Higgins, Diana M.Buta, EugeniaHeapy, Alicia A.Driscoll, Mary A.Kerns, Robert D.Masheb, RobinBecker, William C.Hausmann, Leslie R.M.Bair, Matthew J.Wandner, LauraJanke, E. AmyBrandt, Cynthia A.Goulet, Joseph L.2022-07-112022-07-112020-10-01Higgins DM, Buta E, Heapy AA, et al. The Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study. Pain Med. 2020;21(10):2563-2572. doi:10.1093/pm/pnaa043https://hdl.handle.net/1805/29521Objective: To examine the relationship between body mass index (BMI) and pain intensity among veterans with musculoskeletal disorder diagnoses (MSDs; nontraumatic joint disorder; osteoarthritis; low back, back, and neck pain). Setting: Administrative and electronic health record data from the Veterans Health Administration (VHA). Subjects: A national cohort of US military veterans with MSDs in VHA care during 2001-2012 (N = 1,759,338). Methods: These cross-sectional data were analyzed using hurdle negative binomial models of pain intensity as a function of BMI, adjusted for comorbidities and demographics. Results: The sample had a mean age of 59.4, 95% were male, 77% were white/Non-Hispanic, 79% were overweight or obese, and 42% reported no pain at index MSD diagnosis. Overall, there was a J-shaped relationship between BMI and pain (nadir = 27 kg/m2), with the severely obese (BMI ≥ 40 kg/m2) being most likely to report any pain (OR vs normal weight = 1.23, 95% confidence interval = 1.21-1.26). The association between BMI and pain varied by MSD, with a stronger relationship in the osteoarthritis group and a less pronounced relationship in the back and low back pain groups. Conclusions: There was a high prevalence of overweight/obesity among veterans with MSD. High levels of BMI (>27 kg/m2) were associated with increased odds of pain, most markedly among veterans with osteoarthritis.en-USAttribution 4.0 InternationalChronic painMusculoskeletalObesityOsteoarthritisArticle