About one-third of American adults are obese, yet the disease disproportionately affects Black and Hispanic adults, of whom 50% and 45% are obese, respectively.
Comorbidities that make obesity both more likely and more dangerous — diabetes, hypertension, kidney disease, cardiovascular disease — also occur at higher rates in Black and Hispanic communities.
These higher rates of risk coupled with lesser access to care put patients of color at systemic disadvantage, resulting in worse health outcomes.
Who Can — and Can’t — Access Cutting-Edge Care
Black and Hispanic patients are more likely to have public insurance, which makes them less likely to have coverage for obesity treatments under current laws.
- Medicare disallows reimbursement for weight-loss drugs unless a complicating condition, like diabetes or risk of stroke, requires it.
- Research shows patients covered by Medicaid are 27% more likely to have obesity than people with commercial or private insurance coverage, but less likely to have access to cutting-edge care for that condition. Only 16 state Medicaid programs cover the newest generation of weight loss drugs and only a few states even took up the issue in the last legislative cycle.
The effort to change this dismal coverage picture could get a jolt if federal lawmakers continue bringing attention to the issue and pass federal legislation through bills like the Treat and Reduce Obesity Act. Expanded Medicare coverage could have a ripple effect on state Medicaid programs as well as commercial employers, who often look to Medicare’s lead.
Addressing Obesity Goes Beyond Medications
Other factors that contribute to current obesity rates among racial and ethnic minorities include higher rates of food insecurity, greater access to poor quality foods, lesser access to convenient places for physical activity and targeted marketing of unhealthy foods.
Social stigma can also complicate efforts to change one’s lifestyle or seek treatment. The individual is too often blamed, when so often social and environmental factors also play a role. Given the ongoing systemic challenges, social inequalities and overall burden of obesity, advocates and policymakers would be wise to double down on efforts to address these issues while also working toward expanded access to treatment.
Changing policy can be a slow, iterative process. But it’s the right thing to do when it comes to coverage for weight-loss medications. Expanded access could redefine the life course for millions of patients, including many from communities of color.
