Clinical Obesity最新文献

{"title":"IMPROVE 2023: The 2nd International Meeting on Pathway-Related Obesity: Vision & Evidence","authors":"Karine Clément,&nbsp;Erica L. T. van den Akker,&nbsp;Jesús Argente,&nbsp;Phil Beales,&nbsp;Metin Cetiner,&nbsp;Béatrice Dubern,&nbsp;Sadaf Farooqi,&nbsp;Aurélie Gouronc,&nbsp;Peter Kühnen,&nbsp;Johanne Le Beyec,&nbsp;Louis Lebreton,&nbsp;David Meeker,&nbsp;Hermann L. Müller,&nbsp;Jean Muller,&nbsp;Christine Poitou,&nbsp;Patrick Sleiman,&nbsp;Christian Vaisse,&nbsp;Martin Wabitsch,&nbsp;Jacques Young,&nbsp;Hélène Dollfus","doi":"10.1111/cob.70029","DOIUrl":"10.1111/cob.70029","url":null,"abstract":"<p>A total of 150 clinicians and researchers representing 19 countries came together in person and online to participate in the highly anticipated 2nd International Meeting on Pathway-Related Obesity: Vision &amp; Evidence (IMPROVE), held on 13–15 December 2023 in Paris, France. Building on the success of the inaugural event in 2022, this gathering served as a pivotal platform for attendees to delve into the latest scientific and clinical developments in hyperphagia and early-onset obesity caused by rare melanocortin-4 receptor (MC4R) pathway disease. The central objective of the meeting was to explore the complexities of MC4R pathway-related diseases and generate opportunities for collaborative dialogue among delegates for the advancement of this field. The event unfolded across three distinct sessions, with a dedicated focus on monogenic MC4R pathway disease, Bardet-Biedl syndrome (BBS) and hypothalamic obesity, together with a discussion on the future of the field. Additionally, the agenda featured three insightful workshops designed to facilitate in-depth discussions. One workshop focused on the genetics of monogenic MC4R pathway diseases, another scrutinised the genetics of BBS and the final workshop examined patient management through the exploration of clinical cases. As we reflect on the wealth of information disseminated and the collaborative spirit that permeated the meeting, it becomes clear that IMPROVE 2023 was not merely an assembly of professionals; it was a forum where the future of research in rare MC4R pathway diseases and patient care took centre stage. Here, we encapsulate the key insights, discussions, and initiatives that emerged from this important meeting.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the Early Response to an Oral Shape-Shifting Superabsorbent Hydrogel Capsule With Weight Loss.","authors":"John M Jakicic, Donna H Ryan, Jamy D Ard, Patrick M O'Neil, Robert F Kushner, Holly R Wyatt, Harold E Bays, Frank L Greenway, Sharon Leonard, Yael Kenan, Eti Ganon-Elazar, Thomas A Wadden","doi":"10.1111/cob.70037","DOIUrl":"https://doi.org/10.1111/cob.70037","url":null,"abstract":"<p><p>Early response (ER) to treatment is predictive of longer-term weight loss. In this post hoc analysis, ER to an oral shape-shifting superabsorbent hydrogel capsule (Epitomee) combined with a lifestyle intervention was compared to placebo combined with a lifestyle intervention. Participants (age = 48.5 ± 12.5 and 48.6 ± 12.4; BMI = 34.1 ± 3.3 and 33.7 ± 3.4, in the Epitomee and placebo groups, respectively) were randomised to Epitomee (N = 138) or placebo (N = 141) with lifestyle intervention. Analyses included body weight measurements taken at baseline, week 8, and week 24. Of the 279 participants enrolled in the study, 250 (90% of the ITT population) provided weight data, including 124 participants in the Epitomee group and 126 in the placebo group. Participants with missing weight data at week 24 were classified as non-responders. Early response (ER) was defined as a weight loss of ≥ 2% at week 8. Weight loss at week 24 was greater in ER to Epitomee compared to placebo (9.3% ± 6.0% vs. 6.9% ± 4.3%; p < 0.0001). The odds ratio for ER to achieve > 5% weight loss at week 24 was 4.10 (95% CI: 1.02, 16.46) for Epitomee and 2.38 (95% CI: 0.62, 9.21) for placebo. A greater proportion of ER to Epitomee, compared to placebo, achieved > 5% (76% vs. 62%; p = 0.0472), ≥ 7% (61% vs. 38%; p < 0.0045) and ≥ 10% (39% vs. 17%; p < 0.0025) weight loss at week 24. ER response to Epitomee was associated with greater weight loss at 24 weeks compared to placebo. Monitoring ER to Epitomee and titrating treatment based on ER may enhance weight loss.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70037"},"PeriodicalIF":2.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Deficiencies Following Bariatric Surgery: A Rapid Systematic Review of Case Reports of Vitamin and Micronutrient Deficiencies Presenting More Than Two Years Post-Surgery.","authors":"Sophie Haughton, Sarah Gentry, Helen M Parretti","doi":"10.1111/cob.70035","DOIUrl":"https://doi.org/10.1111/cob.70035","url":null,"abstract":"<p><p>Bariatric surgery is the most clinically- and cost-effective intervention for severe obesity. However, without adequate follow-up, it can lead to nutritional deficiencies. Patients require life-long nutritional supplements and follow-up to prevent nutritional deficiencies from developing. This rapid systematic review is the first synthesis of case reports of patients with vitamin and micronutrient deficiencies at least 2 years following bariatric surgery, the point at which patients are typically discharged from specialist bariatric services. Eighty-three cases (74 studies) met inclusion criteria. Female patients accounted for 84% of the reports. Roux-en-Y Gastric Bypass (RYGB) was the most common procedure to have been performed, followed by biliopancreatic diversion (BPD). The most frequently reported deficiencies were vitamin A (n = 15), copper (n = 14) and vitamin D (n = 23). In some cases, vitamin replacement led to symptom resolution, but some preceded permanent disability or death. Fifty-one case reports detailed factors contributing to the development of the deficiency. These could be divided into patient factors or health care factors and provide areas to target interventions, including support to adhere to supplementation, appropriate follow-up, and health professional awareness.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70035"},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Efficacy and Safety of Tirzepatide in Obesity Management and Cardiometabolic Risk Factors: A Comprehensive Systematic Review and Meta-Analysis.","authors":"Jian-Ying Wang, Jyun-Wei Kang, Tzu-Rong Peng, Hsin-Yen Chen, Shih-Ming Chen, Ming-Chia Lee","doi":"10.1111/cob.70036","DOIUrl":"https://doi.org/10.1111/cob.70036","url":null,"abstract":"<p><p>The global prevalence of obesity and its related complications continue to rise, emphasising the need for effective treatment strategies. Tirzepatide, a novel glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide dual agonist, has emerged as a promising pharmacological option in obesity management due to its potential in weight reduction and cardiometabolic improvement. We conducted a systematic review and meta-analysis following PRISMA guidelines, including randomised controlled trials (RCTs) comparing the efficacy and safety of Tirzepatide with placebo in adults with obesity, with or without type 2 diabetes. We searched PubMed, Cochrane Library, and EMBASE databases up to December 15, 2024. Ten RCTs were included, comprising 6257 participants. Tirzepatide significantly reduced body weight compared to placebo, with a total pooled mean difference of -11.62 kg (95% confidence interval: -14.24 to -9.01, p < 0.001). In the highest dosage group of 15 mg, 88.1%, 63.3%, and 51.8% of participants achieved weight reductions exceeding 5%, 10%, and 15% respectively. Significant improvements were also noted in cardiometabolic risk factors, including haemoglobin A1C, waist circumference, body mass index, and lipid profiles. Tirzepatide showed a favourable safety profile, without increasing the risk of serious adverse events or impacting mortality rates. Tirzepatide has demonstrated effectiveness in achieving significant weight loss and enhancing cardiometabolic health in adults with obesity. While it maintains a favourable safety profile, further studies are essential to investigate its long-term safety and determine the optimal duration of treatment.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70036"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Supervised Exercised Training Before Bariatric Surgery on Body Composition.","authors":"Erika Cornu, Camille Gaulier, Elise Le Roy Feret, Muriel Guilmain, Christine Faure, Mickaël Galeas, Jérémy Hermann, Sara Kidri, Elodie Le Gregam, Tiphanie Satizelle, Marie Bois, Helena Mosbah, Estelle Caron, Séverine Magne, Laetitia Paradisi-Prieur, Anne-Laure Proust, Anne-Cécile Paepegaey","doi":"10.1111/cob.70033","DOIUrl":"https://doi.org/10.1111/cob.70033","url":null,"abstract":"<p><p>The aim of this study was to determine if a program including exercise training before surgery is effective in maintaining muscle mass 1 year after bariatric surgery. This is a nonrandomised, retrospective, single-centre study. Patients were operated on between January 2021 and December 2023. During the preparatory course, patients are offered to join the metabolic rehabilitation protocol. This consists of 3 h of day hospital three times a week during eight consecutive weeks, before surgery. A total of 178 patients were included in the study: 63 (35.4%) in the exercise group and 115 (64.6%) in the control group. A total of 150 (84.3%) were female, with a mean age was 42.0 years and a mean body mass index (BMI) was 41.8 ± 6.0 kg/m². Patients in the exercise group were older than patients in the control group, 45.6 ± 11.8 versus 40.1 ± 10.7 years old (p = 0.002), they had higher LDLc 1.34 ± 0.41 versus 1.21 ± 0.33 g/L (p = 0.05), and more of them were diabetics (p = 0.01). There were no significant differences between the two groups, but the increase in muscle mass seemed higher in exercise group versus control group: 6.3% ± 5.2% versus 5.2% ± 4.4% (p = 0.14). HDLc and delta LDLc seemed higher in the exercise group versus control group: 0.57 ± 0.13 versus 0.55 ± 0.12 g/L and - 0.29 ± 0.27 versus - 0.22 ± 0.26 g/L, and CRP tends to be lower in the exercise group 1.1 ± 1.2 versus 1.8 ± 3.4 mg/L, but these results were not significant. The implementation of a rehabilitation protocol before surgery is difficult in patients with obesity. Nevertheless, it probably allows the patients to establish regular and lasting physical activity.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70033"},"PeriodicalIF":2.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Metabolic Obesity Phenotypes and Atherosclerotic Cardiovascular Disease Risk in Arab Adults.","authors":"Kaiser Wani, Balvir Kumar, Nasser M Al-Daghri, Shaun Sabico","doi":"10.1111/cob.70032","DOIUrl":"https://doi.org/10.1111/cob.70032","url":null,"abstract":"<p><p>This study investigates the 10-year atherosclerotic cardiovascular disease (ASCVD) risk in different metabolic obesity phenotypes in Saudi adults. A cohort of 5460 adults (aged 40-79) was categorised based on metabolic status, body mass index (BMI), and visceral adiposity index (VAI). Using the ASCVD Risk Estimator Plus, the 10-year risk scores were calculated and explored in different metabolic phenotypes. Females showed higher obesity prevalence, while males had a higher metabolically unhealthy phenotype prevalence. Despite being considered healthy by traditional metrics, individuals with Metabolically Healthy Obesity (MHO) exhibited significantly higher ASCVD risk scores compared to Metabolically Healthy Normal Weight (MHNW) counterparts (2.44 vs. 1.34 in females, p < 0.001; 9.60 vs. 6.72 in males, p = 0.008). When obesity was defined by BMI, in men, MHO showed a substantially higher age-adjusted odds ratio (OR) for greater ASCVD risk than MHNW (OR = 2.04, 95% CI 1.3-3.3, p = 0.003). However, when obesity was characterised by VAI rather than BMI, ASCVD risk in metabolically healthy with high VAI (MHHV), equivalent to MHO, was similar to its normal VAI counterpart, independent of gender (OR = 0.92, 95% CI 0.7-1.2, p = 0.55 for females; OR = 1.23, 95% CI 0.9-1.7, p = 0.25 for men). The study provides insights into ASCVD risk in multiple metabolic and obesity phenotypes among Saudi individuals, indicating that VAI outperforms BMI in identifying the metabolically healthy obese phenotype.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70032"},"PeriodicalIF":2.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Dietitian in Weight Management of Adults With Obesity Without Diabetes Using Glucagon Like Peptide-1 Agonist Receptors: A Systematic Review and Meta-Analysis of Randomised Controlled Clinical Trials.","authors":"Israa Moetaz, Suhad Abumweis, Sarah Alqadi, Mahmoud AbuGhoush","doi":"10.1111/cob.70030","DOIUrl":"https://doi.org/10.1111/cob.70030","url":null,"abstract":"<p><p>The aims are (1) to identify and interpret the role of registered dietitian in clinical trials on the efficacy of glucagon like peptide-1 (GLP-1) agonists in adult individuals with obesity but without diabetes, and (2) to quantify the effect of GLP-1 agonists on body weight loss in adult individuals with obesity but without diabetes. An electronic search using PubMed and Scopus was implemented to locate eligible randomised clinical trials. Data extraction and quality assessment were conducted for 13 studies that met the inclusion criteria. Medical nutrition therapy (MNT) steps were evaluated based on the registered dietitian (RD) interventions and procedures that are included in six studies. Data analysis was carried out using specialised software. The meta-analysis results showed pooled mean differences in weight change of -5.4 kg (95% CI: -5.8, -5.0), in waist circumference change of -5.5 cm (95% CI: -7.7, -3.25), and in weight loss as a percentage from baseline of -7.75% (95% CI: -11.1, -4.3). Quality assessment and bias of each study have been reported. Nutrition practice guidelines and MNT are also listed to include screening, assessment, intervention, and monitoring. Based on current available evidence, using GLP-1 agonists for weight loss shows their effectiveness to reduce weight and waist circumference. However, further incorporation of RD in trials will help in understanding the sole effect of MNT in treating obesity using GLP-1 agonists.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70030"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Related to Bariatric Surgery (MORSE Study): A Retrospective, International Collaborative Audit.","authors":"Vignesh Balasubaramaniam, Geoffrey Yuet Mun Wong, Alessandro Martinino, Manel Riera, Mohamed Abouelazayem, Juan Pablo Scarano Pereira, Amira Said, Yitka Graham, Rajesh Kumar Jain, Helen Imseeh, Osama Aljaiuossi, Mustafa Ahmad Abu Jayyab, Said N A Alyacoubi, Kamal Mahawar, Rishi Singhal","doi":"10.1111/cob.70031","DOIUrl":"https://doi.org/10.1111/cob.70031","url":null,"abstract":"<p><p>Bariatric surgery is associated with low but definite early and late mortality. This study aims to further understand early (≤ 90 days) and delayed (> 90 days) mortality related to bariatric surgery. This is a retrospective collaborative audit of patients who had undergone bariatric surgery and developed complications that ultimately led to death. Individuals who were 18 years or older and had undergone bariatric surgery (primary, revisional, and endoscopic procedures) and subsequently died within 90 days or after 90 days following the surgery between 1 January 2022, and 31 December 2022. A descriptive analysis was conducted. About 30 centres from 21 countries submitted data on 82 patients where patient death was deemed to be related to bariatric surgery. Mortality within 90 days post-surgery was observed in 58 individuals (70.7%), while 24 patients (29.3%) died after this period. Causes of mortality after SG include GI leak, PE, respiratory infection, and malnutrition. Causes of mortality after RYGB include GI leak, coronary heart disease, and bleeding. Reported common causes of early mortality in this study were gastrointestinal leaks, bleeding, coronary heart disease, and pulmonary embolism. Reported common causes of delayed mortality were gastrointestinal leaks and malnutrition. This study characterises patients where death was attributed to a bariatric procedure and identifies common causes of death in these patients. This could aid development of strategies for preventing and managing these complications in the future.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e70031"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional analysis of emotional and binge eating in UK adults enrolled on the NHS low-calorie diet pilot for type 2 diabetes","authors":"Jordan Marwood,&nbsp;Duncan Radley,&nbsp;Tamla Evans,&nbsp;Jamie Matu,&nbsp;Kenneth Clare,&nbsp;Chirag Bakhai,&nbsp;Louisa J. Ells","doi":"10.1111/cob.70025","DOIUrl":"10.1111/cob.70025","url":null,"abstract":"<p>This study presents data gathered as part of the Re:Mission evaluation of the NHS low-calorie diet programme pilot for type 2 diabetes, to address two research questions: (1) What is the presence and severity of emotional and binge eating within this population? (2) Are demographic and health factors associated with the presence of binge eating or the severity of emotional eating? An online survey gathered data from <i>n</i> = 580 individuals who were enrolled on the programme but had not yet begun total diet replacement. The survey assessed emotional eating (TFEQ-R21), potential binge eating disorder diagnosis (BEDS-7), wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale), quality of life (EQ-5D-5L), frequency of weight cycling and demographic factors (collected via NHS England programme monitoring). Descriptive statistics and regression analyses were used to address the research questions. The mean emotional eating score from the TFEQ-R21 was 2.58 (0.96), and the presence of a potential binge eating disorder diagnosis was demonstrated in 26.0% of the sample. Regression analyses suggested that being female and engaging in more frequent weight cycling were associated with higher emotional eating and a greater likelihood of binge eating. Lower wellbeing and lower quality of life were associated with emotional and binge eating, respectively. Rates of emotional and binge eating in the NHS low-calorie diet pilot sample are higher than in the general public and in other similar samples. Consideration should be given to screening for emotional and disordered eating and for additional tailored support and monitoring for such individuals.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of body size, prior care quality, and weight gain on health care utilization during the COVID-19 pandemic","authors":"Sean M. Phelan,&nbsp;Samantha R. Philip,&nbsp;Amelia K. Barwise,&nbsp;Jay-Sharee P. Akambase,&nbsp;Matthew G. Johnson,&nbsp;Lily Huang,&nbsp;Megan A. Allyse","doi":"10.1111/cob.70019","DOIUrl":"10.1111/cob.70019","url":null,"abstract":"<div>\u0000 \u0000 <p>The goal of this study was to ascertain the effect of patient body size on clinic- or patient-delayed health care during the COVID-19 pandemic and factors predicting delay. Primary survey data were collected in August 2021 from 3593 individuals living within the communities near Mayo Clinic facilities in Minnesota, Wisconsin, Arizona, and Florida. More people who identified with the higher-weight BMI categories reported having their care appointments cancelled (62.3%) compared to those who identified with normative weight (38.0%) or underweight (47.7%; <i>p</i> &lt; .001) and reported more frequently delaying their own care (67.9%) relative to those who identified with normative weight (47.0%) or underweight (62.3%; <i>p</i> &lt; .001). Higher-weight people were more likely than others to report delay was due to not knowing where to get care (UW: 5.6%, NW: 3.5%, HW: 7.0%, <i>p</i>_chi-square &lt; .001), worrying about weight-based judgement (UW: 2.1%, NW: 2.1%, HW: 4.5%, <i>p</i>_chi-square &lt; .001), and fearing discrimination (UW: 2.9%, NW: 2.4%, HW: 5.5%, <i>p</i>_chi-square &lt; .001). There was no difference across groups in delay due to fear of COVID-19 exposure. Weight gain was associated with care delay in higher-weight and normative weight groups. Having experienced more patient-centred care pre-COVID was associated with less care delay in the normative weight group, but more care delay in other groups. Higher-weight people were more likely to have their care delayed by health care providers and to delay care themselves. Patient weight gain and concerns about discrimination and judgement about weight gain may have driven the delay of needed care during COVID-19.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}