Introduction <p>The epIdeMiology landscape PAtient Care paThways of Obesity (IMPACT-O) study was a multi-country, retrospective cohort study that utilised healthcare databases to determine the landscape/impact of overweight and obesity. Here we describe the sociodemographic, clinical and treatment characteristics of adults with a first record of overweight/obesity or obesity in France.</p> Methods <p>This study utilised electronic medical records from the France longitudinal patient database (LPD) capturing data from general practitioners and specialist clinicians for 2018–2022. Included adults (≥ 18&#xa0;years) had a diagnosis code and/or ≥ 1 body mass index of ≥ 25 kg/m² (overweight/obesity cohort) or ≥ 30 kg/m² (obesity cohort) and a ≥ 12-month observation period before and after their first record indicating overweight/obesity or obesity. Demographic and clinical parameters, including obesity-related complications (ORCs), as recorded by physicians contributing to the database, were described.</p> Results <p>Of 10,206,481 subjects in the France LPD, 93,714 were included in the overweight/obesity and 46,252 in the obesity cohort; of these, 58.9% and 63.1%, respectively, had ORCs. Hypertension was the most frequently recorded ORC for both cohorts (28.8% and 32.9%, respectively). The proportion of people receiving pharmacological therapies with an effect on weight was ≤ 3%; no lifestyle interventions or bariatric surgery were recorded.</p> Conclusion <p>These results highlight the high burden of ORCs in adults with overweight or obesity at first available record and the limited use of pharmacological treatment with an effect on weight. Improving weight-related data capture in centralised electronic medical records could facilitate the integration of multidisciplinary approaches and better support the management of obesity.</p> <p>Graphical Abstract available for this article.</p> Graphical Abstract <p></p>