Recently, the wearable internet of things (WIoT) has brought a new dimension of connectivity to wireless body area networks (WBANs). For instance, the WIoT provides valuable functions, such as collecting, analyzing, and transmitting data for real-time health monitoring of medical services. However, designing a clustering and routing protocol is challenging because WIoT attributes are subject to high interference in dense deployment, social mobility, and limited energy. In a WIoT-enabled WBAN, cooperative control is the fundamental function of clustering and routing. Cluster-based routing protocols are preferred for WBAN because of their scalability. However, one-hop neighbor-based clustering approaches do not ensure connectivity and reachability owing to node mobility. The existing two-hop-based clustering protocols are mostly centralized-based approaches, which are unsuitable for dynamic WBANs. In this paper, we propose a distributed energy-efficient two-hop-based clustering and routing protocol (DECR) targeting WIoT-enabled WBAN. In DECR, in the cluster formation phase, each node obtains the information of its neighbor nodes within the two-hop range. We utilize the modified grey-wolf optimization algorithm for the cluster head (CH) selection and routing optimization. Node connectivity and residual energy were jointly considered when determining the CH in each cluster. We also developed an analytical model to determine the optimal number of clusters by considering intra-and inter-cluster transmission distances to reduce the overall transmission distance and number of transmissions. Finally, we proposed a routing algorithm to ensure energy-efficient packet delivery from CH to sink. Our simulation outcomes revealed that the proposed DECR significantly outperforms the existing clustering and routing protocols in various performance metrics.INDEX TERMS Wearable internet of things, clustering, two-hop range, distributed, cluster head, energyefficiency, grey wolf optimization, routing, wireless body area network (WBAN).