Physical therapists’ perspectives and practices on weight management for chronic pain patients with obesity: a cross-sectional survey

Introduction: Overweight and obesity management in primary care gained importance due to its global rise and association
with cardiometabolic diseases and chronic musculoskeletal disorders (MSD). Physical therapists are well-positioned to incorporate weight management in their practice. This survey evaluates attitudes, barriers and clinical practices of physical therapists
regarding weight management for individuals with chronic pain and comorbid overweight or obesity.
Methods: German-speaking physical therapists in Switzerland volunteered in an online survey. Descriptive statistics summarized physical therapists’ attitudes, barriers and practices. Logistic regression analyses identified factors associated with recommending and implementing weight reduction interventions.
Results: Of the 581 respondents, 92.1% acknowledged the importance of educating patients on obesity-related health risks,
and 81.6% recommended weight reduction. Two-thirds offered weight reduction interventions in physical therapy, although
fewer (57.3%) received corresponding training during entry-level education. Most weight reduction interventions focused on
movement, endurance, and strength, whilst a minority addressed nutrition, sleep or stress. The odds of offering weight reduction interventions were higher among those with entry-level education (OR: 2.1, 95% CI: 1.4-3.3), further education (OR: 1.9,
95% CI: 1.1-3.3), and for those who perceived weight reduction interventions (OR: 6.5, 95% CI: 3.5-12.3) and counseling on
other lifestyle factors (OR: 2.9, 95% CI: 1.2-7.3) as within their professional scope.
Conclusions: While physical therapists showed positive attitudes toward weight reduction interventions for individuals with
chronic pain and overweight or obesity, their education and implementation remain inconsistent, primarily focusing on improving physical activity. Clear competencies and structured training are needed to integrate evidence-based weight management
into clinical practice.