Obesity has long been the leading risk factor for death among Americans — and it’s getting worse. New research by the Centers for Disease Control and Prevention shows that cases of severe obesity have increased over the last decade. It’s the wake-up call we need to demand action to save lives by expanding access to new obesity treatments. Congress has the tools for doing so. It should act now.
While new data shows overall rates of obesity are roughly the same for men and women, women have nearly twice the rate of severe obesity as men. This is alarming, because with severe obesity comes higher risk for many other life-threatening health conditions.
The data also highlights the urgency for equity in access to new obesity treatments, which hold promise for millions of people. The problem is they’re largely out of reach for people without high-end health insurance plans. In many parts of the country, access is so difficult that the medicines might as well not exist.
Four out of five Black women in the United States live with overweight or obesity. This leads to a wide range of health challenges, including cardiovascular disease, diabetes, stroke, cancer, maternal mortality and mental health issues.
On an individual level, this is heartbreaking. Imagine a young mother with obesity battling cancer while caring for her children, or a woman on the verge of retirement, unable to afford medication that might prevent a devastating stroke. At the systemic level, it’s infuriating. Structural racism underpins these health disparities, limiting access to nutritious food, places to exercise and jobs with high-quality insurance. The racial stigma associated with obesity also makes doctors less likely to recommend new medications to Black women.
With new obesity treatments, we have an additional tool for improving health. There’s a solid humanitarian argument to be made for the government to take action that expands access. Severe obesity kills. Treatment saves lives. The latest medications reduce food cravings and offer a host of other benefits, including stabilizing blood sugar for those with diabetes and reducing the likelihood of cardiac events and strokes.
In fact, we’re starting to glimpse how treatment could have health benefits beyond the direct effects on obesity. Recent research shows the medications are associated with a significantly lower risk of opioid overdose. A study published in September, conducted by Case Western Reserve University researchers and others, pointed to these drugs’ potential use in therapies for nicotine and alcohol addiction too — two other important factors in disease, death and disability.
There’s also a sound fiscal argument for the government to expand access to treatment — obesity increases one’s risk of numerous other diseases. By expanding coverage of these treatments, Medicare costs could be offset significantly. And cost savings extend beyond Medicare. A projection by health economists at the University of Southern California puts the potential cost savings at $1 trillion over 10 years.
Earlier this year, Congress took a step toward increasing access to obesity treatment. In June, the U.S. House Ways and Means Committee held a markup session to consider several pieces of medical legislation. Among them was the Treat and Reduce Obesity Act of 2023, authored to expand Medicare coverage for obesity.
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As originally introduced, the bill would dramatically improve access to obesity treatment for those who most need it, which would be a win for health equity. In the end, the committee advanced a scaled-back version of the bill, offering coverage only to patients whose private health insurance covered the same anti-obesity medication the year prior. I applaud the House committee for advancing Medicare access to obesity treatment. It’s a step in the right direction — yet it is only a step, and the road to equity is a long one.
The new obesity treatments are not a panacea. To be most effective, these drugs must be used in combination with lifestyle changes that allow people to address the root causes of obesity, such as inadequate physical activity, lack of access to healthy foods and poorly managed stress. And lifestyle changes must continue after patients stop taking the medication or, as research shows, they risk regaining all of the weight lost and even more. All of this must occur while policymakers address the many structural barriers that racial and ethnic bias, income inequality and gender discrimination present.
The human and social cost of obesity in the Black community is staggering. The House should pass the Treat and Reduce Obesity Act as amended and serve as an ally on the journey toward racial and health equity in the United States. None of us will get there alone.
Linda Goler Blount is president of the Black Women’s Health Imperative.
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