Weight Gain & Foot Health: the Effects of Obesity on Feet

Many of the estimated 70 million obese Americans are trapped in a life-threatening vicious cycle:  Obesity aggravates foot problems, like heel pain and flat feet; sore feet make it hard to exercise and lose weight; and without effects of obesity on feetexercise, obesity worsens and exacerbates progression of diabetes, heart disease and other serious health threats.  Today, Dr. Anthony Weinert urges obese adults & children to seek immediate treatment for chronic, activity-limiting foot and ankle problems to foster compliance with physician-directed exercise programs.

“It’s unfortunate obese individuals get caught up in the vicious cycle of avoiding physical activity due to foot or ankle pain, thereby permitting cardiovascular disease and other life-threatening conditions to worsen as a result,” said Dr. Anthony Weinert, a Fellow of the American College of Foot and Ankle Surgeons, practicing in Warren and Troy, Michigan.  “For example, in many cases, chronic heel pain occurs from carrying too much weight.  Left untreated, it becomes an impediment to physical activity and meaningful weight loss.”

Dr. Weinert, a board certified foot and ankle surgeon,  believes there’s no reason foot or ankle pain should stop obese patients from exercising, and the first step  toward breaking that vicious cycle is to have the problem evaluated by a podiatric expert.

Some of alarming statistics about this dire health problem include:

  • In the United States alone, more than 78 million (about 36%) adults and 12.5 million (about 17%)  children are obese, according to the Centers for Disease Control and Prevention
  • Increasing body mass index (BMI)—specifically, abdominal fat mass—is “strongly associated with foot pain and disability,” according to the authors of an article published in the journal Arthritis Care Research (2012 Feb;64(2):262-8; )
  • The National Foot Health Assessment 2012, conducted for IPFH by The NPD Group, noted a strong negative relationship between obesity and foot health:  51% of survey respondents who characterized their foot health as “fair” or “poor” reported being obese
  • Severely obese females have serious problems with strike pattern when walking
  • Being overweight increases chances of tendinitis, plantar fasciitis, and osteoarthritis

Obesity affects not just the feet, but the entire lower kinetic chain, including the hips, knees and ankles.  Research over the past 10 to 15 years shows there are three major ways in which obesity has a negative impact on the feet and lower extremities:

  • Higher foot pressures, gait alterations, changes in foot morphology and negative impacts on balance and mobility. Studies have shown that compensatory gait alterations are associated with obesity.  Higher BMI was associated with reduced ability to move from a sitting to a standing position and with limited mobility in older patients.  2   Other studies have shown the negative impacts of obesity on walking gait stability, and its association with increased forefoot width and higher plantar pressures during standing and walking.
  • Increased forefoot pain, and increased frequency or probability of specific foot conditions.  Increased BMI has been shown to be strongly associated with non-specific foot pain in the general population and with chronic plantar heel pain in a non-athletic population.  8 Another study postulated that structural changes in the feet of obese children produced discomfort that may hinder them from participating in physical activity.  9  Other studies have shown increased prevalence of gout in obese people, as well as increased probability of tendinitis, plantar fasciitis and osteoarthritis.
  • Risk and severity of lower limb injuries. Increased BMI is associated with increased likelihood of foot, ankle and knee fractures in children.  16  Another study suggests that obese people have a greater risk of sustaining a more proximal distal fracture of the fibula.  17  It has also been found that people with increased BMI are more prone to sustaining distal extremity injuries in general, and that obese individuals are more likely to seek treatment for osteoarthritis of the knee than those with lower BMIs.  18  According to the Canadian Joint Replacement Registry, people with BMIs of 30 to 35 are 8.5 times more likely to need total knee replacement than those with BMIs of less than 25.  Additionally, people with BMIs of more than 35 are nearly 19 times more likely to need total knee replacement, while those with a BMI of 40 or higher are nearly 33 times more likely.

According to Dr. Weinert, many causes of foot pain can be relieved non-surgically through stretching exercises, orthotics and athletic shoes with good shock absorption and support.  If a bunion, heel pain or other condition requires surgery, patients can participate during their recovery in non-weight-bearing activities, such as riding a stationary bike, swimming or weight training.

For those moderately to severely overweight, Weinert said a thorough physical examination is mandatory before beginning an exercise program.  “Once cleared by your physician to begin exercising, don’t try to do too much too soon.  Follow a gradual routine until your body adjusts to the stress of regular physical activity,” He advised.  “For example, I counsel overweight patients to avoid working out on treadmills or elliptical machines to minimize pounding and stress on their joints.”

Shedding excess pounds helps diabetic patients control their disease, but Weinert noted many who experience foot ulcerations and vascular problems caused by diabetes might think they shouldn’t exercise.  “Every diabetic patient needs regular foot exams to check for possible sore spots and assess nerve sensation,” said Weinert.  “And with proper diabetic foot care and the right footwear, most patients can follow an exercise regimen that is safe and appropriate for them.”

For further information about the effects of obesity on feet, contact Dr. Weinert’s Warren office at 586-751-3338 (FEET), or his new Troy office at 248-362-3338 (FEET). You can also visit www.FootPhysicians.com, or Dr. Weinert’s office website for more information at: www.stopfeetpainfast.com