title: The effect of obesity on treatment outcomes for low back pain.
abstract: BACKGROUND
  The objective of this study was to estimate the effect of obesity, as measured by body mass index (BMI), on treatment outcomes for low back pain (LBP).
  
  
  METHODS
  Data from the University of California, Los Angeles, and Friendly Hills Healthcare Network low back pain study (collected from 1995 to 2000) were used to perform a secondary data analysis of this randomized clinical trial on adults who sought care for LBP. BMI was the primary predictor variable. Binary logistic regression modeling was performed to estimate odds ratios adjusted for the effects of confounders.
  
  
  RESULTS
  Using normal weight as the referent population, underweight and overweight populations did not display significant odds ratios for any of the outcome variables. The obese population demonstrated odds ratios of 0.615 (0.379, 0.998) for improvement of disability and 0.550 (0.341, 0.889) for improvement of most severe back pain.
  
  
  CONCLUSIONS
  The results of this study support an association between obesity and less effective treatment outcomes whether measured by disability (Roland-Morris scale) or pain (most severe pain NRS). Overweight and underweight populations do not appear to have significantly different outcomes than normal weight populations.
  
  
  BACKGROUND
  This trial was designed and conducted prior to the advent of registries.
authors.affiliation: University of Western States, 2900 NE 132nd Avenue, Portland, OR 97230 USA.
authors.forename: Stanley C
authors.initials: SC
authors.lastname: Ewald
authors.affiliation: Office of Public Health Studies, University of Hawaii, 1960 East-west Road, Honolulu, HI 96822 USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Hurwitz
authors.affiliation: Southern California University of Health Sciences, 16200 Amber Valley Drive, Whittier, CA 90604 USA.
authors.forename: Anupama
authors.initials: A
authors.lastname: Kizhakkeveettil
keywords: Body mass index; Disability; Low back pain; Obesity; Prognosis