The shifting global landscape of low Back pain attributable to high body mass index: Burden, growth, and inequalities

Abstract

Background

Low back pain (LBP) is the leading global cause of years lived with disability (YLD), with high body mass index (BMI) recognized as a significant and modifiable risk factor. While prior research has linked high BMI to LBP, comprehensive global assessments of the burden attributable to high BMI are scarce.

Methods

We analyzed data from the Global Burden of Disease (GBD) study (1990–2021) to estimate global and regional YLDs of LBP attributable to high BMI, stratified by age, sex, and socio-demographic index (SDI). The Autoregressive Integrated Moving Average (ARIMA) model projected the future burden to 2050.

Results

From 1990 to 2021, global YLDs of LBP attributable to high BMI nearly doubled, reaching 8.4 million (95 % uncertainty interval: 0.8–17.4), with an age-standardized rate of 97.7 per 100,000. Burdens rose across all regions, with the steepest increases in middle- and lower-SDI areas. Women consistently experienced nearly double the burden compared to men. High-income North America had the largest YLD counts, while South Asia showed the fastest growth. YLDs peaked among individuals aged 40–70, with an emerging burden in the 20–40 age group. Projections suggest disproportionate increases in high- and high-middle-SDI regions by 2050.

Conclusion

The rising burden of LBP attributable to high BMI underscores the urgent need for targeted public health strategies. Integrating BMI management and musculoskeletal health initiatives into healthcare policies could mitigate LBP-related disability and enhance global population health outcomes.