Understanding the relationship between overweightness and pain

Chronic pain and overweightness are two prevalent health concerns that impact millions of people even in Singapore. Over 40% of Singaporeans are either overweight or obese! In this blog post, we exploring the factors contributing to overweightness and chronic pain as well as the importance of addressing both simultaneously for improved well-being.

What is chronic pain?

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The International Association for the Study of Pain (IASP) defines chronic pain as pain that persists or recurs for an extended duration. Pain that last beyond the expected time for healing or recovery is considered chronic. Broadly speaking, all pain that lasts for more than three months is considered chronic.

Because chronic pain continue beyond the typical healing time of an injury, it can present even in the absence of injury. In other words, pain doesn’t always mean tissue damage. Chronic pain as a complex and multifaceted condition that can involve biological, psychological, and social factors. For this reason, a biopsychosocial approach to understanding and addressing chronic pain is crucial for long-term success.

This is why overweightness concerns us as chiropractors.

How do I know if I am overweight?

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Did you know high BMI scores and body fat percentages can be risk factors for sarcopenia Sarcopenia is a disease with loss of muscle mass strength and function While more commonly seen in seniors it can also affect young adults

Overweight is a term used to describe an excess amount of body weight in relation to height. This typically results from an accumulation of excess body fat. It is commonly determined using the Body Mass Index (BMI), which calculates the ratio of an individual’s weight to their height.

The international standard for healthy Body Mass Index (BMI) range generally falls between 18.5 and 24.9. However, in Singapore, the healthy range is between 18.5 and 22.9. If your BMI score is 23 and above, you are considered overweight.

BMI is just one measure of body weight. While BMI is a widely used screening tool, it does not account for factors such as muscle mass, bone density, and body composition. To learn about alternatives and more accurate measurement of body fat percent, check out our earlier post on Understanding BMI.

Does being overweight cause chronic pain?

Numerous studies have indicated that being overweight or obese increases the risk of developing chronic pain. Research has shown that obese individuals are twice as likely to experience chronic pain compared to those with a healthy BMI. Furthermore, individuals who are severely obese are four times as likely to experience chronic pain. It is evident that body weight plays a significant role in the experience of pain. As such, managing weight can be a crucial factor in alleviating and preventing chronic pain.

There are several reasons why being overweight may contribute to increased pain levels:

1. Increased mechanical stress

Carrying excess weight puts significant strain on the musculoskeletal system. This impacts your joints, bones, and muscles. The increased mechanical stress resulting from the additional weight can contribute to the development or exacerbation of various painful conditions.

Joints are responsible for connecting your bones and enabling movement. A substantial burden, when excess weight is present, can cause pain, stiffness, and reduced mobility. Weight-bearing joints such as your knees, hips, and ankles are particularly susceptible to this condition.

Additionally, carrying excess weight can strain the structures of the spine, leading to back pain. The spine is responsible for transferring your body’s weight through to your legs. Overweightness has been linked to disc degeneration, herniation, or nerve compression, resulting in chronic back pain.

2. Inflammation and metabolic changes

Adipose tissue (fat cells) is not merely a passive energy storage site! It is an active endocrine organ. Fat cells secrete inflammatory molecules, which can contribute to chronic pain. Excess body fat, especially visceral fat around your organs, can lead to a state of chronic low-grade inflammation throughout the body.

If you have a high body fat percentage, your adipose tissue may secrete more cytokines, such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). These substances can affect the functioning of nerves and pain receptors by increasing pain sensitivity. A sensitisation of your nerve endings can lead to an increased perception of pain.

The presence of chronic inflammation also increases the risk of developing chronic pain conditions such as fibromyalgia, rheumatoid arthritis, and chronic back pain.

3. Hormonal factors

Leptin and adiponectin are hormones produced by fat cells. They play a role in regulating various physiological processes, including energy balance, metabolism, and inflammation. While they primarily influence appetite and body weight regulation, research suggests that these hormones can also contribute to chronic pain.

Leptin, often referred to as the “satiety hormone,” is responsible for signaling to the brain that the body has sufficient energy stores and regulates food intake accordingly. However, in overweight or obese individuals, there can be an excess production of leptin due to an increased amount of adipose tissue. This can lead to a condition called leptin resistance, where the body becomes less responsive to the hormone’s signals. Leptin resistance has been associated with chronic inflammation and increased pain sensitivity. Inflammatory processes initiated by elevated leptin levels can sensitise pain receptors, which may exacerbate conditions.

On the other hand, adiponectin is an anti-inflammatory hormone that exhibits protective effects on your body. It helps regulate insulin sensitivity, promotes cardiovascular health, and modulates inflammatory processes. Low levels of adiponectin is commonly seen in individuals with excess body fat. The deficiency of adiponectin can disrupt the balance between pro-inflammatory and anti-inflammatory factors in the body, potentially contributing to the development of chronic pain conditions.

The interplay between leptin, adiponectin, inflammation, and chronic pain is complex and not yet fully understood. However, research suggests that imbalances in these hormones, often observed in overweight or obese individuals, can contribute to pain sensitivity and the development or maintenance of chronic pain conditions.

How can I lose weight naturally?

If you’re looking to shed some extra pounds in a healthy and sustainable way, natural weight loss strategies can be the key to achieving your goals. Rather than resorting to drastic measures or quick-fix solutions, focusing on lifestyle changes that promote balanced nutrition, regular physical activity, and overall well-being is the foundation for successful and long-lasting weight loss.

Exercise and physical activity for weight loss

If you are a chronic pain patient looking to lose weight, it is important to select exercises that are gentle on your joints and promote overall well-being. Opting for low-impact activities will minimise stress on your body while still delivering effective results in terms of calorie burn and weight loss. Consider engaging in activities such as swimming, water aerobics, stationary cycling, or brisk walking.

If you cannot perform low-impact exercises without pain, it is important to seek professional help as soon as possible. Our chiropractor at Square One Active Recovery can assess your case and help you develop a personalised exercise programme for both your recovery and weight loss.

It is important to understand that exercising with a professional does not guarantee a pain-free experience. The role of a chiropractor or healthcare professional is to assess your risk of injury and choose exercises that are suitable for your current condition. The focus is not to eliminate pain entirely, but rather to select exercises that will not exacerbate your condition and have the potential to improve it in the long run. If low-impact exercises already cause discomfort, it may be challenging to find exercises that are completely pain-free for you. However, the primary goal in your case is not to exercise without pain, but rather to gradually and safely build your body’s strength and resilience without worsening your condition. By following this approach, you can not only achieve success in your weight loss efforts but also contribute to your overall recovery and well-being.

Remember, pain is not always damage! Similarly, pain-free doesn’t mean it is good for you and not making your condition worse!

Eating a balanced nutrition to achieve a healthy BMI score

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Exercise alone is an inefficient approach to losing body weight Most of your daily expenditure comes from your basal metabolic rate An efficient approach to weight loss will also include dietary changes and muscle building By increasing your muscle mass you can increase your basal metabolic rate This means burning more calories even when you are at rest

When focusing on weight loss, it’s essential to understand that relying solely on a calorie deficit is not the best approach. While creating a calorie deficit is necessary for weight loss, it’s equally important to preserve lean muscle mass. Without which, you may end up increasing your body fat percentage! This is why careful planning of nutrients is very important.

To ensure the best results, your diet should not only provide an appropriate calorie intake but also be strategically balanced with macronutrients. Adequate protein intake is crucial to support muscle maintenance and repair while promoting satiety. Incorporating lean sources of protein such as poultry, fish, legumes, and dairy products can help preserve muscle mass during weight loss.

In addition to protein, carbohydrates and fats should be incorporated in a balanced manner to provide energy and support bodily functions. Opt for complex carbohydrates like whole grains, fruits, and vegetables. They provide essential nutrients and promote sustained energy levels. When it comes to fats, focus on healthy sources like avocados, nuts, seeds, and olive oil. They are a good source of essential fatty acids and can also contribute to satiety.

By carefully planning your nutrient intake, you can support weight loss while minimising muscle loss. This leads to a healthy body composition.

Adopting a biopsychosocial approach means you cannot just focus on physical factors alone

One of the most challenging aspects of trying to lose weight is not a lack of knowledge about what to do. You know what to do but implementing them is often not intuitive and can be extremely challenging.

You may already know the basics of weight loss: eating a balanced diet, exercising regularly, and creating a calorie deficit. However, putting these principles into consistent practice can be tough. It requires breaking old habits, making conscious choices, and facing the resistance that arises when trying to change established routines.

The challenge lies in overcoming ingrained behaviors and patterns that may have contributed to your weight gain. Emotional eating, cravings, and sedentary habits are not easily changed overnight. It takes determination, discipline, and a willingness to confront discomfort and push through resistance.

Moreover, societal influences, cultural norms, and external pressures can add further complexity to your weight loss journey. Navigating social gatherings, dealing with food temptations, and managing expectations from others can create additional obstacles that require conscious effort and resilience.

Acknowledging these challenges is an important step in your weight loss process. It allows you to approach your journey with compassion and understanding, recognising that change is not always easy. It’s normal to face resistance and encounter setbacks along the way. However, by cultivating a mindset of perseverance, seeking support from others, and being willing to step outside your comfort zone, you can overcome these challenges and make lasting progress towards your weight loss goals.

Incorporate mind-Body techniques for best results

Incorporating mind-body techniques into your routine can be a valuable approach to encouraging healthy eating and increasing exercise. One effective strategy is mindful eating. In mindful eating, you bring your full attention to each meal and take the time to savor the flavors and textures of your food. You also learn to listen to your body’s hunger and satiety cues. By being present and intentional with your meals, you can make conscious choices, prevent overeating, and develop a healthier relationship with food.

Visualise and affirm your way to success. Picture yourself engaging in regular exercise, feeling strong and energised, and achieving your fitness goals. Repeat positive affirmations such as “I am capable of making healthy choices” or “I find joy in taking care of my body.” It may sound contrived at first, and that is okay. If it already comes naturally to you, you won’t be struggling! This technique helps to reprogram your mindset, boost motivation. It also reinforces that you can make positive changes in your eating habits and exercise routine.

Remember to approach these mind-body techniques with patience and consistency. Start by incorporating one technique at a time and gradually build upon your practice. Embrace self-compassion and be gentle with yourself throughout the process. Developing new habits takes time! By incorporating mindful eating, visualisation, and affirmations techniques, you can foster a positive mindset, enhance self-awareness, and create a supportive environment to set you up for success.

Chiropractic plus personal training dual expertise can give you the best of both worlds

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Jesse is not only a chiropractor but also a personal trainer and solution focused coach Jesse has worked with athletes from amateur leagues to elite world championship levels

Not all of us have all the knowledge and expertise required to achieve our goals. For many of you, having a chiropractor who can also serve as a personal trainer is an excellent solution to help you achieve a better body composition and overall well-being.

Dr Jesse Cai is not your average chiropractor. His work experiences with professional athletes from Australia state to world championship levels give him an unmatched skill set to help you achieve your exercise goals. Through exercises, Jesse has helped his clients with their chronic pain, obesity, self-esteem and confidence, work performance, and even mental health. Jesse is a certified solution-focused coach and is currently pursuing further studies in psychology at James Cook University.

When you’re dealing with pain and overweightness, a chiropractor who is also a personal trainer can offer you unique advantages. We possess a comprehensive understanding of the musculoskeletal system, pain management, and exercise physiology. This allows us to create specialised programs that prioritise both your body recomposition and pain management.

With our dual expertise, you can be confident that Jesse will address your pain while helping you achieve weight loss. We will design exercises and workouts tailored to your needs, ensuring they are safe, effective, and supportive of your overall well-being.

Furthermore, the personal trainer-chiropractor can provide valuable guidance on lifestyle factors that can influence both weight loss and chronic pain. We will offer insights on optimising your exercise, nutrition, and mindset to support your goals. By making the necessary adjustments, we can help you achieve successful weight loss while effectively managing your chronic pain.

Start your weight loss journey with us today

The relationship between overweightness and chronic pain is complex and multifaceted. By adopting a whole-person approach, you can improve their quality of life and reduce the burden of chronic pain.

To take the first step towards being freed from the constraints of chronic pain and overweightness, simply drop us a message via the contact form below. Our team is ready to assist you in scheduling an appointment with Dr. Jesse Cai. Our chiropractor and personal trainer specialises in helping individuals with chronic pain achieve their weight loss goals. We understand the importance of addressing your specific needs and will work closely with you to develop a personalised plan. Let’s take this transformative step together!


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.