Exposing Weight Loss Industry Legislation - Part 1

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A bill in support of weight loss interventions, particularly GLP-1 diet drugs, has passed the Colorado state legislature and been signed into law. Very similar bills are being pushed by the weight loss industry (and their astroturf “patient-advocacy” groups, particularly the “Ob*sity Action Coalition”) in individual states and federally with the goal of increasing insurance coverage (and through that the market, and through that the profits) for weight loss drugs and other weight loss interventions.

Bills like this with suspiciously similar language are being rolled out across the country, with more each legislative session. If you are interested in pushing back against these bills please check out/join/support the Campaign for Size Freedom!

While the bill has the potential to create significant harm by legitimizing and pouring money into interventions that may turn out to be far more beneficial to the weight loss industry’s bottom line than they are to higher-weight people, I also want to point out that many of the legislators who passed this bill likely had good intentions. Their views have been shaped and manipulated by a culture of weight stigma generally, and specifically by weight loss pharma companies who are following (and expanding upon) the roadmaps created by Novo Nordisk and Eli Lilly to make fortunes from Insulin, and Purdue Pharma from selling Oxycontin, to influence behaviors of patients and providers as well as influencing governments and policy, including by paying millions of dollars to doctors who speak on behalf of weight loss industry priorities, often without disclosing that they have been trained, and/or are being compensated by, the weight loss industry.

I’m going to go through the bill bit by bit as it relates to weight science, weight stigma, healthcare, and areas that suggest weight loss industry influence.

Bills like this have three general sections - the justification for the action taken, the action the legislation prescribes, and the details about enacting the legislation. In part 1 we’ll look at the first section and in part 2 we’ll look at the second section (the third section doesn’t include anything else pertinent.)

Note: The bill text includes weight stigma and misinformation. The text from the bill is indented and you can skip it and still get the gist of the piece. Also, there are a lot of complex issues here, so to keep this from becoming ridiculously long I’ve linked to previous pieces for those who want a deeper dive into individual topics.

The short title of this bill is the “Diabetes Prevention and Ob*sity Treatment Act”

This is just the bill title and already we are off to a rough start. It has long been a weight loss industry priority to conflate being higher-weight and Type 2 Diabetes. In truth, people of all sizes get diabetes and attempts to blend these together can easily end up propping up weight loss interventions at the expense of the health of higher-weight people.

In Colorado, the prevalence of the chronic disease of ob*sity is staggering.

A rough start immediately followed up with a mixture of misinformation and weight stigma. The idea of “ob*sity” (which is simply a body size) as a “chronic disease” is a construct of the weight loss industry accomplished in spite of science. I’ve written about that previously. And pathologization of the existence of higher-weight adds to the weight stigma that harms higher-weight people in every aspect of their lives. In fact, the experience of weight stigma is linked to many of the health issues that get blamed on weight, including Type 2 Diabetes, which is what this bill is supposed to be trying to prevent. The (repeated) presence of the “chronic disease” claim in this bill strongly suggests weight loss industry influence.

Ob*sity affects over 24% of Colorado adults, with disproportionately high rates in communities of color: 33.4% and 31 % of Black and Latino Coloradans experience ob*sity, respectively.

The Body Mass Index or BMI (which is used to define “ob*sity”) is a simple height/weight ratio that was created by and for cis, European, white men. Scholars of Color have taught us that the idea of pathologizing higher-weight bodies in general (including with the constructs of “overw*ight and ob*sity), weight stigma in general, and the BMI specifically are rooted in and inextricable from racism and anti-Blackness and continue to disproportionately harm those communities. I highly recommend work like Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness to understand more about how this operates, including in healthcare.

What the percentages laid out in the bill may actually show is that BMI’s racist basis means that Black and Latino people are more likely to be categorized as “overw*ight” and “ob*se” by a metric that was created using white European men, and that this bill may lead to these Coloradans being more likely to be exposed to the weight loss drugs and other interventions that this legislation supports. These drugs have serious, sometimes fatal, side effects and some of their clinical trials underrepresent Black and Latino people which means that they are being targeted for drugs without having been properly represented in the research into the effects of those drugs.

More than one in 4 youth ages 10 to 17 are either overw*ight or experiencing ob*sity, and 24 .3 % of children enrolled in the federal special supplemental nutrition program for women, infants, and children in 2020 were overw*ight or experiencing ob*sity.

First of all, the language “experiencing ob*sity” is perhaps the most ridiculous iteration of the weight loss industry’s marketing of person-first language to support their profit priority of the diseasification of simply existing in a higher-weight body. Worse, while the weight loss industry is duping people into accepting person-first language by marketing it as anti-stigma language, in truth it creates greater stigma for higher-weight people by suggesting that simply accurately describing higher-weight bodies is so terrible that we should talk about these bodies differently than other bodies. (For example, I’ve never hoped that I might find someone experiencing tallness to help me reach the groceries on the top shelf at the store. ) I wrote about that in detail here.

Second, the idea of “diagnosing” children as “overw*ight” or “ob*se” was not the goal of the creation of the growth charts upon which these “diagnoses” are based. Also, these growth charts are based on data from 1963-1994 for kids under 6 and 1963-1988 for kids 6 and up. The difference in dates is because the kids over 6 from the 1988-1994 data were heavier than expected so they were excluded from the data as outliers, lowering the weight in those percentiles. Overall, the percentages in the bill are based on a problematic-at-best comparison of kids today to kids from 62 to 37 (or 31) years ago. Just one issue is that there is no analysis that determines if the differences in kids’ weight today might be due to a reduction in food insecurity/hunger. I wrote about these growth charts in detail here.

The bottom line is that using a comparison to kids from 3-6 decades ago as justification to give kids a drug with possibly fatal side effects, that has to be taken for life to even have a chance of maintaining weight loss (though there is no evidence showing that is possible), all based on a 68 week approval study is truly concerning.

(b) The American Medical Association and the American Academy of Pediatrics declared ob*sity a chronic disease in 2013

They forgot to mention that the AMA did this in response to massive lobbying from the weight loss industry and against the recommendation of their own Committee on Science and Public health who had studied this for a year and recommended that ob*sity NOT be considered a disease. One of their main concerns was overtreatment - that people would be subjected to risky weight loss interventions simply because they existed in a larger body and regardless of health. This legislation shows that their concerns were more than valid.

As far as the American Academy of Pediatrics, I’m not at all certain the bill’s claim that the AAP “declared ob*sity a chronic disease in 2013” is accurate. In 2013 the AAP’s “section on ob*sity” became an official section, but it had been around since July 2011. In 2013 they also founded the “Institute for Healthy Childhood Weight” but and I was not able to find any “declaration” of ob*sity as a disease.

Also, this is perhaps a topic for another time, but given that the AAP has been hyper focusing on preventing/eradicating the existence of higher-weight children for over 10 years and the current narrative, including in this bill, is that there are very many more higher-weight kids than there were before, maybe, just maybe, we could consider that this weight-centric focus is the wrong approach to supporting the health of pediatric populations.

and the American Diabetes Association has recognized ob*sity as a complex, progressive, serious, relapsing, and costly chronic disease

It’s perhaps less surprising that the ADA fully accepts and promotes the weight loss industry’s wildly broad definition of “ob*sity” when you know that the ADA takes a ton of money from the weight loss industry, including and especially Novo Nordisk. I’m currently researching a full piece on this but Novo sponsors programs, conferences, and more. Novo is, for example, one of three “founding pathway sponsors” (with Eli Lilly - another manufacturer of weight loss drugs - and Sanofi) “who cumulatively have contributed more than $53.6 million.”

Novo and the ADA have recently started an “organization” together. In fact, a June 3rd, 2025 ADA press release announced: “The Ob*sity Association™, a division of the American Diabetes Association®, (Ob*sity Association), with inaugural support from Novo Nordisk Inc., is taking the next step toward improved ob*sity care”

The ADA is hitching its fundraising wagon to the weight loss industry’s star. It is unlikely that the legislators who voted for this legislation understood that the ADA messaging is often actually crafted in concert with the weight loss industry, including and especially Novo Nordisk.

Ob*sity serves as a major risk factor for developing comorbid conditions, including heart disease, stroke, type 2 diabetes, renal disease, non-alcoholic steatohepatitis, and 13 types of cancer. Research shows that ob*sity and diabetes increase the risk of more severe coronavirus infection and hospitalization.

This is a classic correlation vs causation error. First of all, these conditions happen to people of all sizes. Further the conditions that are linked to “ob*sity” are also linked to weight stigma, weight cycling, and healthcare inequalities, all three of which may be exacerbated by this bill and its enaction. This is another area in which the weight loss industry has spent millions of dollars to obscure the basic scientific truth and, sadly, these legislators have bought it hook, line, and sinker.

Ob*sity also contributes to many chronic and costly conditions and increases risk of physical injury, including falls, sprains, strains, lower extremity fractures, and joint dislocation.

At this point I think it’s important to note that there aren’t any citations for anything in this bill and this paragraph in particular seems to fall under the category of “now we’re just saying stuff.”

The constant harping on the supposed expense of higher-weight people existing is not supported by good evidence but, even if it was, suggesting that a group of people should be eradicated because their existence costs more is a wrong and dangerous road to go down.

It is unclear where they are getting the claims about these injury rates and again, even if there is research on this, it would still be the same type of correlation/causation issue as above. Which is to say that even if there are higher rates of these injuries in higher-weight people, it’s very possible that these injuries are due to things like muscle loss from weight cycling, weight stigma in fitness leading to trainers and coaches not being knowledgeable (or being exactly wrong) about working with higher-weight bodies, and/or other factors having little to nothing to do with a given individual’s weight.

Further, research finds that up to 50% of the weight lost with GLP1s is muscle mass. In fact, lean body mass has been shown to be decreased in all methods of weight loss attempts. Lower muscle mass increases the risk of many of these injuries.

This claim in and of itself, let alone its use to justify pushing weight loss drugs and other weight loss interventions, is not remotely based in good science

( c) Strong and consistent evidence shows that effective weight management can delay the progression from pre-diabetes to type 2 diabetes and is highly beneficial in treating type 2 diabetes. In people with type 2 diabetes who are also overw*ight or experiencing ob*sity, modest weight management clinically improves health, including reducing glycemia levels and reducing the need for glucose-lowering medications. Greater weight management substantially reduces AlC and fasting glucose levels and has been shown to support sustained diabetes remission for at least 2 years.

This is simply false. The research that is used to prop up this claim includes not just weight loss but also behavior changes which precede the weight loss. It makes absolutely no attempt to determine if the reason for the improved health measures are due to the weight loss, or due to the behavior changes. Luckily, Tomiyama, Ahlstrom, and Mann did the research and, in correlational analysis, found no clear relationship between weight loss and health outcomes related to hypertension, diabetes or cholesterol, “calling into question whether weight change per se had any causal role in the few effects of the diets. Increased exercise, healthier eating, engagement with the health care system, and social support may have played a role instead.”

Even if it was the weight loss (and, to be clear, the science suggests it’s not!) about 100 years of research has shown that the vast majority of people who attempt weight loss will lose weight short-term and gain it back long term and, remember, weight cycling has been linked with worse glycemic management. So weight loss does not meet the criteria for an ethical, evidence-based intervention for glycemic management, and weight loss attempts may actually make glycemic management worse.

( d) The 2023 American Academy of Pediatrics ob*sity guidelines recommend that comprehensive, evidence-based ob*sity treatment for youth should include anti-ob*sity medications and that this treatment option is safe and effective.

The American Academy of Pediatrics itself, and several of the guideline’s authors, took money directly from Novo Nordisk and then made special dispensation to include these drugs in the guidelines. I wrote about these deeply concerning guidelines here.

Eight out of ten adolescents with ob*sity will continue to have ob*sity as adults.

A similar number of adolescents with tallness will continue to have tallness as adults. Behold, genetics and body diversity.

Treatment significantly improves an individual’s health and quality of life

Says who? Certainly not for the people who experience significant, sometimes long-term, sometimes fatal side effects or the people who experience weight cycling. I wish there was a citation so I could provide a more specific critique but as I said above, the idea that weight loss improves health and quality of life is far from proven, even if it was achievable which, for the vast majority of people, the research suggests it is not. Finally, the use of “treatment” here instead of just saying weight loss is another example of weight loss industry marketing language working its way into this legislation.

and has the potential to significantly reduce health-care costs by preventing the development and progression of ob*sity-related complications, including diabetes.

At least they summoned the honesty to use “has the potential” since there is simply no proof of this and it’s possible that all of the money poured into these weight loss interventions massively increases healthcare costs with, at best, little to no benefit and, at worst, significant harm to higher-weight people.

So that’s the language they are using to justify the legislation. In Part 2 we’ll take a look at the legislation itself.

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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.