Suggestion: edit the Word file before putting it into the Reader. Docs converted from PDF can carry some weird (and often useless) settings that make for huge filesizes.
Change the whole thing to a single font, pick some margin settings & set them for the whole doc, make sure the whole thing is using a single page size, and so on. If you don't care about font sizes, make it all a single size. Check for section breaks and remove them if that's feasible.
Use "save as" instead of "save" to create a new file, instead of adding changes to the old one; this also condenses the file.
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