Obesity and Chronic Pain

Obesity impacts your health in many ways. These include chronic (ongoing) pain due to inflammation and extra stress on the body.¹

Chronic pain:²

• Reduces quality of life
• Increases the risk of chronic illness
• Increases the risk of early death

Researchers continue to explore the link between obesity and chronic pain. One study found overweight people report roughly 20 percent more pain than people at a normal weight. The percentage rose to almost 70 percent for obese people.³

The rise of chronic pain over recent decades affects overall health among US adults. Studies show that obesity itself can cause pain. It also increases the risk that a person with obesity will develop pain.^1,2

Together, obesity and chronic pain:^1,2

• Contribute to reduced mobility and increased disability
• Co-occur with depression and eating disorders
• Lead to a greater decline in both physical and mental well-being

Physical causes of chronic pain

People with obesity report higher rates of chronic pain. But what causes the pain? The relationship between pain and excess weight is complex. Researchers believe body mechanics and psychosocial factors play a role in pain perception.^1-4

This is due to:^1-4

• Extra weight putting extra stress on joints and spine, causing extra wear and damage
• Greater disk compression while lifting
• Increased risk for degenerative disk disorders
• Changes in the gut microbiome
• Chronic inflammation increasing pain
• Behavioral and psychological changes
• Chronic pain leading to inactivity

Inflammation and chronic pain

Metabolic and biochemical changes also occur in people who are obese. The effects of extra weight create a pro-inflammatory state. Being in this state also increases pain.^1,2

Other factors include:^1-3

• Changes in leptin, a hormone linked to inflammation and joint damage
• Obesity increasing risk of depression and vice versa
• Lower serotonin levels increasing pain response
• Disrupted sleep and sleep apnea
• Lack of physical activity increasing pain
• Chronic stress, trauma, and emotional eating
• Age and other chronic illness

Researchers continue to investigate the link between the gut microbiome, obesity, and chronic pain. Smoking, other mood disorders, and stress response also play a role in how a person perceives pain.³

Most common types of pain with obesity

The most common types of pain reported with obesity affect bones, muscles, and joints. Areas affected include the knees, feet, lower back, and shoulders.^1-3

Other types of pain include:^1-3

• Nerve pain
• Fibromyalgia or widespread pain
• Chronic pelvic pain
• Headaches
• Abdominal pain

Obesity linked to chronic pain conditions

In addition, people with chronic pain tend to become sedentary due to pain. This can cause more weight gain and joint pain from inactivity. This creates a cycle that is hard to break.¹

Obesity is closely associated with other chronic pain conditions and comorbidities, such as:^1-4

• Lower back pain
• Osteoarthritis
• Rheumatoid arthritis
• Diabetic neuropathy
• Respiratory diseases
• Heart disease
• Depression

Over time, people with chronic pain and obesity may become less active. This lowers endurance and energy levels. You may stop doing activities you once enjoyed, like playing with your children or going on vacation.¹

Treatment options for chronic pain

If you have chronic pain, you may be afraid to speak up or share your concerns with your doctor. But your doctor may be able to help you put together the team of people you need to support you. That may include a physical therapist, pain specialist, dietitian, psychologist, and other specialists. It takes caring, nonjudgmental doctors who:^1-4

• Affirm your pain is valid
• Address root causes
• Take a "whole person" approach
• Treat other co-occurring conditions
• Consider lifestyle factors such as sleep and stress
• Suggest modifiable behaviors around diet, exercise

Treatment should go beyond long-term use of pain medicine or simple weight loss. The best plan involves a holistic approach to manage both pain and extra weight and may include:^1,3

• Nutrition and anti-inflammatory diet for a healthy gut microbiome
• Sustainable meal plans
• Physical therapy
• Psychotherapy
• Behavioral changes
• Anti-obesity drugs

If you are in pain, it may feel hard to make sustainable lifestyle changes. Pain can be a barrier to success. But not addressing obesity can make it hard to manage chronic pain.^1,3

Other factors such as depression also affect motivation, self-control, and self-esteem. You should gather a qualified care team to help manage your chronic pain and support your health goals.^1-4