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Optical devices for monitoring individuals’ physiology are becoming omnipresent with the advent of wearable and point-of-care (POC) devices capable of photoplethysmography and pulse oximetry. These devices can also provide unique opportunities for managing obesity. We have conducted a pilot human study to characterize the obese optical properties and their connection to body mass index (BMI – a metric of obesity). We have shown computationally and experimentally that obesity is an important biological variable that cannot be ignored when developing optics-based instrumentation. We will report on our recent findings and propose strategies to improve wearable functionality.