Yes, I'm Fat.

Yes, I'm in Pain.

No, They're Not Related

Pain Has No Size Limit

Let’s talk about chronic pain. Not the sanitized, medical-textbook version, but the raw reality that millions of us live with every single day. The medical establishment wants us to believe that up to 40% of people worldwide experience chronic pain because we’re doing something wrong – we’re too sensitive, too inactive, or just not trying hard enough to “get better.”

The reality? Chronic pain is a complex condition that affects every aspect of your life. It’s not just about the physical sensation – it’s about the toll it takes on your mental health, your relationships, your ability to work, and your financial stability. And for Fat people, it’s yet another battlefield where we face discrimination, dismissal, and outright medical neglect.

The Medical System's Favorite Excuse

Here’s what happens when a Fat person seeks help for chronic pain: Before we even describe our symptoms and before any examination takes place, our weight becomes the primary diagnosis. Doesn’t matter if we’re dealing with migraines, nerve pain, or post-surgical complications – somehow, magically, it’s all because of our size. This isn’t healthcare. This is medical gatekeeping wrapped in a thin veneer of “concern.”

The medical establishment loves to pretend that losing weight is the universal solution to chronic pain. Never mind that there isn’t a single study showing sustainable long-term weight loss is possible for the majority of people. Never mind that thin people get chronic pain too. Never mind that delayed treatment makes our conditions worse.

The answer is always the same: “Lose weight and come back.”

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What Chronic Pain Management Should Look Like

Here’s what your doctors won’t tell you: You deserve pain management regardless of your size. end of discussion. Chronic pain is defined as pain that persists or recurs for more than three months. Unlike acute pain, which is a normal response to injury, chronic pain is a complex condition with biological, psychological and social components. Let’s break this down, because understanding your pain is the first step in advocating for proper treatment.

First, a crucial truth that many doctors conveniently forget: Pain does not require visible tissue damage or pathological findings to be real and valid. The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience.” Notice what’s missing from that definition? Any requirement for proof on an MRI or blood test.

Your pain is real because you experience it. Full stop.

Chronic pain typically falls into three main categories:

  • Nociceptive pain: This comes from tissue injury or inflammation. Think arthritis, tendinitis, or that shoulder that’s never been the same since your accident. It’s your body’s alarm system saying “something’s irritated or damaged here.”
  • Neuropathic pain: This happens when your nerves themselves are damaged or malfunctioning. It often feels like burning, electric shocks, or pins and needles. Conditions like sciatica, diabetic neuropathy, or post-surgery nerve pain fall into this category.
  • Nociplastic pain: This occurs when your nervous system becomes sensitized to pain. Your pain alarm system essentially gets stuck in the “on” position. Fibromyalgia is a classic example, and it’s just as real as any other type of pain.

And here’s the thing they often don’t tell you: most people experience a combination of all three types. Your pain is complex, and that’s normal.

Beyond these categories, chronic pain can affect different body systems:

  • Musculoskeletal pain: Affects your bones, joints, muscles, and connective tissues. This includes conditions like osteoarthritis, fibromyalgia, and chronic back pain.
  • Visceral pain: Comes from your internal organs. Think IBS, endometriosis, or chronic pancreatitis.
  • Headache and facial pain: Including chronic migraines, tension headaches, and TMJ disorders.
  • Complex regional pain syndrome: An intense form of chronic pain that usually affects limbs and often develops after an injury.

Remember this: Each of these types of pain is legitimate, regardless of whether doctors can “see” the cause. You might have completely normal test results and still be in excruciating pain. That doesn’t make your pain any less real or deserving of treatment. Anyone who suggests otherwise is practicing outdated, harmful medicine.

More importantly, chronic pain is a legitimate medical condition that requires proper treatment – not weight loss lectures.

Your body size has nothing to do with your right to pain management.

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The Red Flags They Can't Ignore

Want to know something infuriating? There are certain symptoms that should ALWAYS trigger immediate medical attention, regardless of body size. These are called “red flags,” and if your doctor ignores them because of your weight, they’re being negligent. Here are some examples (please note that this is not an exhaustive list):

🚩New onset of pain in older age

🚩Persistent bone pain

🚩Night pain that wakes you up

🚩Neurological symptoms (numbness, tingling, weakness)

🚩Unexplained weight loss

🚩Fever and chills

If you’re experiencing any of these and your doctor’s only response is “lose weight,” they’re not just being fatphobic – they’re being dangerous.

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Fighting Back: How to Advocate for Yourself

The system is rigged against us, but we’re not powerless. Here are some suggestions on how to fight back: 

Document Everything

☑️Keep a detailed pain diary

☑️Record all instances where care was denied or delayed

☑️Save all medical records and correspondence

☑️Take notes during appointments (yes, you’re allowed to do this).

Know Your Rights

☑️You have the right to proper pain assessment

☑️You have the right to appropriate pain medication

☑️You have the right to a thorough physical examination

☑️You have the right to refuse weight-related discussions

☑️You have the right to a second opinion

Demand Proper Assessment

A legitimate pain assessment includes:

☑️Detailed discussion of your symptoms

☑️A physical examination

☑️Appropriate blood tests

☑️Imaging in most cases

☑️Discussion of ALL treatment options

Weight loss is not a legitimate treatment option for chronic pain. It puts the body under stress, worsens mood/concentration, and reduces the levels of certain neurotransmitters like ocytocin which are nature’s painkillers.

More often than not, tntentional weight loss makes chronic pain worse. 

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Chronic Pain and the Cycle of Medical Trauma

Every time a Fat person is denied proper pain management, it reinforces the cycle of medical trauma. We delay seeking care to avoid shame and discrimination. Minor issues become severe emergencies. Each negative experience adds another layer of trauma, until avoiding healthcare altogether seems like the safer option.

This isn’t about hurt feelings. This is about survival. When doctors blame our weight for everything, they miss crucial diagnoses. When they withhold pain medication because they assume we’re “drug-seeking,” they force us to live with unbearable pain. When they refuse to examine us properly because they’re uncomfortable with our bodies, they miss potentially life-threatening conditions.

The Path Forward

The solution isn’t weight loss. The solution is dismantling a medical system that uses our body size as an excuse for substandard care. We need:

☑️Healthcare providers who understand that Fat bodies deserve proper pain management

☑️Medical equipment and spaces that accommodate all bodies

☑️Pain management protocols that are fit for purpose and actually treat pain

☑️Medical education that challenges weight stigma

☑️Healthcare policies that protect Fat patients from discrimination

Until then, we must advocate for ourselves and each other.

Your pain is real. Your experiences are valid. And you deserve proper medical care, regardless of your size. Remember: They want us to believe that our bodies are the problem. The real problem is a medical system that uses our bodies as an excuse to deny us basic human dignity and essential medical care.

While we work to dismantle these systemic barriers, you don’t have to navigate this broken system alone. I provide weight-inclusive consultations where your pain will be heard, validated, and properly assessed – no weight loss lectures, no dismissal of symptoms, just real, evidence-based pain management focused on improving your quality of life.

If you’re looking for ongoing support and community…

Join us in The Weighting Room, where I offer regular clinic hours to help guide you through your healthcare journey. Together, we can work towards the care you deserve – because your pain matters, your experiences matter, and most importantly, you matter, exactly as you are.

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