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Spine and Obesity

Every year more patients with obesity are being treated for spine problems. A survey of spine specialists conducted by the North American Spine Society found that 44% of their patients were obese. This is a 67% increase over 5 years. 87% of the spine specialists thought that obesity played a large role in their patient’s spine problems, while 94% recommend weight loss as a treatment option. Following weight loss, 55% of the patients reported significant improvements.

127 million Americans are either overweight or obese according to the American Obesity Association.

How is obesity defined?

Obesity is commonly defined by what is known as a Body Mass Index (BMI). The BMI does not measure a person’s body fat directly, but rather measures it indirectly based on a person’s height and weight. It is used as a screening tool to determine if a person is at a higher risk for health issues.

What is the BMI?

The BMI number is based on a chart which assigns these numbers according to a combination of a person’s height and weight. Specifically, the BMI number is derived from the weight divided by the square of the height which is then multiplied by 703. [e.g. a person 65 inches tall, weighing 150 lbs: 65 divided by (150) squared, times 703 = 24.96]

Here are the BMI ranges for adults:

BMI < 18.5 = underweight

BMI 18.5 – 24.9 = normal weight

BMI 25 – 29.9 = overweight

BMI > 30 = obese

Are there other ways to measure body fat?

Here are some other ways to measure body fat and determine obesity:

  1. Skin fold thickness measured with calipers
  2. Underwater weighing
  3. DXA (Dual Energy X-Ray Absorptiometry) scan
  4. Bioelectrical impedance
  5. Isotope dilution

These methods are not easily available, and the data can be difficult to compare to the rest of the population.

Does obesity cause spine problems?

Here are some of the spine problems which have been attributed to obesity:

  1. Degenerative Disc Disease
  2. Disc Herniations
  3. Spondylolisthesis
  4. Spondylolysis
  5. Spinal Stenosis
  6. Spondylosis (Osteoarthritis of the spine)
  7. Chronic muscle pain

Why does obesity cause spine problems?

  • Obese patients often have atrophy of the spine muscles from inactivity.
  • Excess weight increases the amount of force on the facet joints of the spine, which contributes to facet joint disease and spinal stenosis.
  • Obesity increases the workload of the discs in the spine; eventually, the discs become more prone to wear and tear, as well as injury.
  • Excess weight in the abdominal area causes a change in the spinal curvature (hyperlordosis) which can contribute to back pain.
  • Patients with a BMI > 25 have an increased risk for back problems.