Nine reasons why weight loss is so important for chronic pain patients.
1. Pain reduces activity
Pain often leads to reduced activity and exercise, which can cause patient’s to gain weight, due to loss of metabolically active muscle.
2. Pain prevents restful sleep
Pain disrupts sleep, reducing growth hormone production, which causes patients to gain weight. Pain also causes elevated cortisol levels and epinephrine levels, which reduces sleep and independantly cause obesity.
3. Pain effects hormones
Excessive fat accumulation leads to a buildup of visceral fat which produces xenoestrogens, which inhibit the production of testosterone, which causes further fat weight gain and loss of muscle mass.
4. Obesity predisposes patient’s to diabetes
Excessive fat accumulation decreases insulin sensitivity and produces insulin resistance, a form of pre-diabetes.
5. Pain effects your pocketbook
Pain often leads to significant functional disability, reducing the patient’s standard of living, which encourages the consumption of subsidized foods, often rich in carbohydrates (food stamps buy significantly more calories of carbohydrates than protein).
6. Obesity effects joint load bearing
Excessive weight dramatically increases the amount of load joints must support. For every extra one-pound of fat you have, you increase the force on your lower back by nearly 20-24 pounds. If you are 10 pounds overweight, your back is carrying an extra 240 pounds of force, and if you lose 10 pounds of weight you will reduce load bearing by 240 pounds.
7. High blood sugar reduces the effects of pain medications
Patient’s with elevated blood glucose experience significantly more pain and find that their pain medications are less effective as the glucose level rises and more effective as the glucose levels fall. There is a direct effect on the opiate receptor by excessive glucose, which prevents activation of the receptor.
8. High blood sugar makes proteins sticky (Glycation)
Glucose or sugar is a sticky carbohydrate. Imagine if you poured sticky goo into the engine of your car, it would bind up the machinery. Extra glucose binds onto nearly all of the proteins in your body, making them work less efficiently, and predisposing patient’s to heart attacks and early aging.
9. Carbohydrates are themselves addictive
Although eating sugar may give you an immediate lift or rush, it quickly disappears when insulin drives the blood sugar into the cells, which then leaves you craving more sugar because your blood sugar level drops precipitously. Elevated blood sugar temporarily seems to partially activate the endogenous opiate receptors and some people do actually become “addicted” to carbohydrates, requiring ever increasing dosages, which leads to fat accumulation.