Survey: Most Americans view obesity as a chronic disease deserving insurance coverage

Nearly two-thirds of Americans (63%) know that obesity is a chronic disease rather than a personal failure and more than 8 in 10 believe that insurance should cover its treatment, whether it be medications or surgeries, according to a new nationwide survey conducted by The Harris Poll on behalf of the American Gastroenterological Association (AGA).

Adult Obesity Rate by State, 2024 (State of Obesity 2025: Better Policies for a Healthier America’, Trust for America’s Health)

"The American public is highly aware that obesity is medically treatable and that reducing it will also save people from a wide variety of other serious diseases," said Dr Pooja Singhal, gastroenterologist, hepatologist and obesity medicine specialist at Oklahoma Gastro Health and Wellness. "Despite this awareness, access to treatment, particularly because of cost, is a major barrier. This AGA survey reinforces the urgent need for increased coverage of safe, effective, and life-saving treatments for obesity."

Two-thirds of Americans (66%) say they are familiar with weight loss trends (e.g., keto and intermittent fasting), and nearly 6 in 10 are familiar with new weight-loss medications and surgeries. Still, more than 4 in 5 (81%) cite barriers that make or would make it difficult or prevent them from accessing treatment if they need it. Top roadblocks cited include high out-of-pocket costs (50%) and a lack of insurance coverage for procedures or medications (40%), among other obstacles.

More than half of Americans (57%) believe losing weight requires the assistance of a health care provider. Eight in 10 (80%) say that gastroenterologists play a crucial role in obesity care, but 61% also say they cannot afford weight-loss interventions beyond personal lifestyle changes. Some also report that difficulties finding an available provider (24%) and experiencing long wait times for appointments or procedures (23%) are, or would be, barriers to accessing weight-loss treatment if they needed it.

"When it comes to weight management and obesity care, gastroenterologists should be considered providers of direct care," added Singhal. "Many serious GI-related medical conditions like metabolic dysfunction-associated steatotic liver disease (MASLD) are associated with obesity and could be treated or resolved with weight management."

Medicare cannot currently cover weight-loss medications for patients without a co-occurring medical condition unless lawmakers change the law. Lawmakers first introduced the bipartisan Treat and Reduce Obesity Act (TROA) in 2013 to expand Medicare coverage and improve access to obesity-prevention and treatment tools, including prescription medications and intensive behavioural therapy. Unfortunately, despite strong support, TROA has languished in Congress and has been reintroduced in every Congressional session for the past 12 years.

"There is an urgent need for expanded access to affordable, effective treatments for obesity," said Dr Shazia M Siddique, AGA Government Affairs Committee and assistant professor of medicine, division of gastroenterology, University of Pennsylvania. "Passing TROA is one way to expand access and improve early intervention and treatment options, helping patients live healthier, more productive lives."

About seven of 10 Americans (73%) say they have been diagnosed with a medical condition by a health care provider, including 17% with obesity. The latter group was more likely to suffer from other illnesses and more likely to cite difficulties obtaining weight loss treatment (91% vs. 79% not diagnosed with obesity).

Americans named a mix of behavioural and genetic conditions as contributors to obesity, including eating patterns/nutrition (70%), level of physical activity (67%), mental health conditions such as anxiety and depression (61%), and genetics (58%).

In addition, 87% of Americans believe obesity increases the risk or can worsen existing symptoms of other chronic conditions. Nearly 2 in 3 Americans (64%) understand the connection between obesity and a person's specific risk for liver disease.

Th AGA survey was supported by Novo Nordisk.