Background

Fatigue is associated with obesity, but it is unknown if this relationship holds in an underserved population. Furthermore, the potential mechanisms driving this association have not been tested. The aim of this analysis was to examine how perceived fatigue is related to anthropometric measures and eating behaviors in an underserved population.

Methods

Participants enrolled in the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) trial were studied at baseline. Individuals with obesity (body mass index [BMI]: 30.0-50.0 kg/m2) were recruited. Fatigue T-scores were determined from the Patient-Reported Outcomes Measurement Information System (PROMIS)-29 instrument. Body weight, BMI, and waist circumference (WC) were measured. The Eating Inventory was used to assess dietary disinhibition and restraint. General linear models adjusted for age, sex, and race compared outcomes between individuals categorized as mildly to severely fatigued (T-score ≥ 55) and those with fatigue in normal limits (T-score < 55). Outcome data are presented as mean ± standard error of mean.

Results

In our sample (N=800), 40% and 64% of participants documented their annual household income below $20,000 and $40,000, respectively. Overall, 266 participants (33%) were categorized as mildly to severely fatigued. These individuals showed greater body weight (+3.4±1.2 kg), BMI (+1.4±0.3 kg/m2), and WC (+2.4±0.9 cm) compared to those with fatigue in normal limits (P<0.01). Participants with mild to severe fatigue also showed greater disinhibition (+2.3±0.3) and lower restraint (-0.8±0.3) than those with fatigue in normal limits (P≤0.02).

Conclusions

Greater perceived fatigue is linked to higher body weight and poorer eating behaviors in underserved populations. Fatigued individuals appear to be most in need of weight loss regimens, yet the influence of fatigue on weight loss needs to be tested. Eating-related constructs may offer treatment targets to improve weight loss in fatigued individuals with obesity.