How Can Pain Cause Weight Gain?  

For years the assumption has been that “obesity” leads to pain. Many patients have had the experience of looking for explanations of pain issues, only to have the problem never investigated and told to lose weight instead. Then years later, find out that their pain was actually the result of an underlying issue, made worse through a lack of early treatment. You might have seen a comic or visual joke involving a visibly injured patient and the doctor saying “have you tried losing weight?”

In my book, Young, Sick, and Invisible, I discuss how this same trope was directly responsible for my own autoimmune conditions being ignored long enough to cause long term and severe disability and damage.

In a recent post, I had responded to an intentionally insulting comment with a long explanation of how their assumptions about my use of a mobility aid and my weight was influenced by a series of misunderstanding about obesity, pain, and disability. Included among this explanation was the statement that “obesity” or rather weight gain, can often be a symptom of chronic pain rather than it’s cause.

In response to this statement I received a question, and while the phrasing made it clear the comment wasn’t actually a legitimate inquiry but another chance for the commentor to engage in fat shaming, the underlying question sparked my interest.

Heavily edited, the question was this:  

“I understand how obesity can contribute to pain by putting stress on joints, but I don’t understand how the opposite can happen. Can you Please explain it to me and help me understand? How does Pain cause Weight Gain?”  

To begin, the concept of “obesity” is widely misunderstood and is oppressive in and of itself. As a knowledgeable friend recently explained it –  The word is based on the Body Mass Index scale (BMI) where the ratio of height and weight was determined and everyone who scored within certain parameters was considered as having a healthy BMI while anyone whose BMI was above this range was deemed obese. A person who had very little body fat, but was very muscled, especially in relation to their height, would be classified as obese. In fact, since muscle tends to weigh more than fat, a body builder is more likely to be classified as obese than what most people consider to be representative of an “obese” person.

The concept that obesity is synonymous with fatness is a misunderstanding that has become accepted as a standard, and is used by doctors to excuse their own medical negligence when it’s the result of internalized biases regarding fatness.

What’s more, more and more evidence suggests that body fat percentage is not actually a reliable indicator of an individuals health, nor is there actually a reliable standard as to what fat percentage can be considered healthy and which is unhealthy. That rather fat distribution and percentage is really just a variation in body type much the same way that shape, height, etc. are.

The attempt to pathologize fatness ultimately makes as much sense as claiming that a certain eye colour is an indicator of overall health. Contrary to popular belief, just being fat is not in itself unhealthy.  A fat person can be just as healthy as someone who is considered slender. What is unhealthy is when there is a sudden significant increase or decrease of body fat percentage outside of regular growth and development. In the specific case of an increase in body fat levels, what is unhealthy is when it is spurred by malnutrition, stress, and immobility which in addition to spurring weight gain also have a measurable negative impact on blood pressure, blood sugar, and arterial plaque. Even in this case, it’s not the weight gain in particular that is of actual medical concern, but rather the specific effects on those measured stats.

The medically accepted myth that fatness all by itself is unhealthy is another example of the fallacy that correlation signifies causation. Additionally, this accepted fallacy has had significant impacts on our social understanding of body size and health. 

A more accurate way to look at the connection between a high body percentage and pain would be that it can contribute to pain when an underlying problem exists, and when the specific individuals natural body fat percentage is significantly lower than what it is now. There are many people out there who are fat, who not only experience no pain whatsoever, but also have perfectly healthy stats.

In fact, the social convention of proper weight is so distorted, that the little abdominal bulge many women spend years trying to eliminate, is actually not the result of fat but is actually their internal organs pressing up against their abdominal wall.

Weight on it’s own, doesn’t cause pain. Rather, in an event that someone has an underlying condition that may cause pain, carrying more weight than their body naturally would under optimal conditions, can put additional stress on the injury site and make pain more intense. The impetus for the pain however, is still the initial underlying injury or condition.

What many ignore is that pain and its related symptoms can actually be the cause of accelerated weight gain and that the best way to address both is to treat the underlying cause of pain and to treat the pain itself.

How can this be?

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How Can Pain Cause Weight Gain?  
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5 Things the Straw Ban Argument Shows us About How we Treat Disability

five things the straw ban argument reveals about how we treat disability over a picture of the sun reflected in water.
In the last few weeks, the increasingly frequent straw bans have sparked debates across social media and even the news. For those who are unfamiliar, the Straw Bans are a new fad of laws that ban plastic straws in an effort to reduce ocean waste and plastic. The popularity of the law was inspired by a viral video featuring something sad happening to a turtle. Environmentalism is great, so what’s the problem?

The problem is that plastic straws are necessary for the survival of people with certain disabilities. Necessary for Survival. Without them People Will Die.

I wish I could say that that statement marked the end of the matter and the question of whether or not it is worth proceeding. Instead, what’s followed is endless weeks and arguments about whether we’re really sure that’s we will really actually die, and don’t we know that that doesn’t really happen.

While I’m not one of the people directly affected by this ban, I say we because while the specifics here don’t apply to me, I recognize all too well ALL of the arguments that showed up during the debates. They’re the same arguments I’ve faced whenever the subject of any disability accommodation comes up. These same themes form many of the backbones of systemic ableism. They are the arguments that are essentially used to excuse banning people from immigration on the basis of disability, the arguments against raising disability support payments, putting together socialized pharmacy care, building accessible housing, providing easy accessibility, and so on and so forth.

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5 Things the Straw Ban Argument Shows us About How we Treat Disability

Let’s Chat: Ignoring Community Input on Strategic Priorities for the OPS

On Saturday July 14th, I signed up to attend a community consultation on Strategic Priorities for the Ottawa Police Service for the coming years. I attended at the request of a friend, an anti-torture activist who is desperately trying to convince the police force to stop the new policy that would give a taser to every police officer in Ottawa.

I agreed to attend not just because she asked me too, but also because for some time I’ve been thinking of ways to improve accessibility in Policing. Also, because I wanted to be a white face bringing up racism against people of colour.

Institutional Racism in the force is a problem that is starting to be talked about by more people not directly influenced by it, as it should, and is a major issue that needs MORE attention than it is currently getting. A related issue however is Institutional Ableism.

A recent review of fatal police interactions in Canada shows that most people killed by police are disabled. Something like 72% of those killed in police interactions were shown to be mentally ill or to have substance abuse problems, which is itself also considered a mental health issue.

In the US, 1 in 2 people killed by cops is disabled.

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Let’s Chat: Ignoring Community Input on Strategic Priorities for the OPS

Ableism Kills

A while back, I wrote a post begging the Canadian Government to open it’s borders to Americans with Disabilities as refugees from a slow-motion genocide. Someone left a comment on that post to which I’ve been meaning to respond for a long time.

CYNTHIA: I had previously mentioned this to Michael.

Reluctantly, as a fellow Canadian, I cannot fully support this.

As you know, the United States has 10x the population of Canada. It is a first-world country.

There is no way that the math works for Canada to be able to support the complex heath care needs of Americans with pre-existing conditions. As you mention, the system is already at capacity when it comes to providing proper health care with disability support programs for Canadians. No system can function unless you have a large base of relatively healthy people paying into the system to cover the costs of those who are using it more.

Of course, in a situation of someone being a genuine refugee from any country, humanitarian considerations should come into play. That can’t be extended to American “medical costs refugees”, though, because it would break our system.

In the long run, Canadians need a system that is sustainable – and ultimately, that benefits all Americans as well. Americans are looking at us to see how our single-payer system is functioning. If it works relatively well, that increases political support for it. If it doesn’t, that increases the dire warning about “socialized medicine”. The most vulnerable Americans ultimately need an American health care system that works, and they are less likely to get it if the Canadian health care system breaks or if ordinary American voters stop fearing the consequences of repealing Obamacare because they think that free health care will always be available to them in Canada. Right now, that fear has managed to stop the repeal attempts, to the benefit of all Americans who will ever need health care.

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Ableism Kills

Foot In the Door: The Rise of Nazi America

Text: The Rise of Nazi America, showing an American Flag where the stars are swastikas and behind the red bars of the flag are the silhouettes of two imprisoned children
It starts “innocently” enough.

Someone carves a swastika into a school desk or draws one inside a textbook. They don’t understand the symbolism. They don’t understand the horror, the pain, the death, that was brought about as a result of that symbol. They’re just trying to be edgy.

Youth of all stripes make the news when they joke at doing the Nazi salute or dress up in Nazi costumes, even those in the public eye like Prince Harry take their turn at parading around the costume. To them it’s just a joke. They never experienced what it was like to face a world where Nazis didn’t just exist, but wielded terrifying power.

It isn’t long before comment sections explode with the use of racial slurs. Words that were considered egregious social faux-pas are used like common expletives. They’re just kids enjoying the power of anonymity. They’re basement dwellers making themselves feel better by pretending to more power than they have and living fantasies of superiority.

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Foot In the Door: The Rise of Nazi America

I can’t just put my disability on hold

title over abstract photo
For the last year or so, I have been basically living out of boxes.

Alyssa’s and my breakup took place right in the middle of my attempts to rebuild my office. I had to halt construction and rethink how to reorganize the smaller bedroom from being an office into being an office bedroom. Then as our actual separation approached, things were packed away and divided. I’ve been struggling for the past year to put everything back together; my room, my apartment, my life, myself.  ‘

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I can’t just put my disability on hold

What Are the Chances?

CN: Discussion of Statistics in relations to disability, other social issues, sexual assault, and abuse.

There are times when I am talking to someone about my life- about the fact that I’m scared of new proposed laws making it harder for me to survive in Ontario, or about how I’m one particularly unlucky day away from being homeless – when I get the feeling like the person I’m talking to thinks I’m exaggerating. They get this look on their faces that makes it clear they’re just humoring me by not pointing out how ridiculous I’m being. Meanwhile, I’m already minimizing how severe my situation is out of fear of being accused of exaggerating. Worse still, my circumstances are relatively minor compared to that of many of my friends and readers. 

When they don’t automatically dismiss what I’m saying as being hyperbole, the people I speak with assume that my case is rare – an exception. A circumstance not worthy of planning against because it’s unlikely to happen again. And yet? Every day I meet someone new in the same type of situation I find myself in. It’s become so textbook, some people look at me as though I’m performing magic when I manage to guess the ridiculous circumstances they find themselves in or repeat almost verbatim what they’ve heard from doctors, therapists, or other people.

It’s a matter of framing, of perspective.

To someone in the mainstream, what is happening to me must be the result of either something I did wrong, or something extremely rare, or impossible. It seems like the probability of all the things going wrong that go wrong happening seem impossible.

What are the chances that every relationship you’ve been in is abusive?

What are the chances that so many of your doctors end up incompetent? That so many doctors end up holding biased opinions?

What are the chances that everyone around you is so terrible? Doesn’t it seem more likely that you are the problem? Statistically speaking that is?

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What Are the Chances?

GUEST POST: Why It’s Hard to Reveal My Disability to Strangers

By Kella Hanna-Wayne

A dancer on a dark background with title of post in white

CN: ableism, chronic pain

With every new person I meet, I have to gauge just how much to tell them about my disability. I try to be as open as possible about my health issues because I want to reinforce the idea that people who look like me- young, relatively fit, no noticeable limitations- can also be disabled. But being open about my disability means opening myself to potential scrutiny of my body, my diet, my medications, my exercise routine. Any decision I make about my physical health becomes fair game for intrusive questions. Until I get to know a person better, I have to assume they will default to treating me as if my health history is in the public domain.

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GUEST POST: Why It’s Hard to Reveal My Disability to Strangers