Pain in People Living With Obesity: Baseline Multidimensional Profiles, Prevalence and Biopsychosocial Factors From a Cohort Study

BACKGROUND: Obesity is considered a risk factor for pain, and comorbid obesity and pain have a cumulatively worse impact on function and quality of life than either condition alone. The aim of this study was to estimate the prevalence of pain and describe the multidimensional biopsychosocial pain profiles of people with obesity (PwO). METHODS: This pre-specified cross-sectional study reports the baseline data from a longitudinal cohort study. We recruited 519 PwO from three specialist obesity clinics in Ireland. Participants completed pain-, obesity- and health-related questionnaires to capture the multidimensional biopsychosocial characteristics of their pain experience. Data were analysed using descriptive and inferential statistics. RESULTS: Pain prevalence was 77% (95% CI: 73.1%-80.6%) (70.7% female; mean age 46.6 ± 12.7 years). Participants' pain characteristics reflected heterogeneity in the pain experiences of PwO, including (mean; SD): pain intensity (0-10 numerical rating scale) (3.97 ± 2.9), number of pain locations (0-35) (5.06 ± 5.3), levels of pain-related disability and self-efficacy. The prevalence of nociplastic pain was 54% (95% CI: 49.3%-58.6%) and neuropathic pain was 30% (95% CI: 25.6%-34.8%). Clinically significant levels of pain-related worrying and kinesiophobia were reported by 20.9% (95% CI: 17.3%-24.8%) and 49.9% (95% CI: 45%-54.7%) of participants. CONCLUSION: The majority (77%) of PwO attending specialist obesity treatment services report experiencing pain. The intensity, nature, and impact of their pain vary. Over half reported nociplastic pain, one-third neuropathic pain, one-fifth significant pain-related worrying, and half kinesiophobia. These findings have implications for pain management in PwO. SIGNIFICANCE STATEMENT: This is the first multicentre prospective cohort study to investigate the multidimensional pain profiles of PwO. Pain prevalence was 77%. This is the first study to estimate (i) baseline prevalence of nociplastic-dominant pain in PwO (54%); (ii) baseline prevalence of neuropathic pain in PwO (30%); (iii) clinically significant levels of pain-related fear (20.9%); and (iv) clinically significant levels of kinesiophobia (49.9%), in PwO attending specialist obesity treatment services. These findings have clinical implications for the treatment of pain in PwO.