Many important medical associations now define obesity as a disease. Being overweight or obese is a serious disorder that affects adults and children. Most people know that obesity contributes to the development of coronary heart disease, diabetes, high blood pressure, and colon cancer. However, did you know that obesity is a contributing factor to back pain? It's true. Being overweight or obese can significantly contribute to symptoms associated with osteoporosis, osteoarthritis (OA), rheumatoid arthritis (RA), degenerative disc disease (DDD), spinal stenosis, and spondylolisthesis.

How Being Overweight or Obese Can Affect the Spine
The spine is designed to carry the body's weight and distribute the loads encountered during rest and activity. When excess weight is carried, the spine is forced to assimilate the burden, which may lead to structural compromise and damage (eg, injury, sciatica). One region of the spine that is most vulnerable to the effects of obesity is the low back—the lumbar spine.

Why Exercise is Important
Lack of exercise can lead to poor flexibility and weak muscles in the back, pelvis, and thighs. This can increase the curve of the lower back, causing the pelvis to tilt too far forward. Further, this is detrimental to proper posture and as posture weakens, other regions of the spine (neck) may become painful.

Back Pain Only Age-related?
You may try to dismiss the cause of some of these spinal disorders to the process of normal aging. It is true that with age, body tissues can cause changes to spinal anatomy. However, if you are overweight or obese, chances are you have, or will have, back pain. You may have or develop one of the following conditions:

• Posture: Unhealthy posture accounts for neck and back pain. A level of physical fitness is necessary to properly support the spine. 

• Low Back Pain: Obesity may aggravate an existing low back problem and contribute to recurrence of the condition.

• Osteoporosis: A sedentary lifestyle coupled with an unbalanced diet can affect the density, or strength of the bones (spinal vertebrae). When the structural architecture of a vertebral body is compromised, it is at risk for fracture. Vertebral fractures can be painful and disabling. If you have been diagnosed with osteoporosis, you have probably lost between 25% to 30% of desirable bone density. 

• Osteoarthritis (OA) and Rheumatoid Arthritis (RA): The joints in the spine are called facet joints. Excessive body weight places unnatural pressure and stress on the joints during movement and at rest.

Development of Obesity
Industrialization and modernization has had a tremendous impact on our food. Food can be purchased just about anywhere. No longer is it necessary to expend physical effort to hunt and forage for food. There are vast numbers of processed food products available and labor-saving devices (eg, microwave ovens) to cook food. The market for many convenience foods and kitchen devices came about when women entered the workforce.

For the time period 2011-2012, the following statistics were published:

• 34.9% of adults (age 20 and older) were obese¹
• 16.9% of children and adolescents (ages 2-19) were obese¹

Are you overweight or obese?
If you are overweight or obese, there are many tools available that can help you lose and maintain a healthier body weight. How to get started? Talk with your physician or spine specialist to find out how to safely start a weight loss program. This is important because if you have back pain, your exercise program will probably be different than for a person without back pain. Remember, no two people are the same, and considering that obesity is a disease, obtaining professional help may be the best first step for you.