Maintaining a healthy weight is an essential factor in maintaining our wellness. Being overweight or obese can increase the risk of many health issues, including diabetes, cardiovascular disease, higher cholesterol, stroke, as well as all-cause death. Carrying unneeded weight can also impact pain levels.
People that are overweight or obese are more likely than those within a “healthy” BMI range to experience pain due to carrying the additional weight. Excess weight puts more strain on the joints and musculoskeletal system, negatively impacting the mechanics of how we move and hold ourselves, ultimately leading to increased pain. “Being just 10 pounds overweight increases the force on your knees by 30 to 40 pounds with every step you take,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University.
Several studies have shown a positive correlation between increased BMI and increased musculoskeletal pain, especially low back pain and lower limb pain. When the joints in the lower body (like the lower back, and knees) bear extra weight, it increases the risk of injury as well as the potential for osteoarthritis. When you consider the mechanics of how we move in good health, it is no wonder that increased body weight can literally overload our bodies. One source breaks down how our weight impacts our body:
“When you walk across level ground, the force on your knees is the equivalent of 1½ times your body weight. That means a 200-pound man will put 300 pounds of pressure on his knees with each step. Add an incline, and the pressure is even greater: the force on each knee is two to three times your body weight when you go up and down stairs, and four to five times your body weight when you squat to tie a shoelace or pick up an item you dropped.”
Research also shows an association between obesity and a state of increased inflammation, which can also lead to higher pain levels. Exercise is a crucial element in managing pain levels, with one study at the University of California San Diego School of Medicine finding that just one session of moderate exercise can also act as an anti-inflammatory. Regular physical activity also strengthens the muscles surrounding joints, and helps decrease bone loss.
Dr Osama Tashani, a senior research fellow at the Centre for Pain Research at Leeds Beckett University explains that apart from increased pain on the joints due to increased weight, “Stud[ies] suggest that even in areas of the body which are not bearing weight, obese people are more susceptible to pressure pain.” Dr. Tashani participated in a study published in the European Journal of Pain, which showed that obese people are likely to have the lowest pressure pain threshold when compared to those that were not obese. The study also suggested that those with a low pressure pain threshold are more likely to become obese. “It could be the case that a person who is more sensitive to pain is less likely to do physical activity and therefore more likely to gain weight and become obese,” says Dr Tashani.
Chronic pain may lead to obesity in previously non-obese individuals. One reason for this subsequent weight gain is adoption of a sedentary lifestyle. A study of the impact of knee osteoarthritis on physical activity found that only 12.9% of male and 7.7% of female patients with knee osteoarthritis were meeting the recommended weekly levels of exercise. Unfortunately, low levels of activity are not unique to people with pain- as we’ve shared before, most Americans do not participate in physical activity despite established information on the benefits to our overall wellness.
Whether it is pain that leads to obesity because of physical inactivity (sometimes paired with eating habits that lead to weight gain), or that excess weight leads to higher pain levels, the relationship is established. Genetic, psychological or metabolic factors may also lead to both obesity and pain. Yet despite the potential for those factors to play a role, establishing a healthy lifestyle that includes exercise, a balanced diet, as well as working with a provider to manage pain and other health concerns can help how you feel and how your body functions.