Who is Behind the Obesity Bill of Rights - Part 2

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In Part 1 we discussed the “ob*sity” bill of rights and the first 5 “rights.” Today we’ll look at ”rights” 6-10 as well as discussing who is behind this whole thing.

“Right” #6
The right to accessible ob*sity treatment from health systems, so those with severe ob*sity receive care in settings that allow for privacy, using size-and weight-accessible equipment and diagnostic scans.

How easy would it have been just to say “the right to accessible treatment from health systems for higher-weight people”? Instead, they only concern themselves with accessibility to weight loss treatments.

Here we also get a whole new arbitrary and made-up diagnosis of “severe ob*sity” which is supposedly a “serious medical condition characterized by more than 100 pounds of excess weight or having a body mass index (BMI) of 40 or higher)” Again, no definition of what “excess” means and a continued reliance on the worse-than-useless BMI measure. Also, shouldn’t it be “and/or,” or are they suggesting that having “more than 100 pounds of excess weight” and having a BMI of 40 or higher are mutually exclusive? It’s not just BS, is poorly-written and ill-defined BS.

Next we have another reminder that they see higher-weight people as walking, talking pathologies:

“because these individuals face rampant discrimination in the health system, they are unlikely to receive quality “ob*sity” care.”

Try this: Because people at the highest weights are seen by the healthcare system as less valuable and more risk-able, as well as being seen as walking dollar signs by the weight loss industry, they are often offered care solely focused on changing their weight (interventions which often risk their lives and quality of life,) including being denied or excluded from the care that a thin person with the same health status/presentation would receive.

I’ll note that a few of the things that they are for in this section are also things that I’m for, but I would never make a deal with this devil because they follow up the right to inclusive spaces and equipment and a reduction in BMI-based surgical denials with

“Medically necessary “ob*sity” treatment without step-therapy or an overly burdensome preauthorization process.”

One concerning possibility here is that this results in higher-weight people, particularly the highest-weight people, being moved immediately to the most drastic, dangerous (and, often most profitable,) weight loss “treatments.” This is another example of predicating risk on size such that the lives of the highest-weight people are again seen as less valuable and more risk-able. This also allows them to sidestep weight-neutral treatment options since “ob*sity treatment” focuses on weight change.

“Right” #7:
The Right for Older Adults with “ob*sity” to Receive Quality Ob*sity Care that comprises a respectful, comprehensive care approach consistent with their personalized medical needs

This one is deeply worrying. First, because a large and long body of research has shown that intentional weight loss in this population predicts increased risk of mortality and health issues (I went into detail about this here,) even above and beyond the typical issues associated with weight cycling. Second because this population is typically vastly underrepresented in the intervention trials and studies, meaning that there is little to no reliable data produced for them. To target them for (often expensive) treatments with so little existing data is ethically questionable at best.

“Right” #8
The Right to coverage for treatment with access to the full range of treatment options for the person’s disease as prescribed ty the individual’s health

This is just a naked grab for the pharmaceutical industry’s priorities. They are trying to use these so-called advocacy campaigns to try to legislate what they can’t accomplish medically – they are trying to force insurance companies to cover treatments for which there is limited short-term, and no long-term, data and which insurance companies find are not worth the exorbitant cost.

Again, this entire “Bill of Rights” is an excellent chance to test out what I wrote about in my piece “How to spot an effort to trick you into lobbying for Novo Nordisk and Eli Lilly’s weight loss drugs”

But wait, you say, this bill of rights isn’t from the pharmaceutical companies, it’s from the National Council on Aging and the National Consumers League, isn’t it?

I’m so glad that you asked. It seemed…implausible…to me that these two organizations came up with a document that reads like it was written by a Novo Nordisk lobbyist all on their own.

The National Council on Aging (NCOA) was easy. Novo Nordisk is a massive supporter. They are, in fact, a platinum sponsor which is the highest level of sponsorship. They are also a sponsor of the annual conference. According to the prospectus an annual sponsorship is $400,000. Novo Nordisk also gave an educational grant to the NCOAas part of the study “A call for solutions for healthy aging through a systems‐based, equitable approach to ob*sity” in 2022.

The National Consumer League was a bit trickier. I started researching and, at first, I couldn’t find a connection between the National Consumer League and Novo. So I started searching through their board and it turns out that Andrea LaRue who is a board member of the National Consumer League is also…wait for it…a lobbyist for Novo Nordisk working on the “Treat and Reduce Ob*sity Act” which is the legislation that this campaign supports. Fascinating.

There’s plenty more to unpack here – a questionable origin story, even more questionable claims around the “need” for this, and the phrase “We invite you to join the movement and lend your voice to making quality “ob*sity” a right of all people.” Those are subjects for another day.

For now, I’m going to finish this off with the first thing I noticed. For all of their insistence on (stigmatizing) person-first language and that the focus should be on people and not their so-called “disease of ob*sity,”) their give away the truth here - because this is the “ob*sity bill of rights,” it isn’t for people, it’s for “ob*sity.”

The weight loss industry made up a disease and now they’ve written it a bill of rights.

Reminder: As I was completing my final proof before publishing, I got an email saying that the Association for Size Diversity and Health (ASDAH) is offering a member forum around this topic on April 26 with Angel Austin and Tigress Osborn, both incredible activists and educators in this space. You can find details and register here! (Full disclosure - I’m an ASDAH member, but receive no compensation if you register, I’m just boosting the signal!)

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More research and resources:
https://haeshealthsheets.com/resources/

*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.