In her recent television special, Oprah highlighted a critical fact: obesity is not a decision or a personal failure, but a chronic disease. And she’s right—leading health organizations, such as the Centers for Disease Control and Prevention, have clearly established obesity as a chronic and treatable disease.
But another fundamental reality we need to recognize is that obesity is particularly a women’s health issue. Although the prevalence of obesity is similar among men and women, obesity has disproportionate impacts on women physically, socially, and financially.
After more than 25 years of working in health advocacy, I have seen the devasting impact of what happens when women don’t get care for chronic diseases like obesity. Although a wide range of obesity care options are available, stigma around obesity persists, particularly for women, and access to comprehensive obesity care—including behavioral therapy, nutrition services, weight-loss surgery, and anti-obesity medications—remains a challenge.
Despite their importance, women’s health issues are often minimized and ignored. By recognizing the disproportionate effect of obesity on women, we can start to reduce the challenges women face and improve access to care. Here are three things to know about the impact of obesity on women:
1. Obesity disproportionately impacts women’s health and well-being.
Obesity is connected to over 200 other chronic diseases, including diabetes, cancer, mental illness, and cardiovascular diseases, and women with obesity are more likely to be impacted by many of these conditions—such as heart disease, anxiety, and depression—compared to male counterparts.
Women with obesity also face a higher risk for unique challenges such as breast cancer, fertility and maternal health complications, and polycystic ovary syndrome (PCOS). Moreover, as many as 70% of perimenopausal women have overweight or obesity, and women with obesity have more severe hot flashes and night sweats during menopause.
2. Obesity exacerbates women’s health disparities.
Beyond its disproportionate impacts on women broadly, obesity particularly impacts women of color. More than 1 in 3 American women are affected by obesity but those numbers are even higher among Black and Hispanic women, at 57% and 44% respectively. Black and Hispanic patients also face decreased access to bariatric surgery and weight-loss medications.
In the US, we know wide health disparities exist among women of color across diseases, and a lack of access to obesity care continues to widen these gaps. True strides towards increased health equity and reduced health disparities cannot be achieved unless the women with the greatest need have access to the obesity care and treatment options that are right for them.
3. Obesity impacts women’s experiences in the workplace and beyond.
Women with obesity face increased stigma and discrimination in the workplace. They earn as much as 12% less than peers not affected by obesity and this wage disparity comes on top of women already earning 20% less on average than men in the US. Additionally, women with obesity are less likely to be promoted. As a woman, getting to the C-Suite level is made even more difficult when living with obesity.
Obesity also impacts women’s experiences beyond the workplace. In healthcare settings, 69% of women with obesity say that they have faced bias from their healthcare provider, and many also report stigma from family and friends. Instead of promoting discrimination and shame, we should recognize obesity as a chronic disease with a major impact on women.
So, what can we do for women living with obesity?
To champion women's health and empower women in the workplace and beyond, we must advance access to comprehensive obesity care. Due to persisting stigma and misconceptions about obesity, less than half of employers currently cover or are considering covering the latest generation of anti-obesity medications. Only 16 state Medicaid plans cover anti-obesity medications, and Medicare does not cover medications for obesity at all. State and federal policymakers must pass important legislation, such as the Treat and Reduce Obesity Act (TROA), that would expand access for all who could benefit from obesity treatments in public programs. Additionally, employers must provide robust coverage for obesity care.
Oprah underscored for a national audience that obesity is a pressing health concern and we need to let go of the shame and stigma surrounding it. Everyone living with obesity should have the option to work with their doctor or healthcare provider to decide the best approach for them—and receive the same insurance coverage for physician-recommended care and treatment as they do for other chronic diseases. Thankfully, we aren’t debating whether it’s appropriate to cover treatments for heart disease or cancer—but we apply a double standard to obesity. Recognizing that obesity is an important issue for women’s health is the first step to supporting women and ensuring they have access to the care they need.
Millicent Gorham, PhD (Hon), MBA, FAAN, is the CEO of the Alliance for Women’s Health and Prevention (AWHP), a non-partisan 501(c)(4) non-profit organization working to ensure that all women and girls have access to high-quality preventive care. AWHP is the convenor of the EveryBODY Covered campaign.
