{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:05:12Z","timestamp":1790024712891,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"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                      The\n                      <jats:italic>Lancet Diabetes &amp; Endocrinology<\/jats:italic>\n                      Commission proposed a new definition for clinical obesity. However, its prognostic value remains unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical obesity was defined using the Commission's criteria in the China Health and Retirement Longitudinal Study (CHARLS), the English Longitudinal Study of Aging (ELSA), and the National Health and Nutrition Examination Survey (NHANES). Prevalence estimation was conducted across four categories based on obesity and organ dysfunction status. Cox proportional hazards models were used to assess associations with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of clinical obesity was 2.50% (CHARLS), 6.18% (ELSA), and 9.08% (NHANES), respectively. Overall, older adults and men had lower prevalence, while older men in NHANES showed higher prevalence. Compared with non\u2010obesity without dysfunctions, clinical obesity and non\u2010obesity with dysfunctions showed higher risks of cardiovascular outcomes. Compared with preclinical obesity, clinical obesity elevated cardiovascular risk in CHARLS (HR\u2009=\u20092.49, 95% CI: 1.32\u20134.70) and ELSA (HR\u2009=\u20091.80, 95% CI: 1.02\u20133.17) and increased all\u2010cause (HR\u2009=\u20091.88, 95% CI: 1.23\u20132.87) and cardiovascular (HR\u2009=\u20093.11, 95% CI: 1.49\u20136.50) mortality risk in NHANES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of clinical obesity varied by age, sex, and country. Overall, the prevalence was lower among older adults and men. Clinical obesity was associated with increased cardiovascular event risk across cohorts and increased all\u2010cause mortality risk in NHANES, highlighting its value for risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70260","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T07:15:08Z","timestamp":1783667708000},"page":"1669-1676","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Clinical Outcomes of Preclinical and Clinical Obesity Across Multiple Cohorts"],"prefix":"10.1002","volume":"34","author":[{"given":"Sitong","family":"Li","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingning","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"},{"name":"Peking University Diabetes Center, Peking University Health Science Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-4937","authenticated-orcid":false,"given":"Xueyao","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"},{"name":"Peking University Diabetes Center, Peking University Health Science Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6222-2915","authenticated-orcid":false,"given":"Linong","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"},{"name":"Peking University Diabetes Center, Peking University Health Science Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiantong","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Peking University People's Hospital; Beijing Key Laboratory of Innovative Drug and Device Translation in Endocrine and Metabolic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2023.02.003"},{"key":"e_1_2_11_3_1","volume-title":"Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017\u20102018","author":"Hales C. 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