Beliefs about the Impact of Excess Body Weight on Biopsychosocial Functioning in Multiple Sclerosis Patients

Abstract

Background: Recent research indicates that obesity may exacerbate certain symptoms of Multiple Sclerosis (MS). Nevertheless, little research has examined patients’ perceptions of how obesity may impact their MS symptoms. If MS patients are unaware of the relationship between obesity and MS symptoms, they may be less motivated and/or adherent to health behaviors that could reduce their symptoms. Aims: (1) To determine whether functional differences exist between healthy weight and overweight/obese MS patients; (2) To examine patient beliefs about the impact of health behaviors on MS; (3)To explore MS patient beliefs regarding the impact of weight on symptom severity ; and (4) To explore the amount of exercise patients with MS would be willing to engage in to reduce their MS symptoms. Methods: 81 MS patients completed neuropsychiatric tests and questionnaires. Height, weight, and waist circumference were measured to calculate body mass index (BMI) and waist-to-height ratio (WTHR). Participants completed novel measures designed to assess their beliefs regarding how weight gain or loss may impact their MS symptoms, and their willingness to exercise for symptom improvement. Results: There was a significant association between WTHR and depression. There was no association between WTHR and the composite measures of cognition, physical function, or a singular measure of anxiety. As a whole, patients endorsed the belief that excess body weight contributes to worse MS symptoms and progression. Patients reported logical increases in exercise willingness as the percentage of hypothetical improvement increased. Patients with higher current symptom severity reported increased willingness to exercise for higher levels of symptom improvement relative to patients with lower current symptom severity. Discussion: This was the first study to examine patient beliefs about the impact of weight on disease symptoms and how much patients are willing to exercise to improve their symptoms. Results showed that patients with MS believe that excess body weight negatively influences disease symptoms. Furthermore, patients reported increased willingness to exercise as the percentage of proposed symptom improvement increases. This suggests that providing patients with information on the amount of improvement to expect from exercise and dietary interventions may enhance motivation for health behavior change.