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As the narrative evolves, obesity is emerging as a driver and enhancer of many pathological conditions. Among these, the risk of venous thromboembolism (VTE) is a critical concern linked to obesity, ranking as the third most common cardiovascular condition. Obesity is recognized as a multifactorial risk factor for VTE, influenced by genetic, demographic, behavioral, and socio-economic conditions. Despite established links, the exact incidence of obesity related VTE in the general population remains largely unknown. The complexity of distinguishing between provoked and unprovoked VTE, coupled with gaps in obesity definition and assessment still complicates a tailored risk assessment of VTE risk. Obesity reactivity, hypercoagulability, and endothelial dysfunction are driven by the so-called \u2018adiposopathy\u2019. This state of chronic inflammation and metabolic disturbance amplifies thrombin generation and alters endothelial function, promoting a pro-thrombotic environment. Additionally, the inflammation-induced clot formation\u2014also referred to as \u2018immunothrombosis\u2019 further exacerbates VTE risk in people living with obesity. Furthermore, current evidence highlights significant gaps in the management of obesity related VTE, particularly concerning prophylaxis and treatment efficacy of anticoagulants in people living with obesity. This review underscores the need for tailored therapeutic approaches and well-designed clinical trials to address the unique challenges posed by obesity in VTE prevention and management. Advanced research and innovative strategies are imperative to improve outcomes and reduce the burden of VTE in people living with obesity.<\/jats:p>","DOI":"10.1007\/s11739-024-03765-7","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T09:02:58Z","timestamp":1726218178000},"page":"47-64","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Venous thrombosis and obesity: from clinical needs to therapeutic challenges"],"prefix":"10.1007","volume":"20","author":[{"given":"Federica","family":"La Rosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-8729","authenticated-orcid":false,"given":"Fabrizio","family":"Montecucco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Liberale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Sessarego","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Carbone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"3765_CR1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13642","volume":"25","author":"S Nutter","year":"2024","unstructured":"Nutter S, Eggerichs LA, Nagpal TS, Ramos Salas X, Chin Chea C, Saiful S, Ralston J, Barata-Cavalcanti O, Batz C, Baur LA, Birney S, Bryant S, Buse K, Cardel MI, Chugh A, Cuevas A, Farmer M, Ibrahim A, Kataria I, Kotz C, Kyle T, le Brocq S, Mooney V, Mullen C, Nadglowski J, Neveux M, Papapietro K, Powis J, Puhl RM, Rea Ruanova B, Saunders JF, Stanford FC, Stephen O, Tham KW, Urudinachi A, Vejar-Renteria L, Walwyn D, Wilding J, Yusop S (2024) Changing the global obesity narrative to recognize and reduce weight stigma: a position statement from the World Obesity Federation. 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