Obesity Significantly Linked with Pain

obesity and painA large survey of more than one million Americans found a significant association between obesity and pain. The study, published online in the journal Obesity, showed that higher rates of pain were found in the heaviest people. Between 2008 and 2010, respondents were surveyed by telephone interview by the Gallup Organization. The survey questions included height and weight–from which Body Mass Index (BMI) was calculated—as well as questions about pain conditions in the past year, and a question about pain experience yesterday. Previously, small scale surveys had identified a connection between obesity and self-reported pain; however, never had the association been examined on such a large scale until this study.

The analysis found that only 19.2 percent of the participants were classified as Low-Normal BMI, 21.4 percent were classified as Overweight, and the remaining 40.6 percent were Obese. The obese respondents were categorized into three groups based on BMI. The overweight group reported 20 percent higher rates of pain, compared to those in the Low-Normal BMI range. Of the three obese groups, the Obese I group (BMI 30–<35) reported 68 percent higher rates of pain than the Low-Normal group, 136 percent higher for the Obese II group (BMI 35–<40), and 254 percent higher for Obese III group (BMI of 40 or greater). This positive correlation between pain and BMI was robust and even after controlling for several pain conditions and across age and gender, the association was statistically significant.

The large number of respondents also made it possible to examine gender and age effects on the pain and weight association. They found that the association between BMI and pain was steeper for females than males. It was also steeper for those older than 40 compared with younger people.  In all cases, though, there was a moderate association observed. The study authors, Stony Brook University researchers Arthur A. Stone, PhD. and Joan E. Broderick, Ph.D., concluded that there could be several plausible explanations for the close obesity/pain relationship. A few of these explanations  include the possibility that having excess fat in the body triggers complex physiological processes that result in inflammation and pain, as well as that medical conditions that cause pain – like arthritis – might hinder exercise, resulting in weight gain.

Dr. Daniel Davis, Chief of Bariatric Surgery at the Center for Surgical Weight Loss at Stamford Hospital, spoke with us about the study. He added that “Obesity is a major risk factor for osteoarthritis and studies have shown a substantial decrease in the number of quality of life years.  The force transmitted in the knee or hip joint is 3 to 6 times the body weight, increasing body weight impacts the joints tremendously, resulting in severe, irreversible damage.  Adding insult to injury, obese patients with osteoarthritis requiring joint replacement surgery are at increased risk for operative complications and a prolonged rehabilitative course compared to non-obese patients.” Davis concluded that “Effective treatments for obesity, such as supervised dietary programs or weight loss surgery, need to be implemented to reduce pain, optimize for joint replacement surgery and improve quality of life.”

Further Reading

Another condition that has been associated with excess weight is lumbar spine disc degeneration, which results in varying degrees of back pain. A recent study found that overweight and obese people are at significantly increased risk for this painful back condition. You can read the study’s findings here.

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