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The Connection Between Weight and Pain

Last updated: 06-01-2020

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The Connection Between Weight and Pain

We’ve known for a while that obesity has links to preventable chronic conditions like diabetes, heart disease, and high blood pressure. Research shows there are connections between obesity and different types of chronic pain as well.

The good news is that making gradual, stepwise changes can not only reduce pain but also promote overall health and improve your quality of life.

The National Institutes of Health define obesity as having a body mass index over 30. And according to the Mayo Clinic, obesity is a cause of metabolic syndrome, a group of tied conditions including diabetes, heart disease, stroke, and other chronic conditions. Studies have also shown that obesity and pain are inter-connected and influence one another.

What happens with one affects the other?

Migraine, arthritis, and different chronic conditions can cause both physical and emotional symptoms. Extra weight also puts pressure and stress on joints, increases pain sensitivity, reduces flexibility, causes inflammation, poor sleep, and affects quality of life.

Scientists don’t understand the exact relationship between weight and migraine, but studies show there are environmental, genetic, and lifestyle connections. According to the American Migraine Foundation, obesity increases the risk of migraine by 50% percent, and the risk is much higher with a BMI over 40.

A meta-analysis review by Gelaye from the Harvard T.H. Chan School of Public Health, found that obesity raised the risk of migraine by 27%.Scientists believe hormones, certain proteins known as cytokines, and inflammation may all play a part.

A review of 10 prior studies, led by Di Vincenzo and colleagues at theUniversity of Padua in Italy, examined the effect of weight loss on four headache elements: duration, frequency, severity, and disability. The research showed that weight loss improved all four outcomes, with the greatest improvement in headache severity.

There was little difference in results between age groups (adults versus children) or weight loss from surgery versus behavioral change (ie, lifestyle changes). The improvement did not, however, directly reflect the amount of weight loss or the starting weight. In other words, weight loss improved pain symptoms regardless of the amount of loss or how loss happened.

The researchers suggested this may be from a drop in pro-inflammatory cytokines, which play a big role in pain. We need more data to learn the effects of weight loss on headaches since the review only looked at a small number of studies. But the positive news is that weight loss helps cut down inflammation – resulting in less pain.

Rheumatoid arthritis (RA) is an auto-immune condition that causes swelling and pain in the joints. Genetics, gender (females have a higher risk), stress, the environment, and obesity all play a role. Obesity raises the risks of developing RA, changes how some medications work, and affects the path of the condition negatively.

Diet and nutritional quality play a key role in both RA and obesity. Foods with poor nutritional value such as fast foods, foods high in saturated and trans fats, high carbohydrate diets, can all increase weight and cause inflammatory responses in joints. Poor diet also causes tiredness, leading to inactivity and weight gain.

A study published in Autoimmunity Reviews, suggests that a group of hormones called adipokines (adiponectin, leptin, resistin, visfatin), may play a role in inflammation and immunity. These hormones regulate inflammation and your body’s immune response. Adipokines can cause joint inflammation and insulin resistance, making your body work harder.

Other studies have shown people with a BMI greater than 35 have a greater risk of developing or worsening existing conditions like fibromyalgia, which is linked to rheumatoid arthritis, and other chronic pain syndromes. A study by Neumann and colleagues from Ben-Gurion University in Negev, Israel,  reported that a higher BMI limits physical activity, increasesg pain, and leads to poor quality of life.

More on hormone therapy for painconditions.

New research publishedin 2019Joint Bone Spine shows that some RA medications like biologics may not work as well in patients with higher BMI. One type, anti-tumor necrosis factor (TNF), works by slowing the effect of pro-inflammatory cytokines such as TNF-alfa, interleukin, and interferons; obesity may change the way these medications work. According to the Arthritis Foundation, multiple factors may play a role, including the activity of cytokines.

Keep in mind that the connection between weight and chronic pain is not one-dimensional. Nutrition, physical activity, and lifestyle are all components of overall health function. When weight shifts up or down, it can improve or worsen pain symptoms and pain management.

Focusing on improving your quality of life – such as participating in activities you enjoy each day  –  can lead to weight loss as a side benefit. While it’s not easy to change lifestyle habits quickly, having a plan and taking a thoughtful approach can net positive results in weight loss, leading to more energy, less pain, and an overall healthier mindset.

Your diet plays a major role in how you feel and how you manage your weight. Studies show an anti-inflammatory diet rich in omega -3 fatty acids like fish oil is beneficial. For example, following the Mediterranean diet, which includes green vegetables, olive oil, lean meats, and fish, helps reduce inflammation and even reverses damage from chronic pain conditions like rheumatoid arthritis.

Be mindful of what and how much you eat to improve your habits gradually. Explore new spices, recipes, and foods to change up your routine.

Avoid foods high in gluten, which is known to increase inflammation, and neuropathic pain. Reduce intake of processed, high carbohydrate foods, or fast foods. Proper nutrition can lower weight and improve health outcomes for chronic pain and other linked metabolic syndrome conditions like heart disease and diabetes. (More on gut health and pain.)

There are several proven benefits to movement, outdoor recreation, and physical activity for those living with chronic pain syndromes. Along with healthy nutrition, exercise can help reduce pain, increase flexibility, balance [INTERNAL LINK], and strength. Studies show that outdoor activities increase the level of Orexin A as well – this neuropeptide helps to regulate many brain and body functions like sleep and appetite.

Regular physical activity like walking, water activities, strength, and aerobic exercises like light weight lifting, yoga, or Pilates, for at least 30 minutes 5 days a week can reduce inflammation and stress, and improve immunity and associated pain.

Proper sleep duration and quality are essential not only for physical but emotional well-being, and adequate sleep can help with weight loss.

According to the Centers for Disease Control and Prevention(CDC), some steps you can take to improve sleep are to:

Increased use of smart devices (phones, tablets, etc.) can affect sleep quality and quantity, food choices, and physical activity. According to a study by Taheri, from theHoward Hughes Medical Institute, Stanford University, poor sleep increases BMI and changes levels of hormones ghrelin and leptin, which control appetite. Lack of good quality sleep can also lead to insulin resistance, causing weight gain.

Reduce screen time on smart devices and other electronics. A review study by Robinson and colleagues, from theUniversity of Birmingham, Edgbaston, United Kingdom, found distracted eating can lead to eating more and weight gain. While mindful eating with a focus on food taste can reduce snacking and improve weight loss goals, as well as help keep healthy weight long term.

Use your family, friends, and support groups to help you build on your health goals and keep on the right track. Consider joining a pain support group, trying relaxation/deep breathing exercises, and stay on top of your emotional and mental health.

Remember that obesity and pain are a loop; one affects the other in complex ways. Improving eating habits, increasing physical activity, and managing your mental health can result in weight loss, which will help improve pain. All of these activities can also help to reduce stress, which when heightened, can impact pain levels.

With reduced pressure on joints and lower levels of inflammation in your body, you’ll also be able to slow the progression of potential other metabolic disorders like diabetes, high blood pressure, and heart disease.

Set goals and take a planned approach to weight loss


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