Weight-Loss for Pain Relief: Does it Work?

By Dr. Peter Abaci

More than a third of Americans (78.6 million) are now estimated to be obese. Obesity is typically defined as having a body mass index of over 30, and it is widely considered to be a significant risk factor for a number of chronic diseases, including heart disease, diabetes, stroke, and certain types of cancers. Obesity also tacks on an estimated $1429 to a person’s yearly medical expenses.

Increasing evidence has also found a strong correlation between obesity and chronic pain. In fact, there appears to be a strong link between the degree of obesity and pain complaints. As an example, patients with fibromyalgia have been found to be more likely to be obese or overweight compared to individuals without chronic pain. The association between joint pain and osteoarthritis and obesity is also now well-established. Consider obesity as an important identifiable and potentially preventable risk factor for developing chronic pain.

Extra body fat can potentially impact pain symptoms in a number of different ways. Even an additional five to ten pounds can increase stress and pressure on joints like the knees and hips, as well as the spinal column. Abdominal fat, in particular, has been shown to produce inflammatory mediators with the potential of further aggravating pain symptoms. Obesity is also a risk factor for Type 2 Diabetes, and half of all diabetics go on to develop painful neuropathy.

All of this raises a number of questions, including whether or not actually losing weight will diminish pain symptoms or prevent future pain problems? If so, how much weight needs to be lost to get results? And does it matter how the weight is lost?

The main options for treating obesity include diet, exercise, weight-loss surgery, or some combination of these choices. A number of studies have been done to look at the connections between various forms of weight loss and pain reduction over the last few years, and the results seems promising, especially when the changes are maintained.

A new study has just been presented on this very topic looking at bariatric surgery for weight loss and following changes in reported function and pain. Research was done by Wendy King, PhD, from the University of Pittsburgh Graduate School of Public Health, who assessed 2221 patients that underwent bariatric surgery from across the country and followed them for three years. Some of the positive findings noted after three years included 57% of participants who had mobility problems prior to surgery no longer had them, 46% of patients who had been taking narcotic pain killers had stopped them, and 70% reported overall improvements in function. While not everyone’s pain improved, this study certainly found a significant percentage that did.

Sustainable weight-loss is difficult to achieve and sometimes requires substantial lifestyle changes around diet, exercise, and daily activity. In some cases, bariatric surgery may be an option worth considering, especially for those with BMIs over 40 or who are 100 pounds overweight. But the impact these positive changes can have on a person’s pain can’t be overlooked, making weight management a necessary and often overlooked part of effective pain management.