# Empowering the Management of Pain-Obesity-Weight through Enhanced Reward

> **NIH NIH R21** · UNIVERSITY OF FLORIDA · 2021 · $228,750

## Abstract

PROJECT SUMMARY/ABSTRACT
Chronic low back pain (cLBP) is the leading cause of disability worldwide and is one of the top reasons for
seeking healthcare. High-impact low back pain is particularly problematic, defined as chronic pain accompanied
by significant restrictions in work, social, and/or self-care activities for six months or more. High-impact pain is
associated with greater pain-related disability, opioid use, and healthcare costs compared to pain of lower
impact. Thus, efforts to reduce chronic pain impact have become a public health initiative. Low back pain and
overweight/obesity are highly comorbid; overweight and obese individuals are up to 43% more likely to have
cLBP compared to normal weight individuals. Together, the additive effects of overweight/obesity and chronic
pain may play a larger role in increasing the risk for other adverse health-related comorbidities. To understand
the relationship between excess weight and pain impact, we have developed a conceptual model that suggests
the greatest reductions in pain impact for adults with comorbid cLBP and overweight/obesity will be observed by
delivering content aimed at increasing non-food environmental reward and positive affect, in addition to delivering
evidence-based weight loss and pain coping treatments. Therefore, the aim of this exploratory study is to
examine the feasibility and acceptability of an integrated pain and weight management intervention (EMPOWER)
for middle-aged and older adults with moderate-to-high impact low back pain by addressing mechanisms of
environmental reward and positive affect. Forty adults (ages 45-80 years) with comorbid overweight/obesity
(BMI≥25 kg/m2) and moderate-to-high impact cLBP will be assigned to an 8-month intervention, whereby they
will receive a group- and telephone-based program featuring integrated behavioral weight loss treatment and
cognitive-behavioral pain coping therapy. To address the key mechanisms of environmental reward and positive
affect, the proposed intervention will incorporate systematic pleasant activity scheduling and values-clarification
techniques. Assessments will be conducted at baseline and at the 4- and 8-month time points. The proposed
research will be a step toward the development of therapeutic modalities aimed at improving pain and weight
management in adults with comorbid cLBP and overweight/obesity, and will provide essential information to
guide a larger, randomized-controlled trial of the EMPOWER intervention.

## Key facts

- **NIH application ID:** 10107020
- **Project number:** 1R21AG070642-01
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Emily J. Bartley
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $228,750
- **Award type:** 1
- **Project period:** 2021-02-15 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10107020

## Citation

> US National Institutes of Health, RePORTER application 10107020, Empowering the Management of Pain-Obesity-Weight through Enhanced Reward (1R21AG070642-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10107020. Licensed CC0.

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