Background: Everyday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD or WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD and WD in ethnically diverse adults with obesity has not been examined. The goals of this study were

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... to: 1) examine whether weight and racial discrimination are associated with pain intensity and interference, and 2) explore gender as a moderator of the effects of WD and RD on pain.Methods: This is a baseline data analysis from a randomized controlled weight-management trial. Eligible participants were English or Spanish-speaking (ages 18-69 years) and had either a body mass index of ≥ 30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. WD and RD were measured using the Experiences of Discrimination questionnaire (EOD). Pain outcome (pain interference and intensity) were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, and gender, with pain outcomes.Results. On average participants reported mild pain interference (T-score: 52.65±10.29) and moderate pain intensity (4.23±3.15, scale: 0-10). There was a significant interaction effect of RD and gender on pain interference. RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). There were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or intensity. Conclusions: Pain is highly prevalent in adults with obesity, and is impacted by experiences of racial and weight discrimination. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of racial and weight discrimination could help clinicians make culturally informed decisions that address barriers to pain relief and weight loss.Trial Registration: NCT03006328