Pain Management Without Weight Loss
A Patient Guide
Living with chronic pain is challenging, especially when healthcare providers focus on weight rather than providing effective pain management. Despite what your experience has taught you, you deserve evidence-based pain treatment regardless of your size.
What Is Chronic Pain?
Chronic pain is a legitimate medical condition. It describes all form of pain that persists for more than three months. Think of it like a complex alarm system in your body that’s become oversensitive – it’s a real physiological state, not a personal failing or a result of your weight.
Main Types of Pain
- Nociceptive pain (from tissue injury)
- Neuropathic pain (from nerve damage)
- Nociplastic pain (from nervous system sensitization)
- Complex combinations of multiple types
Understanding the Connection
Nociplastic pain occurs when your nervous system becomes overly sensitive to pain signals, like a volume button that’s been turned up too high. Even if there’s no active tissue damage or nerve injury, your brain and spinal cord process normal sensations as painful, creating real pain that can affect any part of your body. We see this in conditions like Fibromyalgia and Irritable Bowel Syndrome (IBS).
When you experience physical pain (from tissue or nerve damage) or emotional distress, these signals can make your central nervous system even more sensitive over time. Think of it like a feedback loop – the more pain or stress signals your brain receives, the more sensitized it becomes, which in turn makes you experience pain more intensely. This is why both physical and emotional experiences can increase nociplastic pain, even if they seem unrelated to the original pain location.
Common Pain Conditions
- Musculoskeletal Pain
- Joint pain
- Back pain
- Fibromyalgia
- Arthritis
- Tendinitis
- Neurological Pain
- Migraines
- Nerve pain
- Sciatica
- Complex regional pain syndrome
- Visceral Pain
- IBS
- Endometriosis
- Chronic pancreatitis
- Bladder pain syndrome
Understanding Pain Management
Most healthcare providers:
- Blame pain on weight rather than investigating underlying causes
- Delay proper pain treatment while focusing on weight loss
- Dismiss symptoms as “weight-related” without evidence
- Miss serious conditions due to weight-based assumptions
- Withhold pain medication based on size
- Require weight loss before offering treatment
Evidence About Weight and Pain
Important facts to understand:
- Pain affects people of all sizes
- Weight has never been shown to cause chronic pain
- Weight loss has never been proven to resolve chronic pain
- Stress from weight stigma increases pain
- Delayed treatment due to weight bias can worsen outcomes
- Weight changes can be a symptom of pain, not a cause
Pain Management Without Weight Loss
Your Rights as a Patient
You deserve healthcare that:
- Treats your pain effectively and promptly
- Doesn’t require weight loss for treatment
- Considers all available pain management options
- Respects your experiences and concerns
- Provides appropriate medication when needed
- Includes regular monitoring and adjustments
- Addresses underlying conditions
Effective Treatment Options
Evidence-based approaches include:
- Appropriate pain medication
- Physical therapy
- Nerve blocks or injections
- Alternative therapies
- Psychological support
- Stress management techniques
Systemic Factors in Chronic Pain
Chronic pain often reflects broader systemic issues in our society, such as economic inequality, discrimination, limited healthcare access, workplace stress, and social isolation. Effective pain treatment needs to acknowledge and address these systemic factors rather than treating pain as purely an individual medical issue. This might include:
- Addressing workplace accommodations
- Improving healthcare access
- Reducing financial stress
- Building social support networks
Advocating For Proper Care
When you hold one or more marginalised identities (such as being Fat or Disabled), finding supportive healthcare can be extremely challenging. When advocating for proper care, consider:
- Research weight-inclusive healthcare providers
- Request referrals to pain specialists
- Seek second opinions when needed
- Connect with patient advocacy groups
- Consider telehealth options for broader access
During Medical Appointments
You can:
- Decline weight discussions and focus on pain
- Request a complete pain assessment
- Ask for all available treatment options
- Provide documentation of pain patterns and triggers
- Bring an advocate to appointments
- Request proper diagnostic testing
- Ask for referrals to specialists
Creating Your Pain Management Plan
An effective plan should:
- Address your specific type of pain
- Include multiple treatment approaches
- Focus on improving function and quality of life
- Have clear goals unrelated to weight
- Include regular monitoring and adjustment
- Incorporate your preferences and needs
- Consider your daily activities and responsibilities
Advocating for Yourself
Your experiences of medical weight stigma are real, valid, and traumatic. Your reluctance to seek healthcare reflects a broken system, not a personal failing. However, you deserve proper care for your symptoms, and there are strategies you can use to advocate for yourself and find healthcare providers who will investigate the real causes of your fatigue without focusing on weight. Here are some suggestions:
- Track your symptoms and their impact on your daily life
- Refuse to engage in weight-focused discussions
- Redirect conversations to your actual symptoms
- Ask for evidence-based treatments
- Request clear documentation of treatment denials
- Consider finding weight-inclusive healthcare providers
- File complaints about discrimination
- Seek support from advocacy groups
- Know your legal rights
Building Your Support System
- Connect with weight-inclusive pain support groups
- Find weight-inclusive healthcare providers
- Build a team of supporting specialists
- Consider working with patient advocates
- Join online communities for resources
Remember
Further Resources
This guide was created by Dr. Asher Larmie (The Fat Doctor), a weight-inclusive healthcare provider specializing in helping patients navigate medical bias and advocate for proper care.
For more detailed information about managing pain and advocating for yourself in medical settings, consider joining Dr. Larmie’s comprehensive masterclass on Fibromyalgia and Chronic Pain. This course provides:
- Detailed pain management strategies
- Communication tools for medical appointments
- Resources for finding weight-inclusive care
- Support for self-advocacy
- Access to a community of support
This information is provided for educational purposes and should not replace professional medical advice. Always consult with healthcare providers for personal medical decisions.
