The Whale: An Opportunity to End the Stigma and Take Meaningful Action Against Obesity
Like any film confronting serious and complex societal challenges, The Whale hasn’t been without criticism for its portrayal of obesity — a disease that impacts 100 million Americans and disproportionately impacts communities of color. But simply registering grievances with the film misses a much bigger opportunity — an opportunity to fuel a nationwide conversation about anti-fat bias, and an opportunity to move the nation’s understanding, perception, and conversation about obesity forward.
The Health Equity Coalition for Chronic Disease (HECCD) recognizes the chance that The Whale presents to dismantle stigma and spur long-overdue, meaningful policy action — especially for communities of color who shoulder the burden of the obesity epidemic more significantly than white Americans. The national platform The Whale has created presents an opportunity that we are morally and socially obligated to seize on — to drive a conversation that leads to meaningful policy action.
Addressing the Problem: Stigma Against People with Obesity is Preventing Access to Life Saving Treatment
Despite being a preventable and treatable disease, the obesity epidemic has become one of the most pressing public health crises facing the U.S. While a common misconception many people believe is that behavioral or lifestyle choices alone cause obesity, the fact is that genetics play a substantial role.
- The CDC declared obesity an epidemic more than two decades ago in 1999, and the American Medical Association and every medical organization has recognized obesity as a disease. Reducing the U.S. obesity rate by 25% would have resulted in 120,000 fewer COVID-19 hospitalizations, 45,000 fewer ICU admissions, and 65,000 deaths.
- Obesity affects nearly 100 million Americans — including more than 42% of adults.
- Obesity disproportionately impacts people of color and historically disadvantaged communities, with nearly half of all Black Americans and Latino Americans living with the disease. American Indians and Alaska Natives are also 50% more likely than white Americans to live with obesity.
Yet, when it comes to changes in medical policy, we still have a long way to go. Until we end the stigma against people with obesity, we will never end this epidemic.
- 79-90% of physicians in the United States have significant anti-fat bias towards individuals.
- On average, medical schools only spend 10 hours teaching obesity education to medical students.
- A study by Dr. Fatima Cody Stanford — an associate professor at Harvard Medical School and one of the top experts on obesity — found that “most medical schools don’t teach that obesity is a disease and in fact don’t even offer courses on it, even though it’s the second leading cause of preventable death in the country after smoking.”
Millions of Americans in communities of color who are disproportionately impacted by obesity depend on Medicare and Medicaid — yet these programs exclude coverage for obesity medication.
When Congress passed Medicare Part D in 2003, which is supposed to help Americans on Medicare pay for necessary prescription drugs, obesity was not recognized as a disease nor had it reached the record levels we see today. While a lot has changed, Medicare still does not cover medication for obesity. Only 19 state Medicaid programs cover obesity treatment, and most Affordable Care Act plans exclude coverage.
For the millions of people reliant on Medicare Part D, Medicaid, or Affordable Care Act plans — many of whom are members of Black, Latino, AAPI, and Native American communities — access to lifesaving medical treatment is out of reach.
What We Can Do To Turn the Tide
To advance health equity and to remove barriers to obesity care facing communities of color, the Health Equity Coalition for Chronic Disease earlier this year called on Congress and the Biden administration to address the obesity epidemic in its Five Urgent Priorities for 2023, which includes:
- Medicare must provide access to the full continuum of obesity treatment and care, including anti-obesity medications.
- Require federal policy to reinforce the full continuum of care through workforce training and federal program coverage policies.
- Prioritize efforts at the CDC and other federal agencies to end the use of language that reinforces negative stereotypes and perpetuates stigma around obesity.
- Require Medicare to provide access to behavioral and nutritional counseling without the requirement of co-morbidities.
- Through Medicare and Medicaid, expand the federal government’s use of innovative programs that increase access to fruits and vegetables, and initiatives that educate families and individuals on how to incorporate these foods into a healthy diet.