The Essence of Autonomy in an Obesity Bill of Rights

Farm WomanYesterday, the National Consumers League and the National Council on Aging introduced the Bill of Rights for People with Obesity. At the heart of eight simple points in this document is a demand of respect for the dignity and autonomy of people living with obesity.

1. The Right to Accurate, Clear, Trusted, and Accessible Information

For too long, health professionals have presented obesity as a simple matter of eating too much and moving too little, easily reversed through behavior change. Researchers and clinicians now know obesity is a complex, chronic disease with many causes.

2. The Right to Respect

Disrespectful treatment has, for too long, been routine in medical encounters. It is an unprofessional  breach of medical ethics.

3. The Right to Make Treatment Decisions

This is the very essence of medical autonomy. One size does not fit all and every person living with obesity has the right to make treatment decisions that meet their personal goals for health. These are intensely personal decisions that deserve respect.

4. The Right to Treatment from Qualified Health Providers

Many primary care physicians do not really understand the science of obesity or its treatment. Patients have a right to receive obesity care from providers who do.

5. The Right to Person-Centered Care

People living with obesity have a right to medical care that meets their personal needs and considers their whole health, not just their weight status.

6. The Right to Accessible Obesity Treatment from Health Systems

Health systems that do not welcome people of all sizes and shapes are guilty of discrimination against people with obesity. Spaces, supplies, equipment, and imaging systems must accommodate persons with larger bodies.

7. The Right for Older Adults to Receive Quality Obesity Care

Medicare imposes a blanket ban on coverage for advanced obesity medicines. People with a medical need for such treatment must have sufficient wealth to pay out of pocket or suffer without it. This is simply wrong.

8. The Right to Coverage for Treatment

Beyond Medicare, health plans routinely discriminate against people with a medical need for obesity treatment. They creating hurdles for people who seek it in hopes they will give up. These corporations value their profits more than the health of their members.

Dissenting Voices

In a culture with pervasive bias against people in larger bodies it’s easy to find dissenting voices. “Should people not be held accountable for being obese and putting a strain on our healthcare system,” says a typical fatphobic tweet. Perhaps unsurprisingly, fat haters and promoters of fat acceptance see this the same way. They both insist that obesity is not a disease. It’s an identity that should be treated as a social issue, not a medical condition.

Medical Autonomy

This is precisely why medical autonomy lies at the heart of the Obesity Bill of Rights. Neither fat haters nor fat acceptance crusaders get the last word on what’s best for a person’s health.

The person living with obesity has a fundamental right to get the last word. One size does not fit all.

Click here to read the full Obesity Bill of Rights and here for its announcement.

Farm Woman, painting by Pablo Picasso / WikiArt

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February 1, 2024