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This multicenter retrospective cohort study includes obese and overweight subjects participating in a weight loss program across 110 French centers. 34 510 participants with baseline FIB-4 available were included, predominantly women (78.3%), median age of 54 years, 70% obese. Baseline FIB-4 values were &lt;1.3, 1.3\u20132.67 or &gt;2.67 in 80.9%, 18.1% and 1% of the participants, respectively. When moving from the lower risk category (&lt;1.3) to the highest (&gt;2.67), the rates of metabolic comorbidities such as diabetes rose (from 3.2% to 13.3%). After 5 (3\u20137) months, all anthropometric parameters improved. A follow-up FIB-4 value was available in 20.7% participants. Among high-risk, 43% changed classes, 4.6% moving to the lower risk-category.<\/jats:p>","DOI":"10.1371\/journal.pone.0333490","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:39:50Z","timestamp":1759858790000},"page":"e0333490","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["FIB-4: A screening tool for advanced liver fibrosis in a cohort of subjects participating in a primary care weight-loss 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