Summary Background COVID‐19 mitigation measures, including closures of schools and recreational facilities and alterations in eating behaviours and physical activity, may impact weight. Objective To examine changes in body weight and body mass index (BMI) in children and adolescents with obesity participating in an obesity treatment program before and during the COVID‐19 pandemic in Ontario, Canada. Methods Body weight and BMI at baseline and 6 months were recorded for the ‘historic’ cohort (females = 34, males = 21) before the pandemic (November 1, 2018, to March 18, 2020) and for the ‘pandemic’ cohort (females = 30, males = 30) during the pandemic (March 19, 2020 to July 31, 2021). Analyses were adjusted for baseline weight/BMI, age, and ON‐Marg score, a measure of the social determinants of health. Results In males, body weight (98.29 versus 89.28 kg, p < 0.001) and BMI (36.46 versus 34.85 kg/m 2 , p = 0.027) were greater in the pandemic compared with historic cohort. In females, body weight ( p = 0.769) and BMI ( p = 0.548) were not different between the two cohorts. Conclusion The COVID‐19 pandemic may have diminished the health impacts of a weight management program, particularly in males, leading to increased body weight and BMI.

T ype 1 diabetes is a common chronic disease of childhood with substantial morbidity and mortality. 1 Optimizing glycemic management is key to preventing complications. 2,3 There are known socioeconomic status (SES) disparities in diabetes management and outcomes. 4,5 For Canadians, financial barriers to medications continue to be an important adverse social determinant of health. 6 This is important because insulin is life sustaining for people with type 1 diabetes.Ontario residents (population 14.5 million) have publicly funded coverage for medically necessary services but not for prescription medications. On Jan. 1, 2018, the Ontario government introduced publicly funded pharmacare (Ontario Health Insurance Plan [OHIP]+), the first payer for drugs for Ontarians younger than 25 years.Before the introduction of OHIP+, only people older than 64 years and those eligible for social assistance had access to publicly funded medications; all others paid out of pocket, through private insurance or were supported, in part, by the Trillium Drug Program (a government program that provides drug coverage for out-of-pocket expenses that are more than 4% of household income). The OHIP+ program covered the cost of medications on the provincial formulary, with no deductible or copayment. Fifteen months after its introduction, the Ontario government changed OHIP+ to exclude those patients with private drug coverage. 7 Thus, Ontario provides a unique "natural experiment" to assess the impact of 15 months of publicly funded pharmacare.Competing interests: Rayzel Shulman has received speaker fees from Dexcom. No other competing interests were declared. This article has been peer reviewed.