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?

Continue reading “How Can Pain Cause Weight Gain?  “

How Can Pain Cause Weight Gain?  
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Let Me Take A Selfie

A few years ago, I participated in one of the Facebook status games. The point of the game was to reveal something about yourself, something that some people might not know or that you think they should know. Among the list, I included that I struggled with fairly severe body image issues. A friend of mine responded that she was surprised to learn that because she always believed me to be very confident. Since I have a tendency to hide my body, even as a nudist, and a tendency to show discomfort around my appearance, I was quite surprised to learn that she believed me to be confident. I asked her why she thought so and she replied: Yours always posting pictures of yourself.

It wasn’t meant as a criticism of me, it wasn’t meant to shame me, and it was simply an observation. I post pictures of myself, I take several pictures of myself, so therefore I must be confident.

As a culture, we’ve created this idea that selfies are a sign of vanity, and we are terrified of vanity. So much so, that we have built an entire culture predicated on teaching everyone to hate their appearance. We create impossible standards and then tell everyone that regardless of circumstance we must achieve it and maintain it. We’ve so thoroughly pervaded our social bias towards people who fall outside the “acceptable standards of beauty” that we as a society no longer treat them as fully human. Perversely, in an attempt to avoid the appearance of vanity we have instead created a cultural obsession towards an obsessive hatred of one’s self.

Ultimately, that is all that vanity is. It is an appreciation for one’s own appearance. It is a love for what you see when you look at yourself. It is a comfort in your own skin. Yes, excessive vanity can be dangerous, just like excess in anything is dangerous. But vanity, by itself? It is an act of self-love.

But selfies? They’re not an expression of vanity, they are a lifeline that reminds myself that I am not worthless. That I am not hideous. It is what allows me to replace my internal image of myself from one of loathing to one of acceptance. Because I don’t love how I look. I hate it. I can’t look in the mirror without desperately wanting to cut off some pieces of myself. Without wondering how anyone can possibly be attracted to me, and wondering if every sexual interaction I’ve ever had was a lie. My body, my appearance, was the weapon used to cut at my psyche over and over and over again. I was told it was the reason I was alone.

Those words, those cuts to my self-esteem are part of the reason why I let myself be taken in by users and abusers when I went out into the dating world. It was the excuse for every negative interaction with people I was interested in. They’re the reason that I sat like this, to avoid my rolls showing up through my shirt, because then people would think of me as fat.

Ania at 14 sitting with her back arched so as to not show any bulges

It is what made me think for years that the girl in this picture was fat.

Ania at 13 standing in front of the Notre Dame

Then I figured out that if I was careful I could take pictures that highlighted the few things that I do like about myself. The contrast of my features against my sk

Ania in a black tank top
in, the darkness of my hair, the colour of my eyes, all things I could appreciate about myself. They were things that let me believe that I had value, that I was worthy of love. Especially in this world that goes out of its way to tell me the opposite. These pictures, these pictures that are used to mock my vanity, to mock the very hutzpah of daring to love even the smallest part of myself when I am so far from perfect. Because how dare I. How dare I?

Older picture of Ania
How dare I look to myself for validation when the world teaches me that I should rely on the approval of men, regardless of whether I have any interest in their approval. How dare I not be grateful for the compliment that men deign to bestow on me, regardless of whether I want them, or whether they make me feel unsafe and like a target. The one that tells me that I am never allowed to refuse an advance because I’m ugly and so they are doing me a favour my being with me and tells me I am not allowed to have standards.

So no, I don’t need you to tell me that I am pretty. Because I have my selfie, so that I can tell myself what I need to hear.

Because that’s what they are. They’re selfies, and they have nothing to do with you.

 

Let Me Take A Selfie