This Obesity Care Week, let’s drop the stigmas and increase support
For the last seven years, the first week in March has marked Obesity Care Week. The annual event was created to raise awareness about the complexities of obesity, counter long-held social stigmas against people who are living with obesity and, ultimately, change the way the medical community provides obesity care. Unfortunately, as it stands now, that system is broken.
Although our cultural messaging might suggest otherwise, living with obesity is not anyone’s fault. Research has increasingly, and convincingly, demonstrated that obesity could possibly be linked to disorders of the brain and is predominantly caused by our genetics and our environment. It has a lot less to do with what we eat or how many miles we’ve run, although the diet and exercise industries don’t want you to know that. But I do.
It is quite possible to be overweight and fit, i.e., metabolically healthy. Until Americans — both your average Jane and Joe as well as their healthcare providers — have a more accurate understanding of what causes obesity and how to treat it, we won’t be able to effectively confront the national epidemic of obesity and facilitate access to compassionate, scientifically driven care.
Today, obesity is widely acknowledged to be among the most severe public health threats facing this country. In 2018, roughly 43 percent of adults over the age of 20 had obesity, according to the Centers for Disease Control and Prevention (CDC) and these numbers are not going down. The costs to the U.S. economy associated with having obesity are significant, to the tune of more than $1.7 trillion annually. A Milken Institute study finds that this includes about $480 billion in direct healthcare costs and $1.24 trillion in lost productivity.
As with many health conditions in this country, the impacts are not shared equally. In 2018, nearly half of all Black adults had obesity and almost 45 percent of Hispanic adults did as well, compared to about 42 percent of white adults. Within those populations, Black and Hispanic women had the highest rates of obesity, with 4 out of 5 African American women categorized as overweight or having obesity.
Disparate social and economic factors, such as geography (higher obesity in rural areas than urban areas), access to healthy affordable food, convenient or safe places for physical exercise, employment, housing, education and access to health care are likely contributing to these inequities.
Obesity is often mistakenly attributed to diet and exercise choices, but it is critical that we acknowledge and understand the complex and multifaceted factors that cause the disease, many of which are largely out of our personal control, such as the genes we are born with.
Instead, we should address the need to improve access to, and the affordability of, much-needed treatments. Limitations and barriers exist that make such access complicated and often unaffordable, creating frustration and failure where instead there should be help. Much of this is covered in the Treat and Reduce Obesity Act (TROA), a decade-old bipartisan bill that has yet to be passed and was reintroduced into Congress last year.
TROA would expand Medicare coverage to include screening and treatment of obesity from a diverse range of healthcare providers who specialize in obesity care and provide coverage for FDA-approved anti-obesity medications. And, since health insurance companies closely align coverage decisions on Medicare, passing TROA may also result in increased insurance coverage for obesity-related care for all Americans. Finally, given the ongoing and elevated risks of a COVID-19 infection to people who are living with obesity, the provisions of this bill and the protections they would provide have never been more urgent.
Although the scientific community has known for a long time now that obesity is not a condition people choose but rather is the result of biology and environment, the rest of the world needs to catch up. That includes our medical providers who can go a long way to improving their care of people who struggle with their weight. It also includes our members of Congress who have the opportunity now to bring about a legislative sea change in the way our government supports the health care of people with obesity. All of us must help destigmatize obesity with more education, understanding and empathy. I know we can do it.
Wouldn’t Obesity Care Week be the perfect time to start?
Martha Nolan is a senior policy advisor for HealthyWomen
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