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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Guest Post: Suffering Stream of Consciousness

The following is a stream of consciousness poem by a friend of mine who has been dealing with overwhelming medical negligence for several years, most recently blinded by a doctor ignoring medical protocol for a medication they put her on. These are her thoughts in the midst of trying to process her most recent medical traumas and yet another severe pain flare that has had no help from doctors. 

TW: Discussions of Death, Abuse, Suffering, Suicidal Ideation, Medical Neglect, Troll Brain thoughts. These are unedited troll brain thoughts as well and so not controlled for slurs and internalized prejudices.

written by friend Sophie; after spending 9 hours in an endless sob session and panic attack before being given a clonazepam and sitting down to write this as the clonazepam started to calm her down.

I am dying.
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Guest Post: Suffering Stream of Consciousness

Disability Misery

I’m multiply disabled, by whichever model you use. I am on disability assistance and I live in Canada where I even have access to healthcare. Given all this, you might think that the fact that I still have disability related depression, that I am proof that disability really is misery. That the medical model is right.

I want to make this really easy to understand.

I’m not miserable because I’m in pain.

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Disability Misery

Lessons from a Root Canal

For the last four months, I have been struggling with extreme dental pain. Four months ago, I went to the dentist for the first time in over 3 years. I had three cavities that needed filling, and I was getting the first two filled. After the procedure, I started feeling pain in my teeth and jaws. I didn’t know what it was, so I went back to the dentist. She said that it was probably just healing pain but to come back if it continued, and that I would probably need a root canal. Unfortunately, I left the country to visit Alyssa’s parents. For the next two weeks I continued on a cocktail of Aleve and Tylenol. The pain wasn’t getting any better. It was getting worse. The day we got back home, I called the dentist and made an appointment. It would be in a week. Then two days before the appointment, on New Year’s Day, the pain got so intense that I couldn’t do it anymore. I went to an emergency dentist, who did an x-ray and gave me an unexpected answer: my wisdom teeth, which were already eventually to be removed, were infected and needed to be removed right away. There was nothing he could do so he gave me x-rays and some painkillers and sent me on my way.

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Lessons from a Root Canal