U.S. and U.K. Health Systems Add to the Burden of Obesity

People living with obesity face a heavy and often hidden burden – financial, physical, social, and psychological – embedded in health systems and extending far beyond health risks. A nationally representative U.S. study reveals that one in six adults with obesity struggles to afford healthcare, routinely skipping medications or even meals to manage cost. With their publication in Annals of Internal Medicine, Bajaj et al underscore an economic shame often overlooked. These findings illustrate how physical weight and financial strain compound each other, intensifying daily hardship.

Older Adults in England

Across the Atlantic, a qualitative study of older adults in England provides a more personal portrait of this burden. Participants described how excess weight limited mobility, requiring informal care from family rather than formal services, often without needed housing adaptations and with increased risk of isolation. Many expressed deep emotional distress: feeling unsafe in their homes, burdening loved ones, and experiencing public discrimination. Together, these voices bring to light a hidden but profound social and mental health impact.

Overlapping Disadvantages

What emerges is a portrait of overlapping disadvantage – where economic insecurity, stigma, and care dependency intersect to deepen inequality. People with obesity often navigate a cost-health paradox: they need more care, yet receive less support, while struggling to afford basic necessities.

A Fair Chance

So the policy implications are clear: addressing obesity isn’t merely about clinical interventions. It’s about giving people a fair shot at a healthy life. Health systems must expand access to affordable care and medications. Social services need to provide safe, adapted housing and structured support networks. Crucially, stigma-reduction training for providers and public education campaigns are essential to counteract bias and isolation.

Without reforming these flaws in health systems, the burden of obesity will continue cycling through generations, exacerbating health and social disparities. Recognizing and responding to these interwoven challenges is not only morally urgent – it’s foundational to an equitable society that values all its members.

Click here for the paper by Bajaj et al, and here for the study of older U.K. adults.

Neva, Light Fog, painting by Felix Vallotton / WikiArt

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June 28, 2025