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It’s no secret that the COVID-19 pandemic devastated the Black community. Compared to white Americans, Black Americans were almost three times as likely to be hospitalized and two times as likely to contract a fatal case of the virus. Unfortunately, many of us have loved ones and community members in our network who were impacted by COVID-19.
One of the reasons that Black Americans were at higher risk of severe COVID-19 infections was because of the increased risk associated with obesity. As director of the Wake Forest Baptist Health Weight Management Center, I see firsthand how obesity impacts a person’s entire health profile, making my patients more susceptible not only to COVID-19 but other chronic diseases. Nearly half of Black Americans live with obesity, a serious, chronic disease that puts us at higher risk for heart disease, stroke and cancer. Obesity has a disproportionate impact on my Black patients; in part due to obesity, Black Americans are 77% more likely to be diagnosed with diabetes and more likely than any other group to have high blood pressure. That makes us extremely vulnerable to serious cases of COVID-19, and also puts us at greater risk of long-term health issues and lower quality of life.
In the wake of the pandemic, the medical community and lawmakers are finally beginning to acknowledge that systemic health inequities are a pre-existing condition for Black people. Yet they are still behind in recognizing obesity as a health equity issue that disproportionately impacts the Black community — and this complacency has cost dear lives during the pandemic.
As we have seen during the pandemic, the systemic problems that we have ignored for far too long have left the most vulnerable communities exposed to death, disease and disaster. Addressing obesity as a serious health condition is something we should have been doing more broadly a long time ago. I had high hopes, as did many of my colleagues, that in 2013, when the American Medical Association (AMA) took a historic step to recognize obesity as a disease — and not just a personal failing — that we would be able to make treatment for obesity more accessible to everyone. Before that point, high-quality obesity treatment was really only available to those who could afford to pay out of pocket because most insurance plans excluded coverage or had limited benefits. Unfortunately, much of the hope we had has not been realized in terms of substantive changes in who has access to obesity treatment, and our society is being devastated by this failing.
Even though the AMA updated their position to be consistent with the most current science, this has not translated to changes in how individual health care practitioners approach obesity. Black Americans still face stigma from inadequately trained physicians who believe obesity is the result of individual choices or behaviors. A recent study found that up to 74% of people living with obesity felt shamed or belittled when visiting a doctor, making them less likely to seek care in the future, further jeopardizing the scant trust that Black people have in the healthcare system.
And despite the conclusive evidence that obesity is a treatable disease, Medicare and some private insurance plans are still not covering comprehensive treatment approaches that include safe, FDA-approved anti-obesity medications. This prevents millions of Black Americans from accessing life-saving care, including many of my patients. And these outdated laws are based on harmful biases instead of following the science.
This is a clear example of how a systemic inequity perpetuates disparities that have terrible consequences for Black Americans. Continuing to deny coverage for obesity treatment disproportionately affects Black Americans because of the higher rates of obesity in our community. We have to change policies to not only catch up with science, but to directly address the systemic inequities that continue to deprive Black Americans of health and wellbeing. That’s why I’m supporting a new campaign, Obesity Care Now, that calls for Medicare to provide more comprehensive treatment for people living with obesity and presses Congress to pass legislation like the Treat & Reduce Obesity Act (TROA) that would make obesity care more accessible and affordable.
I got into medicine because I wanted to help people. Every day at the Weight Management Center, I get to do that for countless patients, providing high-quality obesity medicine treatment and the full continuum of care. Yet, outdated regulations shouldn’t prevent me from getting my patients the care they need.
My patients deserve a chance to live happy, healthy lives, free of preventable diseases. They deserve the best quality obesity care, free of stigma and discrimination. They deserve obesity care now.
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Dr. Jamy Ard is the co-director of the Wake Forest Baptist Health Weight Management Center. He works with specific populations who suffer from obesity disparities, including Black Americans, older adults, and those with severe obesity.
