{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:20:57Z","timestamp":1787808057311,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"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 Science &amp;amp; Practice"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This observational study characterized obesity care pathways and healthcare resource use in England between 2015 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were obtained from Discover and the Salford Integrated Record (SIR), two databases of linked primary and secondary electronic health records in England. Adults with a body mass index (BMI)\u00a0\u2265\u00a030\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      who attended obesity clinics were included over 4\u00a0years (January 1, 2015 [SIR] and January 1, 2016 [Discover] to December 31, 2018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1698 people living with obesity were included from Discover and 561 from SIR. Most (74.9%\u201378.6%) received a lifestyle intervention as their first intervention, whereas 6.2%\u201316.3% received a pharmacological treatment or metabolic\/bariatric surgical procedure. Time to first intervention was typically &gt;\u00a06\u00a0months, and most individuals remained in their baseline BMI group after 8\u00a0months' follow\u2010up. Obesity\u2010related complications resulted in high annual per\u2010person direct healthcare costs, particularly for acute cardiovascular events such as myocardial infarction (Discover: 2285 GBP; SIR: 2194 GBP) and incident stroke (Discover: 3005 GBP; SIR: 1550 GBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In conclusion, the time to first intervention can be considerable for people living with obesity in England and these individuals may incur high healthcare costs. There is an unmet need for timely and effective weight management in England.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/osp4.70173","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:24:09Z","timestamp":1784528649000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping Obesity Care Pathways and Healthcare Resource Use From 2015 to 2019 in England"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3830-3173","authenticated-orcid":false,"given":"Alexander Dimitri","family":"Miras","sequence":"first","affiliation":[{"name":"Imperial College London Hammersmith Hospital  London UK"},{"name":"School of Medicine Ulster University  Derry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Capucci","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S  S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia","family":"Migas","sequence":"additional","affiliation":[{"name":"NorthWest EHealth Ltd  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bozydar","family":"Wrona","sequence":"additional","affiliation":[{"name":"NorthWest EHealth Ltd  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2434-9122","authenticated-orcid":false,"given":"Liwei","family":"Zhao","sequence":"additional","affiliation":[{"name":"IQVIA  M\u00f6lndal Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Casta\u00f1eda\u2010Sanabria","sequence":"additional","affiliation":[{"name":"IQVIA  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise M.","family":"Hagelund","sequence":"additional","affiliation":[{"name":"Novo Nordisk  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Antavalis","sequence":"additional","affiliation":[{"name":"Novo Nordisk  Gatwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla S.","family":"Morgen","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S  S\u00f8borg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.061409"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679\u2010017\u20100262\u2010y"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679\u2010020\u201000416\u20108"},{"key":"e_1_2_11_5_1","unstructured":"National Health Service \u201cClinical Commissioning Policy: Complex and Specialised Obesity Surgery \u201d (April 2013) https:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2016\/05\/appndx\u20106\u2010policy\u2010sev\u2010comp\u2010obesity\u2010pdf.pdf."},{"key":"e_1_2_11_6_1","unstructured":"National Institute for Health and Care Excellence \u201cSemaglutide for Managing Overweight and Obesity \u201d Technology Appraisal Guidance. 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