Rethinking pain: The hidden burden of abdominal fat

Excess abdominal fat has long been blamed for multiple health concerns. Now, going by a latest study, it turns out that excess abdominal fat could be contributing to chronic pain throughout the body. The study has discovered a surprising connection between abdominal fat and widespread musculoskeletal pain, with implications for how we understand and treat chronic pain conditions.Researchers from the University of Tasmania and other institutions analysed data from over 32,000 participants in the UK Biobank study to examine the relationship between abdominal fat and chronic pain. Using advanced MRI imaging, they were able to precisely measure two different types of abdominal fat – visceral adipose tissue which surrounds the internal organs, and subcutaneous adipose tissue, which lies just beneath the skin.The results revealed a clear dose-response relationship – the more abdominal fat a person carried, the more likely they were to experience chronic pain in multiple areas of the body. This held true for both visceral and subcutaneous fat. Participants with higher levels of abdominal fat had greater odds of reporting chronic pain overall and were more likely to have pain in multiple sites like the neck, back, hips, and knees.Intriguingly, the connection between fat and pain appeared to be stronger in women compared to men. Women tended to have more subcutaneous fat and less visceral fat than men but showed larger increases in pain risk as their abdominal fat increased. The researchers suggest this could be due to differences in how fat is distributed and functions in male and female bodies.The results revealed a clear dose-response relationship – the more abdominal fat a person carried, the more likely they were to experience chronic pain in multiple areas. As to why would abdominal fat contribute to widespread pain, the study authors propose several potential mechanisms. Excess fat tissue produces inflammatory compounds that can sensitise nerves and amplify pain signals throughout the body. It may also place increased mechanical stress on joints and tissues. Additionally, visceral fat, in particular, is metabolically active and linked to various health issues that could exacerbate pain.The research, published in the journal Regional Anesthesia & Pain Medicine, challenges the traditional view that obesity primarily affects joint pain through increased load-bearing. Instead, it suggests that fat tissue itself may drive widespread inflammation and pain sensitisation. This could help explain why conditions like fibromyalgia that involve pain all over the body are more common in people with obesity.The findings have important implications for both prevention and treatment of chronic pain. Maintaining a healthy weight and reducing abdominal fat through diet and exercise may help reduce pain risk. For those already experiencing chronic pain, weight loss interventions targeting abdominal fat could potentially provide relief. The sex differences uncovered also highlight the need for tailored approaches for men and women.More research is necessary to fully understand the complex relationship between body composition and pain. However, this study opens up exciting new avenues for investigating the roots of chronic pain and developing more effective treatments. The study was supported by a grant from the Australian National Health and Medical Research Council.