Obesity has become an international public crisis that is estimated to lead to multiple physical and mental health issues. Obesity is a multifactorial health issue resulting from eating habits, genetic factors, lack of physical activities and sleeping patterns. There are also socio-political and cultural influences, such as food insecurities, environmental factors and stress. In the U.S., 40% of the population is living with obesity. While no American is immune to this complex and chronic disease, Black Americans are disproportionately impacted, with nearly half of Black adults living with obesity nationwide.
Approximately four out of every five African American women have obesity — a body mass index (BMI) of 30+ — making obesity one of the most urgent and growing health epidemics in the Black community. Millions of Black people are facing the physical, emotional and financial impacts of living with obesity, more so than any community nationwide.
As the leader of the National Black Nurses Association (NBNA), which represents 308,000 Black registered nurses, most of whom are women, I have seen firsthand the broad impact of this epidemic in communities of color. More Black women are at risk for life-threatening illnesses like hypertension, type 2 diabetes, osteoarthritis and stroke that come from living with obesity
Despite the staggering statistics for how many Black Americans are living with obesity, one of the biggest struggles remains the barriers to accessing the full continuum of care to prevent and treat obesity.
It was almost a decade ago that the American Medical Association (AMA) formally recognized obesity as a disease. Yet, our federal health programs and insurance companies have not evolved to reflect the consensus of the medical community and provide access to comprehensive care. Obesity is a disease and requires individualized, comprehensive treatment plans that include intensive lifestyle changes such as diet, physical activities and sleeping habits. However, in addition, some patients’ regimens may need to include moderate to intensity behavior counseling, pharmacotherapy and/or surgical interventions.
Current science shows that obesity is a treatable chronic disease, yet interventions such as intensive behavioral therapy (IBT) and highly effective, FDA-approved anti-obesity medications (AOMs) are crucial obesity care options that are not covered by Medicare and most health insurance plans.
The newest CDC data shows that our Nation’s obesity epidemic is only growing. As the number of people living with obesity has grown, so will the cost that is endured mostly by communities of color. This is why access to obesity care and treatment must dramatically expand. It is imperative for Medicare to lead the way by updating insurance coverage that provides access to obesity care.
Millions of people of color are included in the next wave of older Americans eligible for Medicare coverage and who are also suffering from comorbidities tied to living with obesity — this problem is only going to worsen unless we act quickly. Medicare Part D plans are not required to cover medicines to treat obesity. Current Medicare rules may perpetuate health care inequities by blocking access to scientifically-backed obesity care for millions of seniors of color in this country.
As nurses, our passion is caring for others. Representing over 300,000 African American registered nurses, members of the National Black Nurses Association work tirelessly every day to care for their patients, but this problem is bigger than that.
We must ensure that we are advocating for the best care possible for our patients. Obesity is a disease we know how to treat. New science shows us how, and we have the medication and techniques to help people. Yet, the barriers remain. To overcome them, it is imperative that we unite patients, policymakers and health care providers in the battle against obesity to bring the best available therapies to bear. Professionally and personally, it is a fight for our health and lives.
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Martha A. Dawson, DNP, RN, FACHE is the President/CEO of the National Black Nurses Association.
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