Central Obesity Rather Than BMI Is Associated with Chronic Pain:A Cross-Sectional Analysis of NHANES 1999–2004

Central obesity, a phenotype characterized by abdominal fat accumulation, has emerged as a more relevant predictor of chronic disease risk than general obesity. Chronic pain, a widespread and debilitating condition, has complex etiologies that are increasingly understood to include metabolic and inflammatory factors. This study reveals that central obesity, as measured by A Body Shape Index (ABSI), is significantly associated with increased odds of chronic pain, even after adjusting for a comprehensive set of covariates, including body mass index (BMI). In contrast, BMI, waist circumference (WC), and body roundness index (BRI) show no significant association with chronic pain after adjustment. The findings emphasize that ABSI may serve as a more sensitive anthropometric marker in pain-related health risk assessments, and support incorporating central obesity indicators into public health strategies for pain prevention and management.