Background <p>The study investigated the acceptance of traditional Chinese medicine (TCM) in (pre-)obese people with the psychosocial atherogenic lipopathic metabolic syndrome (PSALMS) in German-speaking Europe, particularly in people with skeletal pain.</p> Aim <p>To Investigate the influence of pain on TCM preference in (pre-)obese people.</p> Patients and methods <p>A&#xa0;retrospective subgroup analysis of the BARBQTCM (Bariatric Basic Questionnaire for Traditional Chinese Medicine) cross-sectional study collected 496 anonymous questionnaires from the German SANA clinic in Offenbach. Two cohorts, with and without skeletal pain, were compared. Anthropometric data, the use of conventional and complementary therapies, and TCM acceptance for PSALMS complaints were recorded. In addition, the willingness to visit TCM outpatient clinics and to spend money on TCM was examined.</p> Results <p>The cohort consisted mainly of women (73.2%) and had a&#xa0;median age of 45&#xa0;years and a&#xa0;median BMI of 43.1 kg/m². Almost all respondents used conservative (98.5%) and almost a&#xa0;third complementary (29.6%) weight-loss therapies. Two-fifths reported skeletal pain (39.7%). Acceptance of TCM therapies was significantly higher in the pain cohort than in the control group (all <i>p</i> &lt; 0.001). The pain cohort was significantly more likely to visit a&#xa0;TCM outpatient clinic and spend more money on TCM (all <i>p</i> &lt; 0.001). Experience with complementary medicine was the only positive influencing factor on TCM acceptance (RR: 2.84 [95% CI: 1.82–4.41]; <i>p</i> &lt; 0.001).</p> Conclusion <p>TCM therapies can be integrated into multimodal treatment concepts if there is evidence-based proof of effectiveness for (pre-)obesity and skeletal pain, as acceptance in the affected cohort has been impressively demonstrated.</p>