As obesity rates climb across the nation, leading consumer, aging, and public health groups unite to release the first Obesity Bill of Rights for Americans and unveil plans to transform obesity care throughout the health system through changes in federal, state, and employer policies

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Simona Combi
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Arlington, VA (Jan. 31, 2024)—Because obesity—the most prevalent and costly chronic disease in the United States—remains largely undiagnosed and untreated a decade after the American Medical Association (AMA) classified it as a serious disease requiring comprehensive care,¹ the National Consumers League (NCL) and National Council on Aging (NCOA) today 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 organizations, the Obesity Bill of Rights establishes eight essential rights, so people with obesity will be screened, diagnosed, counseled, 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 stigmatized, discriminated against, not treated with respect by their health providers, and have faced significant hurdles and burdensome requirements to receive obesity care.”

As described by Patricia Nece, JD, Immediate Past Chair of the Obesity Action Coalition, “For my entire life, I've been a target of ridicule simply because of my weight. People rarely take time to look beyond my weight to see me.”

Currently, only 30 million² of the estimated 108 million adults living with obesity³ have been diagnosed with the condition, and only about 2% of those eligible for anti-obesity medications have been prescribed these treatments.⁴ The consequence of untreated obesity for the nation is worsening outcomes for over 230 obesity-related chronic diseases,⁵ approximately 400,000 premature deaths a year,⁶ and an estimated $1.72 trillion in direct and indirect costs to the U.S. economy.⁷

Defining quality obesity care for all

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-centered, quality care:

1. The Right to Accurate, Clear, Trusted, and Accessible Information on obesity as a treatable chronic disease
2. The Right to Respect by all members of the integrated care team when screening, counseling, and providing treatment
3. The Right to Make Treatment Decisions about one’s health goals and obesity care in consultation with the individual’s health providers
4. The Right to Treatment from Qualified Health Providers including counseling and ongoing care from health providers with expertise in obesity care
5. The Right to Person-Centered Care that is personalized, respects the individual’s cultural beliefs, meets their specific health goals, and considers the person’s whole health and not just their weight status
6. 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
7. The Right for Older Adults to Receive Quality Obesity Care that comprises a respectful, comprehensive care approach consistent with their personalized medical needs
8. 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 nondiscriminatory 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 recognizes and aims to address their unique challenges.”

Putting the Bill of Rights into practice

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 Dec. 31, 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. 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,” added Joe Nadglowski, President and CEO of the Obesity Action Coalition.

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.

According to Rep. Brad Wenstrup, DPM, R-Ohio, “By tackling obesity head on, we can better prevent numerous additional diseases like type 2 diabetes, high blood pressure, and heart disease. My bill, the Treat and Reduce Obesity Act (TROA), expands Medicare beneficiaries’ access to treatment options to include FDA-approved medications, clinical psychologists, registered dieticians, and nutrition professionals. Not only would this legislation help Americans live healthier and longer lives, but it can also save taxpayer dollars over the long run.”

Added Rep. Gwen Moore, D-Wisc., “Obesity is a chronic condition—not a personal or moral failing. We need to ensure our health care system treats it as a disease, so that Americans with obesity can access holistic, high-quality care that meets the full spectrum of their needs. I am proud to be a co-lead of the Treat and Reduce Obesity Act, which puts us on a path toward effectively treating obesity, helping create healthier outcomes for Americans and supporting enhanced quality of life for Medicare beneficiaries who need comprehensive care.”

Development of the Obesity Bill of Rights

A year in development, the Obesity Bill of Rights is the product of extensive research combined with four town hall meetings hosted in senior centers 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 counseling, 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 56 obesity, public health, and chronic disease organizations and medical societies.

Nearly 60 consumer, aging, and public health organizations endorse the Obesity Bill of Rights

To date, the following organizations have endorsed the first-ever Obesity Bill of Rights:

1. Academy of Nutrition and Dietetics
2. Alliance for Aging Research
3. Alliance for Patient Access
4. Alliance for Women’s Health & Prevention
5. American Association of Clinical Endocrinology
6. American College of Occupational and Environmental Medicine
7. American College of Preventive Medicine
8. American Gastroenterological Association
9. American Liver Foundation
10. American Medical Women’s Association
11. American Nurses Association
12. American Society on Aging
13. American Society for Nutrition
14. Amputee Coalition
15. Association of Black Cardiologists
16. Association of Diabetes Care & Education Specialists
17. Bias180
18. Black Women’s Health Imperative
19. Bone Health and Osteoporosis Foundatin
20. Center for Patient Advocacy Leaders
21. Choose Healthy Life
22. ConscienHealth
23. Council on Black Health
24. Defeat Malnutrition Today
25. Gerontological Society of America
26. Global Liver Institute
27. Haitian American Nurses Alliance International
28. Health Equity Coalition for Chronic Disease
29. HealthyWomen
30. League of United Latin American Citizens (LULAC)
31. Liver Coalition of San Diego
32. Lupus Foundation of America
33. MANA
34. Movement is Life
35. National Asian Pacific Center on Aging
36. National Association of Nurse Practitioners in Women's Health
37. National Black Nurses Association
38. National Grange
39. National Hispanic Council on Aging
40. National Hispanic Health Foundation
41. National Hispanic Medical Association
42. National Kidney Foundation
43. National Menopause Foundation
44. National Minority Quality Forum
45. Noom, Inc.
46. Nurses Obesity Network
47. Obesity Action Coalition
48. Obesity Care Advocacy Network
49. Obesity Medicine Association
50. Patients Rising
51. Partnership to Advance Cardiovascular Health
52. Preventive Cardiovascular Nurses Association
53. Society for Women's Health Research
54. The Obesity Society
55. WeightWatchers
56. WomenHeart

About NCL
The National Consumers League, founded in 1899, is America’s pioneer consumer organization. The organization’s mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

About NCOA
The National Council on Aging (NCOA) is the national voice for every person’s right to age well. We believe that how we age should not be determined by gender, color, sexuality, income, or ZIP code. Working with thousands of national and local partners, we provide resources, tools, best practices, and advocacy to ensure every person can age with health and financial security. Founded in 1950, we are the oldest national organization focused on older adults. Learn more by following us at @NCOAging. 

2. PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

3. Hales CM, et al. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. Centers for Disease Control and Prevention. NCHS Data Brief. No. 360. February 2020. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db360.htm

4. PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

5. Obesity Care Advocacy Network. Fact Sheet: Obesity Care Beyond Weight Loss

6. Hurt Rt, et al. Obesity epidemic: overview, pathophysiology, and the intensive care unit conundrum. Journal of Parenter and Enteral Nutrition. September 2011. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/21881014/

7. Milken Institute. America's Obesity Crisis: The Health and Economic Costs of Excess Weight. October 2018. Found on the internet at https://milkeninstitute.org/report/americas-obesity-crisis-health-and-economic-costs-excess-weight