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The following is a summary of “Weight discrimination partially mediates the longitudinal relationship between Body Mass Index and pain,” published in the March 2025 issue of Journal of Pain by Olson et al. 

Researchers conducted a retrospective study to evaluate weight discrimination in adults as a mediator in the association between Body Mass Index (BMI) and moderate/severe pain over time from the English Longitudinal Study of Ageing (ELSA) cohort.   

They analyzed data from 3 consecutive waves of the ELSA, BMI and self-reported pain were recorded at wave 4 (2008–2009), perceived weight discrimination at wave 5 (2010–2011), and pain categorized as no/mild or moderate/severe at wave 6 (2012–2013). Generalized linear models evaluated the association between BMI at wave 4, both as a continuous variable and as obesity status (BMI ≥30), and pain at wave 6, with weight discrimination at wave 5 as a mediator. Adjustments were made for demographics and baseline pain. Complete data were available for 5,362 individuals, with post hoc analyses conducted on 3,979 individuals who reported no/mild pain at baseline.   

The results showed that higher BMI was linked to an increased likelihood of future moderate/severe pain (b=1.05, Standard Error [SE]=0.01, P <.01), with weight discrimination partially mediating this association (b=1.00, SE=0.002, P =.05). Obesity status (BMI ≥30) was also significantly related to pain (b=1.43, SE=0.11, P <.01); however, weight discrimination did not mediate this relationship (P =.13). Post hoc analyses among individuals with no/mild pain at baseline demonstrated that both BMI and obesity status were associated with pain, and weight discrimination mediated both pathways (Ps<.05).   

Investigators concluded that weight discrimination played a part in connecting higher BMI to augmented future pain, especially for those initially experiencing minimal pain, showing its potential to worsen pain progression. 

Source: jpain.org/article/S1526-5900(24)00750-8/abstract