Negative Effects of Obesity and Overweight

By: Dr. Carrie Diulus M.D.

There is no question that obesity has reached a critical level and dramatic personal and societal changes are needed. Not so long ago I was asked “What an orthopedic spine surgeon knows about nutrition?”  Although I believe most physicians should be experts in nutrition, the question was actually not that surprising because the standard medical school curriculum spends very little time discussing nutrition as it relates to overall health.

As a former athlete, I had a strong interest in nutrition from a performance standpoint but also because I have struggled significantly myself with weight.  At one point my own obesity had serious negative effects on my health. As a result, understanding nutrition from a multidisciplinary standpoint became my passion. I had to make major changes for my own health, but I also needed the tools to have a positive impact on my patients.  Everyday I see overweight and obese patients in my clinic with neck and back complaints.  It is a problem that is only going to get worse as juvenile obesity continues to explode. A recent population based study demonstrated a strong association between back pain and juvenile disc degeneration in overweight and obese kids! (You are right to have a sick feeling in your stomach when you read that, I do.)  In adults, recent epidemiologic studies have demonstrated that being overweight and obese are risk factors not only for acute back pain but also the development of chronic back pain.  Another recent study demonstrated that when the other underlying causes for chronic pain such as osteoarthritis and neuropathy were excluded, obese patients were still substantially more likely to have chronic pain in the legs, back, neck, shoulders and arms.

Additionally obesity significantly increases the risk of complications associated with surgery, so for all of these reasons, I spend a lot of time talking to my patients not only about their pain, but also about what they eat and their relationship with food.  I am no longer overweight, but I find my patients are much more receptive to the guidance that I provide when I share with them my own struggles.

As with Joe, a fantastic role model and I guy I greatly respect, I had to make dramatic changes in my own life with regard to my relationship with food.  Fresh expressed juice played an integral role in me losing weight and improving my health. My first juice fast lasted 42 days and I have never felt better in my life.  I still do intermittent shorter fasts and drink at least one fresh juice per day (so does my family…what better way to get kale into them).  And yes, when appropriate, I talk to my patients about juicing, amongst other dietary changes.

Over the next few months I will be talking about the current research around fruits and vegetables as they relate to health and medical conditions, give some suggestions about when a Reboot might be helpful and provide medical guidance for people considering Rebooting.

–       Samartzis D, et al. A Population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished function. JBone Joint Surg Am. 2011;93(7):662-70.

–       Shiri R, et al. The association between obesity and low back pain: A Meta-Analysis. Am J Epidemiology. 2010;171(2):135-154.

–       RayL, et al. Mechanism of association between obesity and chronic pain in the elderly. Pain. 2011;152:53-59.

–       Hitt HC, et al. Comorbidity of obesity and pain in a general population: results from the Southern Pain Prevalence Study. J Pain. 2007 May;8(5):430-6.

This information is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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Dr. Carrie Diulus M.D.

Dr. Carrie Diulus is an orthopaedic spine surgeon for the Cleveland Clinic. She treats a range of degenerative and sports related spine conditions. She has a special interest in the role of nutrition in orthopaedics and chronic pain. As a result of struggling with her own weight she now includes freshly expressed juice into her daily routine and incorporates juicing and high micronutrient diets into the treatment of her patients. Dr. Diulus has co-authored textbook chapters and her research in orthopaedics, pathology and biomaterials has been published and presented at both national and international meetings.

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