Not so with real pain.  When one is suffering from chronic pain, the gain that often follows is not sought after nor welcomed when it arrives.  Weight gain can be a consequence of real pain.  The reasons are easy to understand.

Pain means that it hurts to move and that sleep is disrupted, shortened or sometimes not even possible.  Pain often means the inability to engage in the normal everyday activities like work, social activities, entertainment -- even just getting out of the house.  Pain means feeling depressed, isolated, tired and upset.  Any type of pain which makes moving unpleasant is going to limit how much a person moves.  If knees, feet, back, and legs hurt terribly when someone walks or climbs steps or even tries to get up out of a chair, then the natural thing to do is to prevent the discomfort by avoiding any unnecessary movement.

All of this is a perfect set-up for weight gain.

When it hurts to move, you tend to stay still.  When you stop carrying out your normal activities, your body uses up fewer calories.  Unless you make almost superhuman effort to decrease how much you eat, weight gain often follows.

A client told us that she had gained more than 20 pounds when she fell on ice and broke her ankle in three places.  "I used to go to the gym every day, and my job as a real estate broker had me climbing stairs all day long when I showed houses.  But after the accident and the operation that followed, I was in a great deal of pain.  I really could not move very much and spent most of my time in a chair in front of the TV."

"After my husband left for work, I was alone and had no one to call as everyone I knew was at work.  So I was really lonely.  The only bright spots in the day were when I was eating.  Unfortunately for my waistline, I was able to hobble to the kitchen.  The strange thing was that I felt hungry even though I was moving about as much  a 200-year-old tortoise.  After all, how many calories do you need when you are sitting all day?  But I wanted my three meals and of course my snacks.  Whenever I felt bored or restless or sorry for myself, I ate.  Now I am trying to undo the consequences."

Added to this equation of pain equaling weight gain is the effect on sleep.  It is hard to sleep when you hurt.  And when you sleep badly, the next day you are likely to feel very tired, depressed, and irritable.  Fatigue, moodiness, and tension are triggers for emotional overeating.  In fact, it is very hard not to eat when you feel exhausted or down in the dumps or upset.  So night after night of sleeping badly because of pain can lead to daily bouts of overeating.

Eating also becomes a distraction from what can be endless hours of isolation.  The activities that those without pain do so easily, like going to the movies or the mall or even out in the backyard, are an exercise in pain endurance for others.  Consequently, food often represents the only accessible entertainment.

The weight gain that follows chronic pain has side effects of its own.  Orthopedic problems, sleep apnea, and the other medical consequences of excess weight may exacerbate an already difficult medical situation.

Finally, some medications that are used to deal with chronic pain can also lead to overeating.  Antidepressants have been prescribed for certain disorders like fibromyalgia to help with the pain, and sleep medications are often used to make it easier for someone with pain to fall and stay asleep.  However, weight gain is a common side effect of antidepressant use.  Recently, night eating while asleep has been associated with the use of popular prescription sleep aids.

But there is help, which comes from the brain.  Your brain contains a chemical, serotonin, which will curb the appetite, increase energy, restore emotional balance and dampen pain.  It is not necessary to take drugs, supplements, or exotic herbal preparations.  All that is necessary is to eat a therapeutic amount of carbohydrate a couple of times a day.

Serotonin is produced when you eat sweet or starchy carbohydrates like honey or potatoes.  When these foods, and many like them, are eaten without any protein, changes occur in the blood that allow tryptophan to get into the brain.  Tryptophan is the chemical from which serotonin is made.  And when serotonin is made, it acts on other parts of the brain to:

• Turn off appetite

• Restore good mood

• Decrease fatigue and increase energy

• Decrease the perception of pain

The interesting thing about serotonin and its relation to carbs is that many people in pain sort of know this already.  Clients who have suffered from a variety of painful disorders told us that when they ate carbohydrates, they were able to cope with their pain and felt less agitated and fatigued.

What they learn from us is that it is important to control calories by eating only carbohydrates that have little or no fat and not eating more than necessary.  One client told us that when she followed our suggestions she slept better and was finally motivated to follow the exercise program her physical therapist had given her.  Another lost enough weight to become eligible for knee replacement surgery.  "I never would have been able to control my appetite to drop the weight the doctors insisted that I lose without following your program," she told us.

Carbohydrates and serotonin will not be able to take away all the pain but together they should help gain some pleasure and comfort instead of weight.

Copyright © 2007 Judith J. Wurtman, PhD, and Nina Frusztajer Marquis, MD

Authors
Judith J. Wurtman, PhD, has been recognized worldwide for decades of pioneering research into the relationship of food, mood, brain, and appetite. Dr. Wurtman received her PhD in cell biology from MIT and took additional training as an NIH Postdoctoral Fellow in nutrition/obesity. The author of five books for the general public, she has written more than 40 peer-reviewed articles for professional publications. She splits her time between Boston and Miami.

Nina Frusztajer Marquis, MD, received her master's degree in nutrition from Columbia University and her medical degree from George Washington University. Her articles on weight, stress, and lifestyle have appeared in numerous publications. With Judith Wurtman, she founded the Adara Weight Loss Centers in the Boston, Miami and San Francisco Bay Area, where she lives.

They are the authors of The Serotonin Power Diet: Use Your Brain’s Natural Chemistry to Cut Cravings, Curb Emotional Overeating, and Lose Weight. Published by Rodale. January 2007; $24.95US/$31.00CAN; 1-59486-346-6.

For more information, please visit www.serotoninpowerdiet.com