Three months into 2021 – how are you doing as you work towards your weight loss goals? They were well in play for many at the start of the year. In fact, if you look at trends in New Year’s resolutions, typically about half are goals to lose weight, along with goals of exercising more and eating healthier. Sound familiar?
Stay with it as we continue on this year. In years past, we focused mainly on our weight and determined if it was above or below where we thought it should be. We are much smarter these days and now focus on BMI, which stands for Body Mass Index so I want you to keep an eye on that too. The reason tracking BMI makes so much more sense is because our height adds to our weight, and it is important to take that into account when calculating ideal body weight. BMI is a number calculated from your height and weight, which provides information about which of the 5 categories you fall in (underweight, normal, overweight, obese, and extremely obese), and can also help to predict health problems associated with these categories.
One of these health problems is low back pain. Studies have shown that the risk for low back pain increases as BMI increases. In 2020, of our new patients coming to see us 63% had a BMI of 25 or greater, with the average having a BMI of 28. If you’ve never done this before (or if it’s been a while), search for a BMI chart on the internet and see what category you fall in. Normal weight is a BMI less than 25. Overweight is a BMI of 25-30. Obese is a BMI 31-35. Extremely obese is a BMI of 36 or higher. Remember that ⅓ of the US population (100 million Americans) suffer from chronic neck or back pain each year. In addition, ⅔ of adults in the US are overweight or obese. These numbers are significant, right? But the facts that hit home the most are these: every extra pound on the body is 4 pounds of pressure on the spine. That means that losing just 5 lbs of weight will reduce 20 lbs of pressure on the spine. Incredible!
Now, what can we do with this valuable information? Once you have a handle on your BMI category, and if it is above the normal range, start your focus on that first 5 lbs of weight (20 lbs of spine pressure). If you don’t have back pain now, there is a chance that with a high BMI, it is in your future. Prevention is a powerful tool that only you can capitalize on. If you already have low back pain, this is the motivation and understanding you need to propel you toward that healthy weight and healthy back. If this doesn’t apply to you but does to someone you love, then educate and support them in this endeavor.
No one wants to hear these words from their spine specialist, “Your spine has worn out and is badly pinching your nerves causing damage. You need spine surgery to relieve the pressure, but your obesity greatly increases your risk of complications after spine surgery.” In that scenario, most patients have too much pain to participate in enough exercise to lose any weight. Time is of the essence when it comes to nerve damage, and there is often not enough time to lose weight at that point even if diet modification could help some. This is a frightening position to be in. Of our patients that had surgery in 2020, 74% of them had a BMI of 25 or greater.
Why wait for that scenario when change can occur now? It is time to get serious about developing a program tailored to your personal needs that combines healthy eating with a fitness routine that is sustainable. Fad diets do not work long-term. This has to be a lifestyle change that you enjoy. These days there are endless options to exercise at home: apps, on-demand videos, live streaming classes, online support groups. Many of these programs do not require any equipment, such as body weight strength classes, yoga, pilates, barre, stretching routines, and have versions for all ages and all fitness levels. This is a great place to start, before buying any expensive equipment or even a gym membership. There are also many online programs that teach healthy eating habits, cooking, food shopping, and can educate you on proper nutrition.
Say goodbye to the excuses of the past. We are lucky to have so much at our fingertips. Utilize the resources available to you wisely. If you need help, your spine specialist and physical therapist can guide you. Make 2021 your year for positive, lasting change. Your back will thank you!
Reviewed by: Dr. Colin Haines, MD, FACS.