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Obesity and foot pain – Can excess weight cause foot problems?

Medically reviewed by Dr Tahir Masud — By Mat Arrain BSc - Updated on 12/01/2023

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Our Editorial Team

  • Mat Arrain BScAuthor
  • EDITOR
  • Dr Tahir MasudMEDICAL ADVISOR

Dr Tahir Masud

Dr Masud is a specialist physician who practices in Nottingham, UK. He studied Medicine at Oxford University and St Bartholomew’s Hospital, London. He qualified as a doctor in 1985 and became a specialist hospital consultant physician in 1994. His clinical and research interests are ageing, Geriatric Medicine and Healthcare in Older People, Musculoskeletal disorders including Osteoporosis, Sarcopenia, Malnutrition, Frailty, Protein, Falls, Fractures, Syncope, Polypharmacy and Medical Education. He has published over 180 peer-reviewed research papers and has lectured extensively around the world. He has held prestigious National and International positions including the Presidency of the Geriatric Medicine Section of the European Union of Medical Specialists.

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Mat Arrain BSc

Mat has extensive experience in medical research as well as nutrition and fitness coaching. As a level 2 qualified fitness trainer Mat specialises in helping clients with obesity and diabetes lose weight. Mat is a CPD-certified dietary and supplement advisor and achieved a first-class honours degree at Sheffield Hallam University. Mat worked at Nottingham University Hospitals NHS Trust, and completed a medical research project on sarcopenia, nutrition and osteoporosis.

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Foot pain and obesity

Takeaway message

Foot pain is an extremely common symptom that affects people of all ages. Being obese or overweight increases the risk of conditions that induce foot pain. Please seek medical advice if you suffer from foot pain or obesity.

Overview

Obesity is a public health problem in most developed nations, including the USA, Canada and the UK. According to the latest reports, up to 56% of English people are either overweight or obese. [1] More specifically, 28% of people in England have a body mass index (BMI) over 30. An additional 36% have a BMI over 25 but below 30. These numbers should give you an idea of just how serious this problem is.

Today, there are hundreds of scientific studies that link obesity to foot issues. [2] Excess weight accelerates the process of wear and tear, inducing arthritis, tendonitis, and plantar fasciitis. Furthermore, obesity predisposes people to type II diabetes, which eventually causes diabetic neuropathy (more on that later).

One important statistic to consider is the following: Every additional pound above your ideal weight places up to 8 pounds of pressure on your hips, knees, and ankles. [3]

Common foot conditions that are linked to obesity

1. Plantar Fasciitis

Plantar fasciitis is an inflammatory condition that affects a ligament known as the plantar fascia. The latter originates at the heel bone and travels to the front of the foot. Due to a process of wear and tear [4], this ligament can get inflamed, leading to the classic symptoms of plantar fasciitis (heel pain).

When compared to a person of healthy weight, an obese person with a high BMI experiences tremendous stress and pressure on various structures of the foot. This includes the muscles, ligaments, and tendons. The continuous pressure on the plantar fascia will inflict micro-injuries that attract pro-inflammatory cytokines, leading to swelling and pain.

In fact, one study found that people carrying excess weight have been shown to have flatter feet, which shows that the foot arch is placed under significantly more stress in obese people. [5]

Over the years, this process becomes chronic, hindering your mobility and limiting your range of motion. A classic symptom of plantar fasciitis includes a stabbing pain that arises when walking or standing for a long time

2. Diabetic neuropathy

Diabetic neuropathy involves damage to nerves of the feet and legs and is the result of a poorly controlled blood glucose level. While diabetes is complex and has a multifactorial etiology, obesity is one of the leading causes of this condition. More specifically, researchers identified that fat accumulation in the waist area is directly associated with insulin resistance and type II diabetes.

As diabetic neuropathy develops, you may start to feel numbness and tingling in your extremities (e.g., hands, feet, fingers, and toes). You can also experience a burning or aching pain at these sites. Initially, the pain is typically mild. However, without proper treatment, it will get worse and extend to other areas.

Over time, walking becomes very challenging. In severe cases of diabetic neuropathy, patients may suffer from the softest touch to their feet.

Unfortunately, up to half, of people with diabetes will deal with nerve pain. This can severely impact their quality of life. A multidisciplinary approach is the best way to deal with diabetic neuropathy-induced foot pain. [6]

3. Hallux Valgus or Bunions

A bunion (also called hallux valgus) is a forefoot deformity where the big toe moves sideways toward the second toe. This bend in the toe causes a bump that can be red and painful when wearing shoes. This condition is significantly more likely to occur in obese people – one study found that hallux valgus affected a quarter of obese participants. [2] This finding is likely a result of excess weight causing overpronation of the big toe.

How to relieve obesity-induced foot pain

The most obvious solution is to lose weight. However, we all know that this is easier said than done. With a myriad of diets and fitness programs out there, it can be very daunting to know what’s right for you.

For this reason, we recommend that you stick to the basics. In order to lose weight, you need to place your body in a state of caloric deficit. In other words, you need to burn more calories than you eat to force the cells to use energy stored in the form of fatty acids.

Ideally, you would work with your GP, nutritionist, and personal trainer to achieve observable improvements.

How to prevent chronic foot pain

Aside from losing weight, here are some evidence-based tips to reduce your foot pain:

  • Purchase comfortable and well-cushioned shoes
  • Make sure to stretch your ankle and toes before any exercise
  • Clean your feet regularly and follow good hygiene
  • Wear footwear every time you are outdoors
  • Do not wear shoes with high heels or those with narrow toe areas

Despite how common foot pain is, you should not think of it as a normal part of your life. Seeking medical help is essential to treat foot problems. Healthcare professionals who specialize in foot and ankle problems are known as podiatrists.

References

1: Obesity statistics: (2022) https://commonslibrary.parliament.uk/research-briefings/sn03336/

2: Obesity, foot pain, and foot disorders in older men and women: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440224/

3: Obesity and Your Feet: https://www.foothealthfacts.org/conditions/obesity-and-your-feet

4: Plantar Fasciitis: A Concise Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951039/

5: The Impact of Overweight and Obesity on Plantar Pressure in Children and Adolescents: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559401/

6: Treating Diabetic Peripheral Neuropathic Pain http://www.aafp.org/afp/2010/0715/p151.html

Additional readings

Understanding the nature and mechanisms of foot pain and musculoskeletal foot disorders. Journal of foot and ankle research. https://doi.org/10.1186/1757-1146-2-1

BMJ clinical evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907787/

Nature reviews. Disease primers, 5(1), 42. https://doi.org/10.1038/s41572-019-0097-9

Obesity research & clinical practice https://doi.org/10.1016/j.orcp.2016.11.001

Journal of Foot and Ankle Research https://doi.org/10.1186/1757-1146-8-S2-O5

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