She ends up giving up

Maria finds it so difficult to do something about her weight and her pain at the same time. She feels like she has no options. Whatever progress she made by training vigorously she has now gone back to her previous weight and even gain some more. Her pain is at the worst possible level, she has lost her sleep. 

She can now see the interconnection between her lifestyle choices. Even the slightest change on her BMI, by losing some weight, she could feel the difference in her pain level, in her mood, she could feel more motivated to be more active, she slept better and she was in a better shape. 

Rethinking her choices she considers now that dietary adjustments and exercise should absolutely become her priorities for her to be able to self-manage better her pain. 

She decides to start over and do it all with the help of her team of healthcare professionals, such as her GP, her friend - the physiotherapist, a nutritionist and probably others that could help her achieve her goals.