What Has Changed in 20 Years of Obesity Patient Advocacy?

April this year will mark 20 years of patient advocacy in obesity by the Obesity Action Coalition. We’ve spent this weekend with the OAC board, looking back and looking forward at advocacy to educate, elevate, and support the voices of people living with obesity. So this is a good time to ask what has changed in those 20 years.

20 Years Ago, Nothing Worked

To understand where we were 20 years ago, consider this summary from a 2005 clinical review in BMJ:

“It is time to be realistic with individuals about the effectiveness of lifestyle interventions and obesity drugs, and to focus on public health interventions rather than individual treatments, to halt the obesity epidemic.”

In short, the view was that obesity treatment was more or less pointless. On top of that, according to this 2005 research, “public opinion had still not crystallized about obesity and most obesity policies did not enjoy broad support.”

So it should not surprise anyone that evidence of progress was scant for many years.

Better Options and Insights Now

The global consensus today is very different. As expressed by the Lancet Commission on Clinical Obesity, it holds that both treatment and prevention deserve attention:

“Policy makers and health authorities should ensure adequate and equitable access to available evidence-based treatments for individuals with clinical obesity, as appropriate for people with a chronic and potentially life-threatening illness. Public health strategies to reduce the incidence and prevalence of obesity at population levels must be based on current scientific evidence, rather than unproven assumptions that blame individual responsibility for the development of obesity.”

The Central Role of Patient Voices

In the progress of these 20 years, patient advocacy of the Obesity Action Coalition has had an unmistakable role. ConscienHealth founder Ted Kyle explains this in the new winter edition of the OAC Your Weight Matters Magazine:

“The Obesity Action Coalition has brought patient advocates into a central role for health policy relating to obesity. Patient advocates have done amazing work to put a spotlight on the prevalence and harm of weight bias. Without an appreciation for the lived experience of obesity, much of the progress today would not have been possible.”

And yet, we have much work yet to do. Access to obesity care is far from equitable. Many health insurance plans do not cover obesity treatments, including medications and bariatric surgery, leaving millions without affordable options. This lack of access disproportionately impacts marginalized communities, exacerbating health disparities. Stigma also continues to be a major barrier – as well as a source of harm.

Meeting these challenges would not even be conceivable without the patient advocacy the Obesity Action Coalition has made active and visible.

To celebrate this progress, plan to attend the 2025 OAC National Convention in Washington, DC, July 24-26. You’ll find more information here.

President George W Bush and His Mountain Bike in 2007, White House photograph by Joyce Boghosian

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February 9, 2025