Disparities in Access and Quality of Obesity Care

Obesity disproportionately affects racial and ethnic minorities and, most severely, Black persons with obesity.28 Health inequities affect many populations, including his-torically disadvantaged populations, persons living in rural areas, people with disabil-ities, and marginalized racial and ethnic groups.86 Many factors lead to this, including limited access to quality obesity care and socioeconomic factors, such as living in an obesogenic food environment or experiencing frequent microaggressions and racism, which can ultimately increase chronic stress and the development of obesity.7,86 Not surprisingly, these disparities in disease prevalence mirror similar inequality in access to quality obesity care and stem from many places, including poor access to care, inability to access quality obesity care with obesity-trained physicians and cli-nicians, and decreased rate of receiving official diagnosis obesity. Despite research supporting the use of lifestyle modification in addition to weight loss medications and surgery, when necessary, there is decreased utilization in persons with lower so-cioeconomic status or who are ethnic minorities. Some studies indicate that weight loss therapies and surgery are less effective in racial and ethnic minorities, but these disparities are likely repercussions of the unique challenges faced by minority communities1,28 With the growing number of individuals with obesity, there is an urgent need to address disparities in access and quality of care. Improving formal medical obesity education and health care policies that expand coverage for obesity care may also be an impactful intervention.16,17 With the varying efficacy of different dietary or sur-gery interventions, precision medicine needs to have a growing role in Obesity medicine.18