The National Consumers League (NCL) and National Council on Aging (NCOA) in the US have introduced the nation's first Obesity Bill of Rights and launched a grassroots movement – Right2ObesityCare – to advance changes in federal, state and employer policies that will ensure these rights are incorporated into medical practice.
Developed in consultation with leading obesity specialists and endorsed by nearly 40 national obesity and chronic disease organisations, the Obesity Bill of Rights establishes eight essential rights, so people with obesity will be screened, diagnosed, counselled and treated according to medical guidelines, and no longer face widespread weight bias and ageism within the health care system or exclusionary coverage policies by insurers and government agencies.
"Our goal with the Obesity Bill of Rights is to define quality obesity care as the right of all adults and empower those with the disease to ask questions and demand treatment without discrimination or bias regardless of their size or weight," said Sally Greenberg, Chief Executive Officer of the National Consumers League. "For too long, adults with obesity have encountered a health care system that is working against them. They have been stigmatised, discriminated against, not treated with respect by their health providers, and have faced significant hurdles and burdensome requirements to receive obesity care."
Currently, only 30 million of the estimated 108 million adults living with obesity have been diagnosed with the condition, and only about 2% of those eligible for anti-obesity medications have been prescribed these treatments. The consequence of untreated obesity for the nation is worsening outcomes for over 230 obesity-related chronic diseases, approximately 400,000 premature deaths a year,6 and an estimated $1.72 trillion in direct and indirect costs to the US economy.
The Obesity Bill of Rights establishes and promotes eight essential rights to drive transformational change and define the core requirements for people with obesity to receive person-centred, quality care:
The Right to Accurate, Clear, Trusted, and Accessible Information on obesity as a treatable chronic disease
The Right to Respect by all members of the integrated care team when screening, counselling, and providing treatment
The Right to Make Treatment Decisions about one's health goals and obesity care in consultation with the individual's health providers
The Right to Treatment from Qualified Health Providers including counselling and ongoing care from health providers with expertise in obesity care
The Right to Person-Centred Care that is personalised, respects the individual's cultural beliefs, meets their specific health goals, and considers the person's whole health and not just their weight status
The Right to Accessible Obesity Treatment from Health Systems, so those with severe obesity receive care in settings that allow for privacy, using size and weight-accessible equipment and diagnostic scans
The Right for Older Adults to Receive Quality Obesity Care that comprises a respectful, comprehensive care approach consistent with their personalized medical needs
The Right to Coverage for Treatment with access to the full range of treatment options for the person's disease as prescribed by the individual's health provider
"Collectively, these rights will ensure that adults with obesity have trusted, accurate information about their disease, respectful and non-discriminatory care from medical professionals, and insurance that provides access to all treatments deemed appropriate by their health providers," said Ramsey Alwin, NCOA President and CEO. "In town halls across the country, older adults told us they often feel invisible when seeking obesity care. The Obesity Bill of Rights recognises and aims to address their unique challenges."
With the goal of reversing the trajectory of the nation's obesity epidemic, NCL and NCOA will spearhead Right2ObesityCare, a new grassroots movement to engage people with obesity, their caregivers, health professionals, community leaders, employers, and a network of obesity and chronic disease organizations to drive adoption of the Obesity Bill of Rights in clinical settings.
Using the online hub www.right2obesitycare.org to mobilize stakeholders, Right2ObesityCare will focus on national and state policy efforts, including developing a set of national "obesity goals" for full implementation of the Obesity Bill of Rights by 31 December 2029. Plans include hosting regional town halls, workshops, and advocacy forums across the country; scheduling meetings with federal and state legislators and regulators; and arming interested citizens and advocacy leaders with materials and tools to advocate for implementation of the Obesity Bill of Rights in their communities and workplaces. NCL and NCOA also will pursue development of a model law that stakeholders can use to incorporate the Obesity Bill of Rights into state law.
"The Obesity Bill of Rights brings us a step closer to creating a society where all individuals are treated with respect and without discrimination or bias regardless of their size or weight,” added Joe Nadglowski, President and CEO of the Obesity Action Coalition. “Establishing eight essential rights for people living with obesity strengthens efforts to end such blame, shame and discrimination and give individuals who want and need it, access to safe and effective options to improve their health.”
Advocacy on implementing the Obesity Bill of Rights also gives policymakers new impetus to pass legislation that will remove the regulatory and insurance obstacles that keep many people with obesity from getting the care prescribed by their health providers.
A year in development, the Obesity Bill of Rights is the product of extensive research combined with four town hall meetings hosted in senior centres and churches in California, Delaware, Mississippi, and Oklahoma between June and August 2023. At these town halls, more than 250 older adults, community leaders, and local clinicians described a health care system that is inhospitable to delivering quality obesity care, and physicians described having limited time for counselling, not enough training in obesity management, and inadequate coverage and reimbursement for obesity care.
After turning this knowledge and the lived experiences of older adults into a first draft, NCL and NCOA hosted a roundtable at The Obesity Society annual meeting in October 2023 where leading obesity experts reviewed the preliminary document and made recommendations. NCL and NCOA then sought feedback from specialists in minority health, aging, and rural health, as well as health professionals and other stakeholders who provided additional guidance. The final step was to circulate the updated Obesity Bill of Rights to a wide group of stakeholder organizations, resulting in initial endorsements from 37 obesity, public health, and chronic disease organizations and medical societies.
To date, the following organizations have endorsed the first-ever Obesity Bill of Rights: 1) the Academy of Nutrition and Dietetics; 2) Alliance for Aging Research; 3) Alliance for Women's Health & Prevention; 4) American College of Occupational and Environmental Medicine; 5) American Medical Women's Association; 6) American Nurses Association; 7) American Society on Aging; 8) American Society for Nutrition; 9) Association of Black Cardiologists; 10) Association of Diabetes Care & Education Specialists; 11) Bias180; 12) Black Women's Health Imperative; 13) Choose Healthy Life; 14) ConscienHealth; 15) Council on Black Health; 16) Defeat Malnutrition Today; 17) Endocrine Society; 18) Gerontological Society of America; 19) Global Liver Institute; 20) Health Equity Coalition for Chronic Disease; 21) HealthyWomen; 22) Lupus Foundation of America; 23) MANA; 24) National Asian Pacific Center on Aging; 25) National Black Nurses Association; 26) National Hispanic Council on Aging; 27) National Hispanic Health Foundation; 28) National Kidney Foundation; 29) Noom, Inc.; 30) Nurses Obesity Network; 31) Obesity Action Coalition; 32) Obesity Medicine Society; 33) Patients Rising; 34) Partnership to Advance Cardiovascular Health; 35) Preventive Cardiovascular Nurses Association; 36) The Obesity Society; and 37) WW International (WeightWatchers).