{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T01:10:04Z","timestamp":1756775404392,"version":"3.44.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T00:00:00Z","timestamp":1749340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000871","name":"Mayo Clinic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Obesity"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The goal of this study was to ascertain the effect of patient body size on clinic\u2010 or patient\u2010delayed health care during the COVID\u201019 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\u2010weight BMI categories reported having their care appointments cancelled (62.3%) compared to those who identified with normative weight (38.0%) or underweight (47.7%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and reported more frequently delaying their own care (67.9%) relative to those who identified with normative weight (47.0%) or underweight (62.3%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Higher\u2010weight 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%, <jats:italic>p<\/jats:italic><jats:sub>chi\u2010square<\/jats:sub>\u2009&lt;\u2009.001), worrying about weight\u2010based judgement (UW: 2.1%, NW: 2.1%, HW: 4.5%, <jats:italic>p<\/jats:italic><jats:sub>chi\u2010square<\/jats:sub>\u2009&lt;\u2009.001), and fearing discrimination (UW: 2.9%, NW: 2.4%, HW: 5.5%, <jats:italic>p<\/jats:italic><jats:sub>chi\u2010square<\/jats:sub>\u2009&lt;\u2009.001). There was no difference across groups in delay due to fear of COVID\u201019 exposure. Weight gain was associated with care delay in higher\u2010weight and normative weight groups. Having experienced more patient\u2010centred care pre\u2010COVID was associated with less care delay in the normative weight group, but more care delay in other groups. Higher\u2010weight 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\u201019.<\/jats:p>","DOI":"10.1111\/cob.70019","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T11:03:39Z","timestamp":1749726219000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of body size, prior care quality, and weight gain on health care utilization during the <scp>COVID<\/scp>\u201019 pandemic"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2091-6297","authenticated-orcid":false,"given":"Sean M.","family":"Phelan","sequence":"first","affiliation":[{"name":"Division of Health Care Delivery Research Robert D. and Patricia E. 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