Obesity and chronic pain are prominent global health problems. Clinical studies have shown that the incidence of chronic pain significantly increases in obese people. Animal evidence suggests that obesity increases pain sensitivity, but the detailed mechanisms have not been completely elucidated. This article reviews the recent mechanisms of obesity affecting chronic pain from the aspects of inflammation, immunity, neuroendocrine，intestinal microbiome and pathophysiological signaling pathways, in order to optimize the prevention and treatment of pain in obese patients and provide thoughts for further research.