How Obesity Medicine Specialists Can Help Improve Women’s Health

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Disclaimer: The views expressed in this blog post are solely those of the author and do not necessarily reflect the views of Eli Lilly and Company.

As a certified women’s health nurse practitioner, I frequently work with female patients who are seeking obesity care. I know the Obesity Medicine Association (OMA)’s members understand obesity as a chronic disease, but it’s also an important women’s health issue.

Obesity impacts more than 1 in 3 American women and disproportionately impacts women of color. It is associated with over 200 other health conditions, many of which have a particular impact on women, including fertility issues, breast and ovarian cancer risk, dementia, depression, cardiovascular disease, and more. Obesity impacts women’s health across the lifespan. The amount of fat mass needed for normal physiologic function (essential fat) is naturally higher in women than men. However, this body composition difference also occurs with lower lean mass and lower basal metabolic rate, which may make women more vulnerable to the current obesogenic environment.

Women also uniquely experience periods of hormonally mediated life events that influence risk of obesity and obesity-related complications — including pregnancy, which for some women can contribute to excess weight gain, and menopause. which contributes to a less healthy distribution of body fat. Exacerbating the burden women experience about their body weight is the fact that women are more commonly the target of our “culture of thinness.” This is why some hypothesize that girls and women are more likely to suffer from disordered eating and eating disorders.

Despite these well-established scientific facts, in my practice, I frequently see female patients who face shame and blame for living with obesity, as many people, clinicians included, still view obesity as a personal shortcoming, rather than a chronic, treatable disease. In fact, 42% of patients with obesity report being subject to weight bias with a healthcare provider. This adds to existing trauma and vulnerability that women may have from facing obesity-related stigma in other settings, such as their social communities or the workplace, delays care, and sets them up for increased health risks later in life.

Despite obesity’s widespread prevalence and extensive impact on women’s health, insurance coverage for obesity care is often lacking as compared to other chronic diseases. In fact, many insurance plans don’t cover the full range of obesity care—including counseling or intensive behavioral therapy, behavior modification, obesity medications, weight loss surgeries, and nutrition services.

I believe that every woman deserves affordable and equitable access to obesity care. I also believe that the more women that speak out, the more likely it will be that we will change coverage decisions. As clinicians, we can help our female patients take control of the narrative and advocate for better coverage of comprehensive obesity care.

One resource you can direct your patients to is the EveryBODY Covered campaign—an advocacy campaign led by the Alliance for Women’s Health and Prevention (AWHP), whose 20 partners include key women’s health organizations such as the National Association of Nurse Practitioners in Women’s Health (NPWH) and the American Medical Women’s Association (AMWA). The campaign is working to ensure that everybody has access to evidence-based obesity care options, which should be covered just as care for other chronic diseases is covered. Through the campaign’s website, advocates can find the tools they need to advocate for better obesity care coverage with insurers, employers, and elected officials, including the ability to share their story, contact their lawmakers, or find resources to have conversations about coverage for obesity care with their employers.

As clinicians, our jobs don’t end when our patients leave our office. We can make a true difference in women’s health outcomes by encouraging those living with obesity to raise their voices to advocate for better coverage of this widely misunderstood yet treatable disease.