Health At Every Size

Chronic Pain and Weight

March 28, 2024

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I'm Michelle — health coach for women who want to escape diet culture and find the health they deserve.

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For those living in a bigger body, the simple fact is this: chronic pain is not taken seriously enough. Instead, we’re told by doctors to just “lose weight” or “exercise more”. But in many cases, that can often exacerbate the issue even more. Diet culture, along with medical culture, dismisses chronic pain. So where are we meant to turn if we want to see advice that goes beyond losing weight? 

To help me explore the intersection between chronic pain and diet culture, I spoke with Dana Karen (DK) Ciccone, a certified Pilates instructor author of the book “You’re Meant to Move: A Guide to Conquering Chronic Pain, Increasing Stress Resilience, and Reclaiming an Active Life”. DK has experienced her own personal journey with chronic pain, alongside persistent battles with food and yo-yo dieting. Eventually, she found relief through Pilates and pain reprocessing therapy. 

Today, I’m sharing her insights on the harmful impact of diet culture on our perception of pain and self-worth, and the importance of creating weight-neutral and size-inclusive spaces for movement and healing. 

Healing Chronic Pain: DK’s Story

DK was 13 years old when she first felt a sharp, crippling pain shooting through her body. She was in the middle of performing in a community theater production of Godspell, a show she had dreamed of being in since her young self could remember. 

Unfortunately, the shooting pain started happening more frequently. And she became overwhelmed with fear as she waited for the pain to happen. It took over her life, and by the time she made it to high school, she had given up on her dreams of applying to the Boston Conservatory for Dance. The pain had completely changed the trajectory of her life.

Throughout her twenties and thirties, DK not only struggled with chronic back pain, she also battled with weight cycling and yo-yo dieting, leading to a sense of frustration and self-blame. As she lived through the binge-restrict cycle for years and years, DK blamed every problem in life on her size. Eventually in her mid to late 20s, she had another severe back flare that led her to an MRI, where she discovered she had a disc herniation. 

As she looks back on this painful time, she realizes that her body and nervous system were trying to tell her something. It alerted her to the fact that years of ignored anxiety and stress needed to be felt and addressed. She knew she had developed wildly unhelpful internal narratives about her body and decided that something needed to change. DK had already started doing Pilates in 2007 because it was the one thing that brought her joy, and relieved some of her back pain. Soon it became an integral part of her pain management program.

How Diet Culture, Body Perception, and Chronic Pain Intersect

The detrimental impact of diet culture goes beyond body image and weight loss. From a young age, we’re conditioned to ignore our body’s hunger signals, which can lead to disregarding other important messages from our bodies, such as stress or toxic relationships. 

DK believes that it is this disconnect from our bodies that may predispose us to chronic pain, as we ignore those initial warning signs until they manifest as severe discomfort. And then it becomes even more fodder to hate the body, leading to a vicious cycle. 

And when you finally get to the point where you might seek medical help, what do the doctors tell us to do? Lose weight. But there is no evidence that helps anybody and in a lot of cases, it can actually make the pain a lot worse.

Pilates: A Practice for All Bodies and Backgrounds

Admittedly, when I think of pilates, I often think of the rich, slender Hollywood-actress-type women gracefully maneuvering through fancy studios. But it’s actually a lot more than that and for DK, it became her lifeline during her battle with chronic back pain.

With a unique combination of strengthening, mobility, and mindfulness, it alleviated her pain and provided a sense of safety for her mind and body.

In many countries, Pilates is integrated into physical therapy clinics, highlighting its therapeutic benefits and versatility in accommodating different body types and needs. Spring-based equipment and specialized exercises allow for safe, joint-friendly resistance training and functional movement practice, suitable for individuals of all ages and abilities.

And encouragingly, DK shares that there is a growing movement within the Pilates community to challenge stereotypes and create welcoming spaces for everyone. Initiatives like Size Diverse Pilates are dismantling the notion that Pilates is exclusive to one specific demographic. Because regardless of body size, gender, or background,  Pilates should be a practice accessible to all. And Pilates teachers like DK are striving to make the practice truly welcoming and beneficial for everybody.

Creating Inclusive Movement Spaces

DK teaches Pilates specifically for people dealing with chronic pain, not because she claims to be a miracle worker who can make your pain vanish (although many do find relief from their pain), but to focus on the importance of moving your body. There are very few situations where not moving is the best choice. Generally, staying active is crucial for our health, yet we make it difficult for people to find suitable options.

Sometimes it can feel like our only option is a brief visit to a physiotherapist or a judgmental group fitness class. So where is the best place to start? We need to recognize that diet culture harms our well-being and find spaces where movement is about feeling good in the moment, not about sweating or meeting weight loss goals.

DK’s environment is weight-neutral and she is part of organizations like Health at Every Size and the Body Positive Fitness Alliance, committed to creating inclusive spaces. She  encourages us to seek out practitioners who share those values, even if it means reaching out beyond our local area.

Ultimately, movement should light you up. It should bring you joy. It should not be a punishment, a burden, an obligation, or yet another thing to feel guilty about. Our bodies crave movement. And I’m confident everyone will have something that they can tap into that will bring them joy.

Navigating Diet Culture and Pain with Self-Compassion

In a world inundated with harmful messages about body image and relentless pressures to conform to unrealistic standards, it’s crucial to remember one thing: the problem lies in the external environment, not within ourselves. Whether you’ve absorbed diet culture messaging, struggled with your relationship with food, or experienced chronic pain, it’s essential to release the guilt and blame. Our society is overstimulated and capitalistic, bombarding us with messages that our nervous systems simply weren’t designed to handle.

But amidst the chaos, there is hope. Your body’s response to stress and pain is a natural mechanism, signaling that something needs attention. It’s a reminder that you’re not broken, just navigating a complex world. And the good news? Your body is incredibly adaptable, capable of progress and positive change throughout your life.

So as you journey through the ups and downs of life, remember to be kind to yourself. Seek out spaces and practices, like Pilates, that prioritize your well-being and honor your body’s needs. And know that with patience, compassion, and the right support, you can cultivate a deeper connection with your body and experience the joy of movement without guilt or obligation.

Learn more about DK’s first book: “You’re Meant to Move: A Guide to Conquering Chronic Pain, Increasing Stress Resilience, and Reclaiming an Active Life” 

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