EMPOWER: Empowering the Management of Pain-Obesity-Weight Through Enhanced Reward

Inclusion Criteria:

• 45-80 years of age

• Have a BMI≥25kg/m2

• Endorse pain in the lower back region (i.e., space between the lower posteriormargin of the rib cage and the horizontal gluteal fold), knees, or hips

• Pain must occur on at least 50% of the days in the previous six months

• Pain must be rated, at minimum, of moderate intensity (rating of 3 on a numericrating scale ranging from 0-10)

• Pain impact must be rated as moderate to severe

• Study physician reviews medical record and declares patient medically appropriatefor exercise protocol

Exclusion Criteria:

• Current participation in another psychological treatment or structured weight lossprogram

• Severe psychiatric illness not adequately controlled by medication or otherconditions anticipated to impair intervention engagement (e.g., substanceabuse/dependence)

• Presence of chronic, malignant pain (e.g., cancer)

• Significant cognitive impairment (<26) on the Montreal Cognitive Assessment (MoCA)

• Inability to read and write English

• Currently undergoing radiation or chemotherapy for cancer

• Self-reported cardiac event in the past 6 months or self-reported Heart Failure (CHF)

• Currently pregnant or breastfeeding, or planning to become pregnant during the studytime period

• Back, knee, or hip surgery within the past six months of study entry (or plannedsurgical interventions for pain during forecasted study participation)

• If currently taking prescription analgesic or psychotropic medication, must bestabilized on these treatments for >4 weeks prior to the baseline assessment

• Blood pressure higher than 180/100 mm Hg at baseline assessment

• Has had bariatric surgery in the past year or is planning to have it in the nextyear

• If participant reports the presence of systemic inflammatory disease (e.g.,rheumatoid arthritis), the study physician will be consulted to determineeligibility