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d SE treatment. Adults with obesity may display disturbed cardiac chronotropic responses during cardiopulmonary exercise testing, which relates to poor cardiometabolic health and an increased risk for adverse cardiovascular events. It is unknown whether cardiac chronotropic incompetence (CI) during maximal exercise is already present in obese adolescents and, if so, how that relates to cardiometabolic health. Sixty-nine obese adolescents (body mass index standard deviation score = 2.23 ± 0.32, age = 14.1 ± 1.2 years; mean ± SD) and 29