Overweight, a burden for chronic pain

In recent years, the prevalence of overweight/obesity has been increasing in our societies. This worldwide and “modern” disease makes us more prone to suffer from other pathologies such as diabetes, cardiovascular diseases, metabolic syndrome, depression, gastrointestinal disorders and chronic pain.

More concretely, when the combination of obesity and pain appear, thus worsen the patient’s functional status and quality of life more than other condition in isolation. These two conditions have reciprocally negative impact on one another and progressively patient’s mobility each day by initiating a vicious cycle of events: reduced activity, further weight gain and decreased muscle strength, leading to increased joint problems and disease progression.¹

Hence, weight loss is a primary goal in obese individuals with chronic pain, although a lot effort is needed to maintain long-term benefit since other conditions may produce weight gain. For example, having poor quality of sleep or mood disturbances like depression or anxiety, makes obese patients more susceptible to weight gain. Also, being under a state of chronic stress, such as being in constant pain, alters the balance of satiety signals and eating behavior as it generates alterations in the nervous system. This situation makes these patients to have less control over their impulses to eat and seek the analgesic-hedonic effect of eating. Moreover, it has been reported that the intake of some drugs can also alter our metabolism, making us more susceptible to weight gain.

As mentioned, the regulation of body weight can be a very complex and challenging task since it requires a lot of effort and perseverance. For achieving an adequate and healthy weight, people suffering from both obesity and chronic pain should have a balanced and healthy diet, as well as active life-style. Even that, the healthy recommendations have to be adapted to each patient, some general guidelines can be taken into account to improve hunger and pain regulation:

• Eat vegetables and fruit daily (between 2 – 3 pieces).
• Reduce meals rich in saturated fats such as red meat, sausages, desserts, cheeses, cookies, pastries and other processed foods.
• Seeds, nuts and trial mix should be included in the diet in small portions.
• Avoid eating foods rich in carbohydrates in the evening; vegetables, salads, fish and eggs are ideal for dinner.
• Make physical exercise every day.

In conclusion, many studies have demonstrated the negative effect of overweight on the level of pain in patients with diseases such as fibromyalgia, osteoarthritis, chronic low back pain, etc. All of them showed that the greater the weight, the greater the pain, therefore if the patient could reduce its weight, even if it is only 10% of the initial weight, they already will notice an improvement.² However, inadequate pain and weight control can be a barrier to effective lifestyle modification and rehabilitation. In this case, the concept of personalized nutrition and sport personalized programs could help to endorse person-centric diet and sport intervention to mitigate obesity and related disorders like chronic pain.^3,4