Happy New Year! This time of year, many commit to resolutions, and weight loss is one of the most common. In this article, we discuss the importance of maintaining a healthy weight with respect to chronic illness and pain.
Obesity is associated with pain-related disability and has a direct relationship with chronic pain. It also impacts physical performance and acts as a barrier for effective chronic pain management. Obesity increases the biomechanical load on joints. Chronic pain in overweight and obese people is driven by an imbalance of gut microbiome (possibly through increased inflammation). Reduction in abdominal fat can alleviate pain and reduce systemic markers of inflammation that contributes to chronic pain.
Applying Science To Practice
A tailored weight reduction program can increase motivation based on preferences, attitudes, and self-efficacy of the patient. It’s important to inform the patient about the impact of their current lifestyle on short and long-term outcomes and adjust information to patient’s level, avoiding medical terms or other professional jargon.
Successful weight loss is often the result of a multidisciplinary approach to care that may include:
- Referral to a registered dietitian
- Universal healthy reference diet
- Vegies, fruits, whole grains, legumes, nuts, and unsaturated oils
- low to moderate amounts of seafood and poultry
- no or low quantity of red meat, processed meat, added sugar, refined grains, and starchy vegies
- Patient should focus behavior that is easiest to adapt
- If first goals are reached easily à effectuate a success experience in patient
- Larger, less feasible goals should be divided into smaller ones
- Planning meals and snacks
- At first: therapist supervision à Gradually patient independent
- Develop weekly planning habits
- Setting up a plan for supermarket, restaurant, other situations
- Affordability of a healthy diet
- Address other lifestyle changes
- Sleep problems
- Aims for increased physical activity
- Reduction of sedentary behavior
- Exercise therapy and physical activity should be stimulated by PT
- Time-contingent, cognition-targeted approach as needed in chronic pain