While it is well-known that obesity can lead to chronic pain, especially in major joints, it may be surprising to hear that the reverse is also true. Chronic pain can lead to obesity, and not just because of its debilitating effects.
Chronic Pain Changes Eating Behavior
Pain seems to alter the brain in ways that make us eat more.The nucleus accumbens plays a major role in addiction behavior. It is involved in dopamine’s role in processing pleasure and reward. Dopamine—sometimes referred to as the “feel-good hormone”—is involved in motivating people to repeat certain behaviors.
Researchers from the Del Monte Institute for Neuroscience in Rochester, New York, investigated the brain’s response to sugar and fat in patients with subacute low back pain, chronic low back pain, and no pain to examine how their eating behaviors differed.
The participants had MRI scans so that the researchers could see their nucleus accumbens, which showed disrupted satiety signals in the chronic pain group and in the subacute pain patients who'd recovered at the follow-up. The chronic low back pain patients reported that foods high in fat and carbohydrates, such as ice cream and cookies, became problematic for them over time.
“We conclude that disrupted eating behavior specifically sets in after pain chronification and is accompanied by structural changes in the nucleus accumbens,” the authors wrote in the study.
The study suggests that the system that tells the brain that you are full or have had enough calories had changed in response to the pain—affecting how much and what one eats. Further research is needed to show the mechanism, but the researchers believe it is the effect of pain on the reward circuitry.
“There are other plausible factors that could disrupt satiety signals and alter the nucleus accumbens in those with chronic pain,” Eugene Aiello, a chiropractic physician and neurologic researcher, told The Epoch Times.
The Risks of Coping With Food
Chronic pain can leave us sad, stressed, angry, and hopeless. Sometimes the easiest way to deal with the pain and the feelings that it brings is to eat something that we enjoy. When eating is the primary coping mechanism for pain, a pattern of uncontrolled emotional eating often follows.While overeating—especially unhealthy foods—may seem a poor way to deal with pain, it is a far better approach than other common strategies, including alcohol, according to clinical psychologist Katie Rickel, CEO of Structure House, a holistic residential weight loss center.
“Overeating is going to be a very sensible way to cope with chronic pain,” she told The Epoch Times. “Food is socially acceptable, accessible, and packs a powerful punch.”
“However, it becomes this vicious cycle where the cure exacerbates the problem.”
However, there is more to this kind of pain than merely the mechanics of posture, Mr. Aiello said.
“A lot of what I see with patients in pain lies mostly in unhealthy eating habits that cause bloating, constipation, gut irritation, and inflammation of the intestines because this causes abnormal abdominal pressure that leads to more lower back pain,” he said. “To add to this is a lifestyle where people aren’t getting enough activity; they’re sitting too much.”
Restoring Order to the Reward System in the Brain
Chronic pain and obesity can form a knot that pulls itself tighter, leaving people bound in misery. To untie that knot, people typically need an integrative approach that includes multiple disciplines to address all aspects of the problem. That includes offering them some hope.“It’s important to give people experiences of feeling in control of their body and of their choices,” Ms. Rickel said.
Addressing pain and addictive eating simultaneously involves slowly tapering off of “comfort eating with activities that bring pleasure and naturally boost dopamine and serotonin,” she said.
“We need to diversify our coping menu to give someone who is struggling with chronic pain something that feels good to look forward to,” Ms. Rickel said.
Connecting with friends and loved ones, spending time outdoors, taking up a creative activity, or listening to music are healthier alternatives that are a step toward rebalancing the brain’s motivation and reward system. But you need patience and support when “rewiring” the brain with habits that often do not provide the immediate gratification of food. It takes time to find a balance of experiences.
These approaches can be part of a behavioral pain management and weight-loss program that helps people to create habits to untie the pain-obesity knot.
- Following a structured menu plan: Plan your daily menu around eating nutritious foods at regular intervals and in appropriate quantities to regulate energy levels. Having consistent energy throughout the day may help to prevent people with chronic pain from giving in to the temptation to “overdo” when feeling energetic and then “underdo” because of burnout.
- Moving your body: Exercise as simple as walking can help to improve pain and quality of life. People with chronic joint pain or osteoarthritis may benefit from swimming and aquatic exercise.
- Learning how to relax: Relaxation is essential in coping well with chronic pain. Relaxation therapies include deep-breathing exercises, tai chi, yoga, meditation, and massage. Lowering stress levels can also help people lose weight.
- Engaging in spiritual practices: Spiritual beliefs that nurture the body, mind, and soul shape how someone views and experiences pain. Multiple studies support the use of spiritual practices in helping people to cope with pain by reducing the sensation of pain and minimizing how much pain interferes with daily activities.
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