 2014;66(9):1364–1373. Available from:

Hisli N. A reliability and validity study of Beck Depression Inventory in a university student sample. J Psychol. 1989;7:3-13.

Ulusoy M. Beck anxiety inventory: a validity and reliability study (Unpublished specialization thesis). Istanbul: Bakirkoy Psychiatric and Neurological Diseases Hospital; 1993.

WHO Consultation on Obesity, World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva, Switzerland: World Health Organization; 2000. Available from:

Huskisson EC. Measurement of pain. The Lancet. 1974;304(7889):1127–1131. Available from:

Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clinical and Experimental Rheumatology. 2005;23(5 Suppl 39):S154-S162.

Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatology International. 2000;20(1):9–12. Available from:

Kirac D, Kaspar E, Avcilar T, Cakir O, Ulucan K, Kurtel H, et al. A new method for investigating eating behaviours related with obesity "Three-Factor Eating Questionnaire". Journal of Marmara University Institute of Health Sciences. 2015;5(3):162–169. Available from:

Karlsson J, Persson L-O, Sjöström L, Sullivan M. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. International Journal of Obesity. 2000;24(12):1715–25. Available from:

Fernandez-Feijoo F, Samartin-Veiga N, Carrillo-de-la-Peña MT. Quality of life in patients with fibromyalgia: contributions of disease symptoms, lifestyle and multi-medication. Frontiers in Psychology. 2022;13:924405. Available from:

Jafari F, Mobini M, Moradi S, Dashti Dargahloo S, Ghafour I, Elyasi F. Health-related quality of life and related factors in patients with fibromyalgia: a cross-sectional study. Iranian Journal of Psychiatry and Behavioral Sciences. 2022;16(1):e115602. Available from:

Campos RP, Vázquez MIR. Health-related quality of life in women with fibromyalgia: clinical and psychological factors associated. Clinical Rheumatology. 2011;31(2):347–355. Available from:

Arnold LM, Hudson JI, Keck PE, Auchenbach MB, Javaras KN, Hess EV. Comorbidity of fibromyalgia and psychiatric disorders. The Journal of Clinical Psychiatry. 2006;67(08):1219–1225. Available from:

Javaras KN, Pope HG, Lalonde JK, Roberts JL, Nillni YI, Laird NM, et al. Co-occurrence of binge eating disorder with psychiatric and medical disorders. The Journal of Clinical Psychiatry. 2008;69(2):266–273. Available from:

Gadalla TM. Association of obesity with mood and anxiety disorders in the adult general population. Chronic Diseases and Injuries in Canada. 2009;30(1):28–35. Available from:

Joustra ML, Zijlema WL, Rosmalen JGM, Janssens KAM. Physical activity and sleep in chronic fatigue syndrome and fibromyalgia syndrome: associations with symptom severity in the general population cohort lifelines. Pain Research and Management. 2018;2018:5801510. Available from:

Okifuji A, Bradshaw DH, Olson C. Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms, and functions. Clinical Rheumatology. 2009;28(4):475–478. Available from:

Senna MK, Sallam RA-ER, Ashour HS, Elarman M. Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial. Clinical Rheumatology. 2012;31(11):1591–1597. Available from:

Ruiz-Cabello P, Soriano-Maldonado A, Delgado-Fernandez M, Alvarez-Gallardo IC, Segura-Jimenez V, Estevez-Lopez F, et al. Association of dietary habits with psychosocial outcomes in women with fibromyalgia: the al-Ándalus project. Journal of the Academy of Nutrition and Dietetics. 2017;117(3):422-432.e1. Available from:

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