{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:00:17Z","timestamp":1785438017711,"version":"3.56.0"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DK138261"],"award-info":[{"award-number":["DK138261"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U54 GM104940"],"award-info":[{"award-number":["U54 GM104940"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Approximately 41% of the US population has obesity, though the prevalence of the highest BMI populations (e.g., \u2265\u200960\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) is increasing most rapidly. Given the association between obesity and surgical disease burden, we hypothesized that higher BMI groups would account for a growing proportion of operative volume over time. This study examined whether individuals with higher BMI have been receiving proportionally more surgical care over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All multispecialty National Surgical Quality Improvement Program (NSQIP) cases from 2005 to 2022 were analyzed (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911,634,075). Multinomial logistic regression was performed to analyze trends among BMI categories (&lt;\u200930.0, 30.0\u201339.9, 40.0\u201349.9, 50.0\u201359.9, 60.0\u201369.9, and \u2265\u200970\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), while adjusting for demographics and comorbidities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Regression models demonstrated decreased odds of patients with BMI \u2265\u200950\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      undergoing surgery over consecutive years, with increasingly higher BMI groups representing greater declines. Patients with BMI 30.0\u201339.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      demonstrated increased proportional operative volume.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite increased growth in higher BMI populations, individuals in these categories undergo fewer surgical operations annually. These findings demonstrate a critical need to understand these inequalities, which are underscored by rising obesity prevalence that may be contributing to poor access to surgical care as well as increased morbidity\/mortality of presentation with more advanced disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70240","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:50:40Z","timestamp":1780980640000},"page":"1647-1654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increasing Obesity Severity Is Associated With Less Surgical Care in the United States"],"prefix":"10.1002","volume":"34","author":[{"given":"Michael","family":"Kachmar","sequence":"first","affiliation":[{"name":"Department of Surgery, Morsani College of Medicine University of South Florida  Tampa Florida USA"},{"name":"Tampa General Hospital  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8429-248X","authenticated-orcid":false,"given":"Florina","family":"Corpodean","sequence":"additional","affiliation":[{"name":"Metamor Institute, Pennington Biomedical Research Center at Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector J.","family":"Garcia Navas","sequence":"additional","affiliation":[{"name":"Metamor Institute, Pennington Biomedical Research Center at Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Perkins","sequence":"additional","affiliation":[{"name":"Metamor Institute, Pennington Biomedical Research Center at Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Galvani","sequence":"additional","affiliation":[{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"},{"name":"University Medical Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"},{"name":"University Medical Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Danos","sequence":"additional","affiliation":[{"name":"Department of Behavioral &amp; Community Health Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Population and Public Health Science Pennington Biomedical Research Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip R.","family":"Schauer","sequence":"additional","affiliation":[{"name":"Metamor Institute, Pennington Biomedical Research Center at Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"},{"name":"Our Lady of the Lake Regional Medical Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5267-8951","authenticated-orcid":false,"given":"Vance L.","family":"Albaugh","sequence":"additional","affiliation":[{"name":"Metamor Institute, Pennington Biomedical Research Center at Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"},{"name":"Our Lady of the Lake Regional Medical Center  Baton Rouge Louisiana USA"},{"name":"Baton Rouge General Hospital  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/159281"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(25)00069-5"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2012.159"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.21170"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.70099"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-25-01720"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1502821"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018820934955"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-003-0161-x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1514010"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000001367"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-022-01466-6"},{"key":"e_1_2_10_14_1","first-page":"817","article-title":"Systematic Review of Prognostic Roles of Body Mass Index for Patients Undergoing Lung Cancer Surgery: Does the \u2018Obesity Paradox\u2019 Really Exist?","volume":"51","author":"Li S.","year":"2017","journal-title":"European Journal of Cardio\u2010Thoracic 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