Why Weight Gain Is An Issue for Fibromyalgia Patients


Dr. Pellegrino, author of the book Fibromyalgia: Up Close & Personal, says that it is common for female Fibromyalgia patients to gain 25 – 30 pounds within the first year of their illness being diagnosed. Weight gain occurs with Fibromyalgia because of:

Decreased metabolism.  This is due to hormone changes that occur with FM.  Affected are the thyroid, cortisol, serotonin, and growth hormone.

Hypoglycemia. Hypoglycemia, or low blood sugar, is also common with FM. According to Dr. Pellegrino:

Increased sensitivity to insulin will result in too much glucose being removed from the blood stream and pushed into the muscle. All this extra glucose pushed into the muscles has nowhere to go as the muscles have very limited ability to store glucose.

The body is forced to go into a fat-storing mode where it converts this extra glucose into fatty tissue. Contrary to the popular myth that obesity is a result of eating too much fatty foods, obesity is usually the result of eating too many carbohydrates. A carbohydrate rich diet causes weight gain by converting the extra glucose into fat and, if Fibromyalgia causes more insulin activity and sensitivity, then the weight gain can be even greater.

Medication. Along with taking medications comes side effects, which include weight gain. Fibromyalgia medications can decrease the metabolism, cause fluid retention, hunger, and hormone deficiencies.

Decreased activity. Fibromyalgia patients will have a decrease in physical activity due to pain.  The more active, the more pain is felt.  Because less calories are being burned, weight gain will occur.

Now that we know what causes weight gain in Fibromyalgia, what can we do about it?  Here is a brief summary of suggestions and you can read the full explanations and article on ProHealth

Foods that are okay to eat:

Good proteins

  • Lean meats, skinless chicken, fish & turkey.
  • Eggs, but egg whites are healthier.
  • Tofu.
  • Soy meat substitutes.
  • Dairy products – use the lowfat varieties.
  • Legumes – beans, peanuts, lentils, peas, soybeans.

Good carbohydrates

  • All vegetables.  Corn has more carbs than other vegetables.
  • Fresh fruits.  Avoid dried fruits.

Good fats

  • Preferably olive oil – other acceptable oils include plant oils, soy, corn, peanut and sunflower oil.
  • Almonds.
  • Avacados.
  • Fish oils.


  • Salad garnishes.
  • Flaxseed oil.
  • Artificial sweeteners, sugar-free beverages (in moderation).

Foods to Avoid

  • Breads, sweets, pastas, white rice, white potatoes, partially hydrogenated oils, carbonated drinks, alcoholic drinks.

Dr. Pellegrino’s Diet Strategies:

  • Think protein always.  A key with this diet is not to eat any carbohydrate foods by themselves, even if they are considered good carbs.
  • Avoid the rush.  To avoid a carbohydrate surge, take a few bites from proteins first whenever you eat.
  • Eat until full.  Try to eat at least 3 meals a day and have 1-2 snacks. At meals, eat until you are comfortably full but not stuffed.
  • Strict during the week, splurge a little on the weekend.   The diet is 5 days “on” and 2 days not so “on.”  This allows people to follow the basic rules during the week but also allows the anticipation of favorite foods over the weekend.


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  1. This is an area of extreme frustration for me, among so many others. I have gained over 70 lbs. with me/cfs. Yes, I realize from anti-depressants and other medications weight gain was to be expected, along with the fact that I can no longer physically keep the pace prior to being this severly ill.

    However, the last three plus months have been a food plan with no refined sugar, and the last two months have been with all simple carbohydrates removed. I eat very much according to what Dr. Pellegrino’s strategies included, with the exception of fruit. I do not eat fruit as I did prior to this food plan. I do not drink my liquids in hefty calories and am very cognizant of food labels and hidden sugars and the various names for them.

    I am still extremely ill to do any weight bearing training or cardiovascular work, but have adhered stricly to the food plan. What another journey in sheer frustration. Two months later and I am down only FIVE pounds. One may speculate that I am in denial about portion control, the types of foods I am eating, or just not telling the truth to myself or others. My husband is here with me 24/7, knows what I eat and don’t eat, sees how much effort I have put into attempting to lose weight not only for appearance sake, but for health benefits, and again, it feels as though it is the same fruitless effort as is “treating” with Hell of living with ME/CFS.

    I am so sad and depleted from all the efforts in every aspect of me/cfs and so on which result in nothing. I thought for sure that by changing my food plan to one of adherence to a strict, healthy food program, it would be one area in my life where I could do something and have a positive outcome.

  2. Pandorash says:

    I just wanted to reply to Nancy’s post. I understand the futility of losing weight with FM. The best diet I ever followed was something called Tony Ferguson (It’s Australian). It’s a little strict so it’s hard to maintain long-term but if you follow it fully you lose the weight quite fast (fast for FM is normal for others!). I find it great to follow for a couple of weeks then maintain the loss for a couple weeks then go on it again and so on. It also made me feel great cos it’s low carb (not to be confused with ‘no carb’) and I think my body has an inflammatory response to wheat (according to my Dr this is common for people with FM). I would encourage you to try it if you can, or if you can’t you could get a nutritionist to create a meal plan similar (they may go on about how you should eat more carbs but it’s only short-term while you’re losing weight and many Dr’s recomend it). It may not work for you but your post sounds really similar to problems I had been having. Also, if you can do even a little bit of excercise (even 10mins a day) you should start because what happens is you actually feel better for it afterwards. The key is to avoid high-impact activities like running and instead do swimming or walking and NOT TO OVERDO IT. Cardio helps burn the cortisol that builds up in our systems and causes more pain. Then try something like gentle/beginners pilates for strength. The cardio is a great short-term release and the strength buidling helps long-term. Just start really small and over time you will feel better and be able to do more. Or, maybe try relaxation. It has similar cortisol-burning effects to excercise but without the physical strain. I hope my advice helps 🙂

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