Americans have poor health habits and as a society, obesity is an ever, increasing problem.
However, obesity among injured workers has even greater implications:
a. Obesity arises out of inactivity that, in turn, may arise out of fear of pain or re-injury.
b. Obesity arises out of boredom; many injured workers spending their days eating, sleeping and watching television
c. Obesity becomes self-perpetuating and the eating of high caloric foods creates a cycle of short intervals between multiple meals and constant snacking
d. Obesity taxes an already injured body, and very soon it is difficult to differentiate whether the pain is simply due to carrying the extra weight
e. Obesity creates its own cycle of inactivity and arises not only from being sedentary but makes any activity more taxing
f. Obesity can be a clinical significant sign of depression (called _hyperphagia_)
When we note that a patient is rapidly (and/or progressively) gaining weight, it is important to determine not only causation but how that one problem will compound or even obstruct rehabilitation.
Interestingly, once the cause of post-injury weight gain is determined, it may be more modifiable and rehabilitation may proceed more rapidly.