Weight Loss Intervention in Overweight/Obese People Suffering from Chronic Low Back Pain

Weight Loss Intervention in Overweight/Obese People Suffering from Chronic Low Back Pain

An International Multi-center Randomized Controlled Trial

The BO2WL study

The BO2WL study is an international collaborative research project with Bern University studying the effectiveness of a combined nutrition and exercise intervention in people with chronic low back pain (CLRP) and obesity or overweight.

Chronic low back pain (CLBP) is the most expensive cause of work related disability: it causes the highest number of years lived with disability. The most severe and debilitated CLBP patients often have comorbidities such as overweight and obesity. Despite the growing body of scientific literature pointing towards the close interaction between overweight/obesity and CLBP, few treatment programs for people with CLBP nowadays take overweight into account. Therefore we propose studying the added value of a behavioral weight reduction program (changes in diet, behavior and physical exercise) to current best evidence rehabilitation (pain neuroscience education plus cognition-targeted exercise therapy) for overweight or obese people with CLBP. An international, multicentred randomized controlled trial comparing a behavioral weight reduction program combined with pain neuroscience education and cognition-targeted exercise therapy versus pain neuroscience education and cognition-targeted exercise therapy alone, will be conducted. The primary outcome is pain and the primary endpoint was chosen at 12 months follow-up; secondary outcomes include 1) other pain related outcomes (pain interference, pain distribution and pain beliefs), 2) anthropometrics (body weight/composition, muscle thickness and fat distribution), 3) energy balance related behavior (24h continuous activity monitoring, dietary intake and sleep) and finally health economics (heath care utilization, productivity loss and quality of life). If the promising results of the proof of concept study are corroborated, the new intervention will have a high socio-economic impact, including an annual health care cost reduction of €66 million in Switzerland, and €60 million in Flanders, and is expected to increase life expectancy in the long term.