Obesity: I Feel The Pain!Wednesday, July 4, 2012
Regular readers will appreciate the importance that I have given to pain both as a driver and consequence of weight gain as well as a barrier to treatment.
Just how closely obesity and pain are associated is now documented by Arthur Stone and Joan Broderick from Stony Brook University, NY, in a paper just published in OBESITY.
This study is based on a Gallup ‘poll’ of 1,062,271 randomly selected US individuals surveyed between 2008 through 2010.
BMI and pain yesterday were reliably associated (even when adjusted for a wide range of demographic variables): the overweight group reported 20% higher rates of pain than Low-Normal group, 68% higher for Obese I group, 136% higher for Obese II group, and 254% higher for Obese III group.
All of the tests of association between the pain conditions and BMI groups were significant, with the strongest association for the knee and leg condition.
The association held for both men and women but in women, the trend to more pain as BMI increases was steeper than in men.
The association between BMI and pain increases moving from the younger categories to the older categories; for those in the Obese III group, the odds ratio for the youngest group is 1.72 compared with a ratio of 3.79 for those in the highest age group.
As the authors note,
“The association is robust and holds after controlling for several pain conditions and across gender and age. The increasing BMI-pain association with older ages suggests a developmental process that, along with metabolic hypotheses, calls out for investigation.”
Despite the possible limitations due to the nature of the survey (telephone, self-reported height and weight and pain levels, etc.), the relationship between higher weight and pain is striking.
Assessing for pain (the 2nd ‘M’ or ‘Mechanical’) should be routine part of any exam for obesity and may have to be tackled in any obesity management program.
Stone AA, & Broderick JE (2012). Obesity and pain are associated in the United States. Obesity (Silver Spring, Md.), 20 (7), 1491-5 PMID: 22262163
Wednesday, July 4, 2012
Nobody wants to exercise when they’re in pain. I know that when I weighed over 400 lbs, I never wanted to exercise, even walking, because my arthritis pain was so bad. After losing around 180 lbs over the last 8 years (80 lbs over the last year and a half), I am more active and more willing to be active as my arthritis pain has been reduced.
Wednesday, July 4, 2012
Perhaps, as a follow-up to these findings, we could explore the reluctance and shame that people struggling with obesity feel when bringing this pain to the attention of their health care providers. My grandmother suffered with advanced osteoarthritis in both knees for the better part of ten years and yet was reluctant to bring it up with her physician. She believed that there was nothing that could be done for her unless and until she lost weight. This, I believe, was the perfect opportunity for her physician to have screened her with respect to the Edmonton Obesity Staging protocol.
Saturday, July 7, 2012
I was at 260 lbs when I started having knee pains and because of that I was not able to exercise and I kept gaining until I decided to undergo mini gastric bypass surgery to help me lose weight and ease all other complications I was having when I was at 300 lbs. I’m glad I found an alternative to surgery. I did not lose that much but I am still losing and counting. Now at 230, I am able to do simple exercise without hurting my knees and positive that I can get back to my normal weight slowly using the mini gastric bypass alternative.