Alex Simotas, MD

Hospital for Special Surgery
Board Certified Physiatrist
Specializing In Spine & Sports Medicine

Home > Learning Center > Risk Factors > Weight Control, Diet & Back Pain

Weight Control, Diet & Back Pain


Repeat studies have shown that weight is a factor in back problems. Carrying extra pounds (especially around the waistline) means that your muscles work harder to perform routine tasks. Being overweight may change your normal posture and add strain to the back muscles.


A nutritious diet includes plenty of fresh fruits and vegetables, lean protein, and low fat dairy products. Eat a variety of colored fruits and vegetables. Different color fruits usually have different antioxidants. Study food nutrition labels. Avoid foods high in saturated and trans fats, sugars, sodium. Look for foods with a higher intake of calcium, fiber, and iron.

Lack of sleep can cause excess hunger, overeating, and weight gain. Exhaustion also impairs your judgment, which can lead to poor food choices. Aim for around 8 hours of quality sleep a night.

Exercise is essential to weight loss. It burns calories, and will improve your resting metabolism. The amount of exercise will determine your calorie consumption. The amount of work expended is directly related to the intensity and length of exercise periods. One way to keep track of actual amount exercise you perform is to use a heart rate monitor. This will best calculate the calories you consume during exercise.
Exercise needs to be performed constantly. No time to exercise? Consider short periods throughout the day. Research shows that even three 10-minute spurts of exercise per day are better than not exercising at all.

You reduce your daily calorie intake by replacing soda, alcohol, or coffee with water. Thirst can also be confused with hunger, so by drinking water, you may avoid consuming extra calories, plus it helps break down and digest food.

Fruits, Vegetables, Beans, Whole grains. High fiber foods are more “filling” and satisfy your hunger with far less calorie intake.

Consider consulting a dietician or nutritionist.


Step 1: Create a target weight.
Be realistic and plan for gradual changes. Your ideal body weight (IBW) is important to know even though it may be unrealistic to use this as a target the first time around.

Your ideal body weight (IBW).
Refer to any chart to figure this out.  A rule of thumb is:

  • Woman: 100 pounds of body weight for the first 5 feet of height, and then add 5 pounds for each additional inch.
  • Men: 106 pounds of body weight for the first 5 feet of height plus 6 pounds for each additional inch.
  • For a small body frame, subtract 10%. For a large frame, add 10%.

BMI and body fat
Body fat is a better measure of under- or overweight. Body Mass Index is an estimate of body fat using weight and height. Refer to the Center for Disease Control‘s website to compute this easily:

  • For women: 20-21%.
  • For men: 13-17%.

Step 2: Figure out your daily caloric needs to maintain the same weight. Click here to figure this out:  Healthy Weight Tool Kit.

Step 3: How much exercise? How much calorie restriction do I need?
This varies widely dependent on the individuals metabolism but as a rule of thumb:

  • Overall 3500 calories is felt to be equivalent to one pound.
  • 500 calories less per day either through exercise or diet should result in 1 pound a week weight loss.
  • Consult a calorie counter, to estimate what you are consuming per day. Many sources available. Click here for one example.
  • Many websites are available that will calculate average calories burned by exercise of different types although a more accurate measurement is obtained by using a heart monitor. Click here for an example.

HEALTHY WEIGHT LOSS: Other Considerations

  • Making a long-term commitment to a lifestyle change: No weight loss program is a quick-fix. Consider a life-long commitment for more permanent results.
  • Engage support: Social support systems include Weight Watchers, family, friends.
  • Consistency more than speed. Slow and steady weight loss is best. (1 to 2 pounds a week). Fast weight loss can result in losing mostly water and muscle, rather than fat.
  • Stop eating before you are full. It takes time for the signal to reach your brain that you’ve had enough.
  • Set goals and track your progress.
  • Eat a healthy breakfast. It can prevent binge eating later in the day.
  • Smaller portions: consider using small plates, bowls, and cups.
  • Plan your meals ahead of time.
  • Cook your own meals.