Weight loss is a difficult thing to discuss. As a physician, I am always worried that somehow, the patient will be offended by this discussion. If I talk to some of my Primary Care colleagues, some have stopped bringing this topic up, as some patients have gotten upset enough to “fire” them, or even worse, report them to the State Regulatory Body for insensitivity. As a physician, I am not judging you. I need to bring this up for discussion, as it is part of my education and counseling protocols. You cannot help yourself improve without understanding the causes of some of the pain.
Many of my patients come to the office looking for advice. Most would like to avoid surgery. Most will not be a candidate for surgery. So what can you do to help yourself?
Instead of having a discussion on weight loss, I like to discuss things in the following manner.
Have you ever carried a 20 pound backpack all day? Have you carried it despite having knee pain, hip pain or BACK PAIN? Didn’t it feel much better when you took that backpack off? Well, your extra 20 pounds of weight is like carrying the 20 pound backpack. (As an aside, there is good information that heavy backpacks can lead to pain for children).
I know you have heard all the reasons to lose weight. It will help with diabetes. It helps control blood pressure. It decreases demand on your heart. But, while those things are good to control, usually, you do not have pain directly from diabetes or high blood pressure. And, by the time you have heart related pain, it may be too late.
But back pain is a good way for your body to remind you to keep the weight down. Will losing weight get rid of all the pain? Probably not. But, it will definitely help. Besides, you have all the benefits described above, plus, you look better, feel more confident, and therefore may also feel less depressed. And, just so you understand, depression is associated with increased pain.
Losing weight has all sorts of benefits. If you are more than 10 pounds overweight, please discuss the situation with your primary care physician. They can help you lose weight appropriately. It is a lifestyle choice. I have heard all the “pundits” saying it is a now an access to good food, and a societal issue. While there may be some truth to this, in the end, it comes down to personal motivation and choice. Please help yourself, and keep the weight down. Your Spine will appreciate it.
- Kolstad F, Breivik H. The obesity epidemic makes life difficult for patients with herniated lumbar discs - and for back-surgeons: Increased risk of complications. Scand J Pain. 2016 Jan;10:103. PubMed PMID: 28361756