Many people living with pain also struggle with their weight. It can be extremely difficult to establish and maintain healthful eating and exercise routines when you are suffering from the debilitating effects of chronic disease or injury. Extra weight can actually worsen the effects of your persistent pain condition, as well as put you at risk for developing other diseases or complications, such as heart disease, diabetes and some forms of cancer.

Even if it feels like it's impossible to exercise or eat well, taking small steps to increase your health by moving more and eating better will eventually help you feel better.

Getting started

If you want to lose weight to improve your health, your first step should be to make an appointment with your doctor. He or she can help you identify reasonable goals, guide you through the process to reach your goals and even recommend a nutritionist or dietician if necessary.

The doctor will probably measure your body mass index (BMI) to get an idea of how much extra weight you are carrying. If you'd like to figure this out at home, use the National Heart, Lung and Blood Institute's online BMI calculator.

According to the National Institutes of Health, if your BMI is between 25 and 29.9, you are considered overweight. If your BMI is 30 or more, you are considered obese. There are some limitations to using the BMI to determine if you are overweight or obese. For example, very muscular people may fall into the "overweight" category when they are actually healthy and fit. People who have lost muscle mass may be in the "healthy weight" BMI category (BMI 18.5 to 24.9) when they actually have reduced nutritional reserves.

It is important to discuss your BMI and other health issues with your doctor to determine the best way for you to lose weight and become more active.

Diet overhaul

After talking with your doctor, your next stop should be the grocery store. Stock up on fruits and vegetables, whole grains (oatmeal, whole wheat English muffins, brown rice) and lean proteins (skinless chicken breasts, veggie burgers, low-fat cottage cheese) and leave the pre-made, sugary or high-fat foods and snacks behind.

Jump start your metabolism in the morning by eating a good breakfast and set a time at night when you are DONE eating for the day. If you are still hungry, make yourself a cup of tea with skim milk to tide you over.

Try to eat smaller portions more frequently throughout the day and be sure to include protein with every meal or snack. Many experts recommend eating every three to four hours in order to keep blood sugar stabilized and minimize the tendency to binge.

Cut back on all drinks other than water, seltzer and skim milk and vegetable juices, and try to use low-calorie alternatives for condiments or dressings whenever possible.

Get moving!

Exercise is the key to healthy – and long-term – weight loss. In addition to helping you lose weight, exercise strengthens your joints and bones, lowers blood pressure and improves cardiovascular endurance. Stress can increase the amount of pain you experience and exercise helps reduce stress.

Buy a pedometer and start tracking the number of steps you take a day. Some experts recommend that people take 10,000 steps a day. If that seems overwhelming, start small ... every little bit helps! Other ways to work in exercise include playing with your pet, kids or grandkids, gardening or even walking up stairs instead of taking the elevator. Swimming is an excellent option for people with arthritis or joint problems. Talk with your health care provider about which exercise options are best for you and about ways you can pace yourself to prevent injury.

Consider joining a gym and hiring a personal trainer to help teach you proper form and technique.

Also look into Pilates and yoga classes at a local gym, or even the local YMCA or recreation center. Most qualified instructors have a lot of experience teaching people with physical limitations and can help design a program that suits you and your needs.