Eating to deal with chronic pain is often overlooked as a cause of weight gain, overlooked by everyone, that is, but the over eater. Individuals who experience pain for days, or even years, also often suffer from the collateral damage of obesity or being overweight. The overeating occurs either as a response to pain itself, depression, and/or sleeplessness due to pain. Too much weight may exacerbate pain in bones, joints and muscles,* and make even gentle exercise difficult because it is so much harder to move.
Pain often seems less bearable at night; perhaps because there are fewer distractions. Often pain drives us from bed and we wander around the house hoping the pain will recede so we can go to sleep. Munching on snacks to relieve pain and the anxiety and frustration at not being able to go to sleep is common. And the overeating carries over to the next day in an attempt to feed wakefulness into a drowsy body and mind.
Lack of sleep and chronic pain, not unexpectedly, are often accompanied by depression. Who wouldn’t be depressed if neither a good night’s sleep nor a life free of pain was attainable? Anti-depressants are often prescribed, but they may cause intense cravings and overeating.
And, of course, pain itself may provoke excessive food intake.
I still remember the frantic way a co-worker raced into our office asking if anyone had any chocolate. Someone handed her a chocolate bar, and she tore off the paper and gobbled it down in seconds. She normally was extremely controlled and deliberate; the most impulsive thing she might do is kill a mosquito, so we were amazed at her behavior.
“I am getting a migraine,” she explained, after the chocolate had been eaten. “I usually carry something sugary with me to eat when I feel one coming on, but I didn’t have anything with me. If I manage to eat some sugar, sometimes I can stop the pain from worsening. ”
Overeating as a result of chronic pain is probably even more common than eating during an acute painful episode. A young woman who came to me for weight-loss counseling after a painful recovery from a sinus operation told me, “I just wanted to eat sweets! I don’t know why, but they made it easier to bear the pain, and gaining weight was not as important as having some pain-free moments.”
Is it possible to eat to endure a painful condition and not gain weight?
Yes. If eating is not indiscriminate, but rather focused on foods which will reduce pain and are eaten in the correct portion size. There is a specific class of foods that will decrease pain: these are sweet and starchy carbohydrates. Protein has no effect mitigating pain, nor does fat. Eating a bacon cheeseburger or barbecued spare ribs may act as a distraction from pain because of the pleasure of eating these foods, but will not diminish your brain’s perception of painful signals from your nervous system.
Carbohydrates however, (except fruit sugar, fructose) will decrease discomfort by bringing about an increase in brain serotonin. Carbohydrates do this by potentiating the entry into the brain of tryptophan, the amino acid from which the brain makes serotonin. (Even though tryptophan is found in protein, eating protein prevents serotonin from being made.)
Serotonin, a multi-tasking neurotransmitter involved in mood and eating regulation, is known to diminish pain. In fact, this is why anti-depressants that increase serotonin activity are sometimes prescribed for the chronic pain of fibromyalgia, and even back pain. However, these drugs do not increase the amount of serotonin in the brain; only eating carbohydrates can do this.
Twenty-five or thirty grams of a fat-free or very low-fat carbohydrate food like pretzels, Cheerios or oatmeal are sufficient to raise brain serotonin levels. Eating two or three 25-gram snacks a day to reduce pain contributes no more than 300-400 calories to the day’s calorie total. This is less than the calorie content of a modern day bagel. It is important that the carbohydrate be consumed on an empty stomach, however, to speed up digestion so pain is decreased more quickly. It is also important to avoid carbohydrates that are processed with fat such as cookies, ice cream, piecrust, fries, chips, and chocolate, because fat slows down digestion and adds unwanted calories. Of course it is more pleasurable to snack on these foods than steamed rice or rice cakes. However, the long-lasting comfort carbohydrates provide comes not from their effect on taste buds, but from their effect on increasing serotonin.
Anyone who has suffered acute or chronic pain yearns for its end. Eating carbohydrates won’t bring this about. But doing so might make the pain bearable at least for a few hours and that small relief is welcome.