Pediatric Research Update | Power of All, Power of Many and Power of One: Obesity and Advocacy

Each month, the OMA Pediatric Committee reviews a pediatric-focused obesity research update to help keep you up to date about the latest findings.

Article Summary

Highlighting Advocacy: Providing care to patients with obesity can be complex. The Obesity and Advocacy joint statement from the Obesity Medicine Association and the Obesity Action Coalition 2024 provides a clinical focus, an action-based framework, and a guide for health care providers. This review highlights the importance of health care providers as advocates at many levels to improve weight stigma and bias and increasing access to evidenced-base treatment.

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Article Review

Your adolescent patient comes in crying at her appointment because one of her basketball teammates “body shamed” her at practice yesterday. Your patient calls distressed because their health insurance does not cover any obesity treatment including medication and metabolic bariatric surgery. A mom complains at her child’s well check that their school has eliminated gym and recess for this school year. These are examples of the complex concerns and illustrate some of the problems of weight bias, weight stigma and barriers of access to evidenced-based, safe, high-quality care.

In the United States, one in five children and adolescents, and one in three adults are obese. Current projections estimate by the year 2030 half of all adults in the US will be obese. Currently, there remains stigma and bias in our society and in health care which detrimentally affects not only the care provided but also healthcare outcomes.

The Joint Statement on Obesity and Advocacy of the Obesity Medicine Association and the Obesity Action Coalition provides not only a great framework for advocacy to impact our patients and families but also provides the degree and steps that a health care provider, at any career level, can interact to support and advocate for patients. It has great information for all health care providers who work and care for people throughout the life span who have obesity. It answers the question on how a health care provider can make an impact with information presented in a thoughtful way with impactful graphs that are easy to read.

Advocacy is defined as access to care, mitigating stigma, bias, and inequity. There are five components that include: Narrative Shaping, Education, Lobbying, Communication, and Coalition Building. The article details integrative levels of advocacy: Self-advocacy, individual advocacy, and system advocacy, explaining how each level can influence patient care.

The most compelling information in this article is as we educate and advocate, we provide comprehensive obesity management. There is a comprehensive list of resources for health care providers, and they highlight advocacy successes thus far.

The Obesity Medicine Association (OMA), with over 5000 members, is the largest medical organization dedicated to addressing obesity. It is timely that the next annual OMA meeting, in 2025, is in Washington, DC which provides a great opportunity for members to utilize advocacy with their state representatives to discuss important issues such as access to care, gaps in care and insurance coverage to evidence based interventions including medical treatment for obesity and its co-morbid health conditions on a national level.

The Obesity and Advocacy article provides a great framework, but it is up to the health care provider to choose an action of advocacy for their practice and their patients. This may look like using patient first language in a discussion with medical students, or an open discussion with patients and families about obesity as a chronic disease. In Pediatric practice, the focus could be interacting with families on how they talk about weight in the home and school, empowering patients to discuss with their employers about options for health care coverage for family members including obesity treatment or providing expertise to local schools to discuss how physical activity is important for children.

Providers can choose the extent to which they want to engage in advocacy. No matter which level or extent chosen, the power of all (systems advocacy), the power of many (individual advocacy) and the power of one (self- advocacy) will improve the progress of diminishing weight bias and stigma and increase access to evidenced-based, safe and high-quality obesity management.