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obesity

AUTHOR: Marc Mitnick DPM

REVIEWED BY: Podiatric Medical Review Board

--> obesity and the feet

....as it relates to the feet and ankles

Obesity in America is in epidemic proportions! We as a country are getting fatter. It is estimated that two thirds of Americans are now considered overweight. This is up from 45 percent in 1960. This problem threatens to bypass smoking as the number one health hazard in America.

One third of us are considered obese which is defined as a body mass index (BMI) of greater than 30. Even more alarming is the fact that 17% of children are considered obese.

What are the causes? Obesity occurs when a person consumes more calories than he or she burns. For many people this boils down to eating too much and exercising too little. But there are other factors that also play a role in obesity. Genetics! Obesity and thinness tends to run in families. In a study of adults who were adopted as children, researchers found that participating adult weights were closer to their biological parents' weight than their adoptive parents'.

Being overweight is a risk factor for a number of health problems including diabetes, heart disease, stroke and osteoarthritis. As a result, being overweight may adversely affect the feet, ankle and legs including the knee and hip joints.

The effect of obesity on the lower extremity should come as no surprise as it is estimated that every pound of body weight puts three pounds of force through the foot while walking and as much as seven pounds when running. For example if two people, one of normal weight and the other overweight suffer the exact same injury through the same mechanism of injury, the overweight person will suffer a greater degree of injury meaning it will end up more severe. For example this could be the difference between straining a ligament versus breaking a bone.

In obese children the problem is further magnified. Children live in an environment of activity, from every day activity to athletic activity. The obese child is at a severe disadvantage. Overweight children tend to walk more slowly and with more exertion compared to normal weight children. Obese children also tend to walk with a diminished sense of balance or stability. This translates into a very quick swing phase of gait where the rear foot swings forward and a prolonged double support stance phase where both feet are on the ground. This lack of stability forces overweight children to walk more rigidly in an effort to better stabilize their gait.

Since children's bones are still forming, excessive body weight creates abnormal stresses on these forming bones and can result in less development in the arch of the foot. Some experts recommend putting all overweight kids in orthotics to control the formation of the arch of the foot, while others only recommend orthotics for symptomatic children.

To make matters worse, overweight people may suffer from metabolic syndrome which can slow the healing process. Going back to the example earlier, this means not only will the overweight person require more time to heal because of a more severe injury than the normal weight person, but the overweight person’s metabolism will further delay the healing process because in the metabolic syndrome the body is not working at its optimum capability.

Scientists have found a direct correlation between obesity and pathology of the lower extremity. Carrying added in weight in an individual who tends to pronate, may lead to chronic heel pain.

So why am I writing about obesity? It should be clear that there is a direct connection between some foot and ankle pathology and excessive weight. This occurs on two fronts. One is the biomechanical abnormalities that I have already discussed such as being more prone to worse injuries and being more susceptible to chronic type of foot and ankle pains.

Additionally, overweight people have a greater tendency to become type II diabetics. Most disconcerting is the fact that there has been a substantial rise in diabetes among our youth; those ages between 10 and 19 years. (1)

As obesity relates in everyday practice, I see many people with a variety of foot and ankle problems who happen to be overweight. In spite of all the treatment protocols available to me for various conditions, one central fact remains. Unless these people lose weight, their lower extremity problems are not going to totally resolve themselves and even if we are lucky in eradicating a problem, those that are overweight have a much greater chance of redeveloping the same problem.

In many circumstances where I feel the major catalyst to the particular problem a patient presents with is their weight, I am point blank about that fact. I tell these patients that I am not a magician and unless something is done about their excess weight this particular problem (and others) will continue to plague them.

I have seen this hundreds of times over my career where excess weight and foot and ankle problems lead to a vicious cycle of pain, leading to diminished activity, leading to further weight gain, leading to even less activity.

So, for those of you reading this article and who happen to be overweight suffering from the same cycle and problems above, I cannot emphasize how important it is to take charge of your life and do what ever it takes to lose that weight. I cannot speak as an expert on how obesity affects the rest of your body, but I will tell you this; over time the foot and ankle will continue to degenerate and only get worse and whereas there may be treatments that were once helpful for your foot or ankle problem, eventually even those treatments will become less effective.



1. NIH. Statistics related to overweight and obesity, Accessed at: NIH Statistics



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Fla
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Ontario, Canada
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Andrew

Fla.
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Judy

(location unknown)
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New York
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Memphis, TN
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Scotland
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J. Simmons

(location unknown)
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Redondo Beach, CA
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LH

(location unknown)
First, thanks for putting together this website. Its the most informative site I have found dealing with foot problems. Last June I started having pain and swelling at …….

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(location unknown)
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(location unknown)
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Madison, Alabama
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Denison, TX
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West lafayette, IN
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Texas
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Tampa, Florida 33624


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UK


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Regards,

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South Africa


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Mansfield Ctr, CT


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Placentia, California


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Unknown

Unknown location


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Unknown location


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Pacific Grove, CA


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All the best,

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Alameda, California


By the way, millions of websites could use yours as a guideline on how to organize information and make the site user-friendly. Kudos to you!

Anonymous


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Anonymous




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Thanks very much for the wonderful informative site.

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New Zealand


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Sincerely

Josette


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Arizona
I searched the internet everywhere for a clear description and illustration of my symptoms/problem. https://www.foot-pain-explained.com/ was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

Florida
1st of all THANKS A LOT for your great site......

Anna

Poland
Thank you so much for your response. I will let you know how I am doing if you would like. Your website is awesome!

M P

South Carolina
Hello! I want to thank you for such an informative website! I found you based on my ankle pain search and am happy to realize that there may be a relatively simple cause and solution....

Natalie

unknown location


...Thanks for your fantastic service.

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Arlington, VA


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San Clemente, CA


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Pam

location unknown


Great insights! Thanks Doc, you're the best.

Glen

location unknown


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Bre

location unknown


Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous




Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

anonymous




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Poland




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Seattle, WA


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Bonnie

location unknown




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Bill

New Jersey




Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown




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Chrissy

location unknown




Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA




Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown




Your website is full of a lot of helpful information, and I am very impressed with the time in which you responded to my post. Thank you again for your time and consideration in your response.

-Sunny.

location unknown




Thank you very much for the information, I will consider it. Excellent web site.

Jackie

San Diego, CA




Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY




Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown




THANK YOU SO VERY MUCH FOR YOUR TIME AND EFFORTS, YOU ARE SO VERY APPRECIATED. THANK YOU FOR ALL YOU DO.

Jackie

Whichita, KS




thanks again, this site is very helpful.

mark

Boston, MA




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....Keep up what your doing. Your a life saver.

Michelle

Colorado




Thanks again for the information provided on your site. It's easy for non-medical folk to understand your writing, and helps provide better communication between patient and doctor.

annielou

Colorado


Wonderful advice

by: Anonymous

This is the best site for foot problem info.


Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown
Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

Barb D.

Canada
I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

Bonnie

location unknown
Again, Thank you from the bottom of my heart for taking the time to answer my question....your an angel!

Nancie

Wisconsin
Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown
Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

Renae

North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown


Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida
Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown
Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey


Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown


I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!

Melody

Lenoir, NC


Thank you so much Doc for a quick and thorough response!

Rustam

Bellevue, WA


I cannot thank you enough for your response, opinion, and suggestions! I want you to know how much it means to me, and I'm sure everyone else who has ever asked you a question! I feel like you're a lifesaver and have empowered me to take a stronger role and stand up for myself and my feet!

Jodi

location unknown



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