UGH, I just lost my recent updates to this blog post, and I had the intro perfect lol, so I’m going to try writing it again! Let’s hope my memory cooperates!

Over the holidays, I spent a lot of time reflecting on the journey writing my blog has taken me on, and what I truly want to accomplish in the coming year. As I looked back at the posts I wrote in 2025, one profound conviction kept surfacing: That I covered a lot of important topics relating to chronic pain that have helped people all over the world, but I felt I was missing something important. When I stopped and thought about what I felt was missing, or that I could do more of or better, I knew what I wanted to do and how I could start to build on that. So with that in mind, this year my goal is to go deeper. To write about all the hard, not talked about stuff. I want to write more blog posts that talk further about the invisible loads we carry, and the things that are difficult, embarrassing, or we feel are too shameful to admit, even to our closest loved ones or our doctors. 

We all carry this silent weight, the fears, the guilt, the despair, that settles deep in our hearts and makes us feel incapable of basic, simple things, and profoundly alone in our pain and distress. It’s the hidden burden that drains our spirit more than the physical pain itself. This year, I want to change that. We need to pull these secrets out of the shadows and talk about them openly, because silence is the true barrier to healing. 

By sharing more about the hard stuff, like this post that shares common struggles with body image, we will not only alleviate the heavy burden of carrying it alone, but we will also forge deeper connections with ourselves and each other. I want this blog to become a space where we can openly discuss these realities, support one another, and learn compassionate, realistic and attainable strategies to cope better with the full, complicated reality of living a chronic life. My goal is to start honest conversations that validate our experiences and, in doing so, lighten the load for us all.

So in the spirit of this goal, let’s get to it. 

I’ve always said that living with chronic pain is often like having a full-time job. No joke, it really is like working 16+ hours a day, 7 days a week, with no breaks. Day to day I am managing multiple appointments, tracking my symptoms, taking and managing my medications, trying to be as active as I can, and pacing myself with household chores and tasks. It’s a lot to deal with. In addition to pacing for my household tasks and chores, I have to manage and schedule self care into my day, as well as work on my business and be social with my family and friends. It took me years of living with pain to realize I am navigating a world that isn't built for my needs. In speaking with others who suffer from chronic pain, I found that there is a silent struggle in all of us we share that often goes unspoken in doctor's offices and with our loved ones: the profound shift in how you see, feel, judge and relate to your own body. It can be so hard to talk about and admit the dark thoughts we have in relation to our pain. 

When your body becomes a source of pain, it can feel like a betrayal. Add in the weight fluctuations caused by necessary medications and lifestyle changes, and you have a perfect storm for what I’ve learned is called Body Image Distress, which is defined as a profound psychological and emotional struggle with how you see, feel, judge, and relate to your own body.

If you are anything like me and have looked in the mirror and felt like you were looking at a stranger and someone you don’t recognize, or worse, an enemy, you are not vain, and you are not alone. This blog post explores why this happens and offers compassionate, realistic strategies to find peace in a body that is fighting a hard battle.

The Why: The Sense of Betrayal

For the general population, body image issues often stem from societal beauty standards. We’ve been hammered for years on what society deems beautiful, and learned how hard it is to live up to that shallow and unrealistic standard, especially as women. For Pain Warriors though, it goes much deeper, becoming a struggle of the self-trust and identity we used to have in ourselves. We look different, and we feel different too. The body, once a reliable partner, can become a source of unpredictable pain and a sense of failure, creating a psychological split filled with guilt, shame and the feeling we are not living up to society's standards. Furthermore, weight changes and physical limitations are rarely a choice, leading to a profound loss of control and requiring us to grieve the energetic and capable self of the Before, a form of Ambiguous Loss that lacks closure. 

1. The Body as an Unreliable Partner

I never really gave it much serious thought until recently, but lately I’ve realized I’ve been feeling the heavy weight that feels like my chronic pain has severed some sort of trust between me and my physical self for a long time. I can’t trust myself to commit to too much because I don’t know what my pain is going to be doing on any given day, or even any given hour or part of the day. The way your pain can change throughout the day and from day to day, makes it hard to have a consistent, daily routine and commit to things that are in the near future. We are always managing what we can do. Some days it feels like our bodies have failed us or are actively working against us because everything takes so much effort, causes more pain, and we can’t do what we could do before as able bodied people. This actually creates a psychological split: The Mind (which wants to do things) vs. The Body (which refuses). If I think back, I have felt this way for so many years, I actually don’t remember what it’s like not to have this split. It is hard to love a vessel that feels like a prison. I’m hoping that this year I am able to find that love for myself again. 

2. Loss of Control

Weight changes in chronic pain are rarely a choice. It’s not like we don’t want to be active because most of us do. We just can’t be as mobile as we used to because in addition to the pain, the medications we take have side effects that make it harder to navigate being active. They are often the result of:

• Inability to move: The exercise you once loved may now be impossible. I used to play 4 different sports, I was a goalie for a few women’s hockey teams, played goalie for field hockey, I was batcatcher and shortstop for a local softball team, and I enjoyed hiking, mountain biking and rollerblading. I was also really active with the kids and volunteered at their schools, took them on hikes, swimming and just getting out. All that changed in a matter of seconds, and playing sports and getting out in the community in those ways were pulled out from under me and these activities were no longer a realistic option for me. Overnight I went from this active, healthy person who enjoyed all forms of exercise, to someone who has to rest after doing something small that most able bodied people take for granted.
• Metabolic changes: Pain itself is a stressor that releases cortisol, which can alter how your body stores fat. When you live with chronic, unremitting pain, whether you feel it or not, your body is in a constant state of fight or flight. I’ve forgotten what it was like to have normal cortisol levels, because mine have been so elevated for so long. What that means for me is my body has persistent, high-level stress that causes a continuous flow of the stress hormone cortisol. These sustained levels of cortisol disrupt normal metabolism by signaling the body to maintain energy reserves. This can lead to insulin resistance and an increase in blood sugar, which in turn encourages the body to store fat, often specifically as visceral fat around the abdomen, sometimes referred to as a Cortisol Belly. This isn't a failure of willpower, even though we feel that way and blame ourselves. It is a hardwired hormonal response to the continuous biological threat of chronic pain. In other words, it’s not our fault.

• Medication side effects:

3. The Grief of the "Before" Self

You aren't just dealing with how you look now, you are grieving the body you had before. This is known as Ambiguous Loss, which is a loss that is unclear and lacks closure. It is the deep, persistent sorrow for a self that is no longer physically present but not neatly gone either. This is because there is no funeral or definitive final goodbye. You might miss your old muscles, your reliable energy levels, or the simple comfort of having clothes fit the way they used to. Our faces also change, due to weight gain, lack of sleep and medications. I look way different than I did before, and I have a profound sadness for the old looking me. I just don’t look like me. This type of grief is compounded by the knowledge that the loss is often permanent, which is a profound shift from a body that was a source of identity and strength to one that feels like a stranger or even an adversary. This grief I have for the old me is always going to be an ongoing, unacknowledged emotional burden that sits heavy alongside my physical pain. 

Compassionate Strategies for Coping

Standard body positivity advice (like love your curves!) can feel toxic or impossible when your body is a source of daily, unpredictable and unrelenting pain. This is because society’s standard movement often asks you to celebrate your aesthetics, but for a Pain Warrior, the central struggle is not about beauty standards. It is about function, survival, and grappling with the sense of betrayal from a body that no longer cooperates and doesn’t look the same. Asking someone to love a body that feels like a prison is a cruel, dismissive request. Instead, we need strategies rooted in reality and self-compassion that acknowledge the struggle and prioritize gentle acceptance and dignity over forced celebration. 

1. Shift from Positivity to "Body Neutrality"

Body Positivity asks you to look in the mirror and say, "I am beautiful." Body Neutrality asks you to say, "I am here, and I am worthy of care regardless of how I look." The shift from love to respect is the most crucial part.

• The Mindset: You don't have to love your painful knee, your medication-induced weight gain, or the scar from a procedure. But learning to respect that your body is the vehicle keeping you alive and carrying you through this chronic battle, can help lessen the emotional impact of your changed body. It's also about finding peace, not forced adoration, by acknowledging your body's current reality without judgment. This is something I am really going to be working on this year, accepting myself as I am, and reminding myself not to self criticize, but to tell myself that it is enough. That despite it all, I am enough. 
• The Affirmation: Instead of the pressure of saying, "I love my body," try a gentler, more realistic mantra: “My body is fighting hard for me today” or “My worth is not defined by my pain or my size.” This reframes your relationship from adversary to comrade in survival. 

2. Practice "Radical Closet Edits"

Holding onto clothes that fit your before body is in a way, a form of self-torture. Every time you see those jeans, they remind you of what you lost, serving as painful, physical markers of the changes and grief you are navigating. I hung onto my old clothes for longer than I should have, but once I got rid of them, I felt relieved. This relief from purging my clothes that were too small or that bothered me, motivated me to find clothes in styles I like for me that do fit. I had a lot of fun thrifting and finding new clothes that fit me. I used it as an excuse to pretty much overhaul my whole wardrobe over a period of time with clothes that suit my personality. I chose clothes based on comfort, how they’d make me feel, and I put together a really fun and unique wardrobe that is totally me.  

• The Strategy: Practice Radical Closet Edits by packing away, or even donating, the old clothes. I say packing away because you might not be ready to get rid of your clothes that don't fit entirely, but storing them in totes puts them out of sight, and hopefully out of mind. This removes the daily, unavoidable reminders of your Before self. Instead, buy or thrift a few items that fit your current body comfortably, in a style you like and that bring you dignity. This isn't giving up, it's a necessary act of self-preservation. 
• Pain-Friendly Fashion: I also learned to prioritize comfort and function while maintaining my style and any current trends that I like. Things like looking for waistbands that don't dig into sensitive areas (like areas affected by weight gain or bloating from medications or chronic abdominal pain). Choose soft, breathable fabrics that are not too restrictive. You deserve to look good and feel comfortable, affirmed, and dignified in the body you have today, regardless of its size or current challenges. This is something I felt when I replaced my wardrobe in 2024. I feel good in those clothes and I like the unique style I created with mixing patterns and wild colours with one another.

3. Grieve the Loss

This was something that took time for me to do. Don’t make the same mistake I did by not acknowledging the losses you feel. You’ve got to give yourself permission to cry over these changes. You are allowed to be angry that the steroids changed your face shape or made you gain weight. You are allowed to miss running or any sports or physical activities you used to enjoy. This grief is valid and necessary. By acknowledging the full scope of what you've lost, you can begin to process it instead of letting it become an unacknowledged emotional burden. I’m not going to lie, this can be really tough to do, especially when many chronic pain sufferers have a perpetual grief cycle that starts with each new loss or restriction of what you once could do. With chronic pain, it feels like I am always grieving something, but I learned ways to process that grief so that it doesn’t hang around longer than it needs to. 

• The Exercise: It may sound silly, but try writing a letter to your old body thanking it for what it did, the strength it provided, and the memories you shared. Be honest in your writing. Then, write a letter to your current body acknowledging its struggle, its resilience, and the difficult battle it is fighting every day. This creates a bridge of compassion between the before and the now self. Writing it down can be very therapeutic and help you feel less burdened by the unwanted changes in your body. When I write, whether it’s in one of my journals, or for my blog, it sets a little of these burdens free and I feel like I can manage and live my life better because I’m not weighed down so much by these heavy and hard to manage burdens.

4. Separate Movement from Exercise

While researching this blog post I learned something really important. That society’s view of exercise often implies hours of exercise, burning calories or sculpting the body, which are goals that can be dangerous for Pain Warriors, as they invite self-criticism and can push the body past its limits. I learned to reframe exercise as Movement. 

• The Goal: The best thing you can do for yourself is shift your focus from aesthetic results to bodily function. Move to lubricate joints, improve mental health, or simply maintain your current level of mobility without any unreasonable or unattainable expectations. And do not compare yourself to an able-bodied person. It won’t do you any good and is unfair to do to yourself. For Pain Warriors, Movement should be done with a goal of gentle care, not exertion. It’s taken me a couple years to build up my exercise and Movement routine. I do between 5 and 10 minutes of light exercise and movement every day. But I didn’t start out by doing it every day though, I had to work up to it. I started with doing a 10 minute exercise video twice a week with my mother-in-law, and I did that for over a year. Last summer I felt confident enough to try expanding and building on my existing fitness routine and the last 6 months or so I’ve been slowly adding more days to my fitness routine and I’ve built up that routine to be daily, or most days. With everything I’ve read on the subject of Movement and chronic pain, the key thing I took away from it all is not to be hard on yourself for going slow because slow is actually better, not just for your body, but for building regular, gentle movement as a daily habit. The science of habit building backs this up. This year my goal is to continue doing exercise daily, or most days, and work at building up how long I exercise for. 
• The Action: If you gained weight because you can no longer run or play sports, do not punish yourself or try to push through pain. It can have serious physical and mental consequences. Your best option is to find what is accessible now and treat it as a necessary act of self-care. This might mean restorative yoga, low-impact activities like swimming or aquacise, or simply gentle stretching in bed. The key is to find joy and function in what you can do, rather than dwelling on what you've lost and can’t do. It took me many years to even start a fitness routine because I never thought I’d be able to do it. I was thinking of exercise and what exercise is with my old brain though, instead of my new brain which has been impacted by pain. I thought only doing 5-10 minutes a couple days a week wouldn’t make a difference. Boy was I wrong. Once I set realistic exercise goals for myself, and was exercising regularly twice a week, I learned how wrong I was. 5-10 minutes of low impact exercise a couple times a week does make a difference, and for me it made a big one. Both physically and mentally. The biggest thing for me was my balance, strength and endurance improved and I look forward to exercising, something I never thought would happen in this lifetime. So don’t let yourself get caught up in thinking like I did that to make any difference you have to do an hour long exercise class, or go to the gym for hours, every day. It’s simply not true. 

5. Advocate in the Doctor's Office

If your weight gain is rapid and distressing, or if a doctor dismisses your pain as just needing to lose weight, you have the right to push back. This interaction can be one of the most stressful parts of pain management, as it often requires you to challenge a professional on a sensitive topic. I am really lucky that for me, this was not the case. My doctor fully knows why I’ve gained so much weight and does not use that as an excuse not to treat my pain. 

• Script: “I have noticed significant weight gain since starting [Medication], and it is severely affecting my mental health and body image. Is there a weight-neutral alternative we can try, or is there a safe, medically-managed way to address or mitigate this specific side effect?”
• Script: “I understand weight is a factor in overall health, but my mobility and ability to be active are currently limited by my untreated or poorly managed pain. I need to treat the pain first to be able to engage in consistent movement. Can we focus our discussion on effective pain management strategies right now, and then address lifestyle changes once my pain is under better control?”

A Final Note to the Warrior

Your body has changed, yes. It may be softer, heavier, or scarred. But remember this above all else: it is a survivor of 100% of your bad days. It has fought relentlessly, day in and day out, on your behalf.

The weight you gained might not be a burden, it’s the shield that allowed you to take the medication that lets you get out of bed and engage with your life. The softness might be a sign of the rest your system desperately needed to keep fighting. Don’t forget, every change is a testament to your endurance. 

And try to be gentle with yourself. You are fighting a battle most people cannot see or understand. You don't have to love the pain, but try not to hate the vessel that carries you through it. Acknowledge its struggle and honor its resilience. 

Who’s ready to work on this together.