Summary

In medicine, the media, and the public sphere, the cause of obesity is often oversimplified as a basic caloric imbalance: too many calories in and not enough calories out. This platitude influences physician opinion and shapes insurance coverage, typically leading to a treatment approach focused solely on calorie-restricted dieting and increased physical activity. The personal-responsibility framework reflected in this approach places blame on individual patients without considering important biopsychosocial aspects of obesity. These factors can include challenges related to the food environment and the effects of other social determinants of health and a lack of access to the full spectrum of effective obesity treatments. As understanding of obesity has evolved, we believe approaches to managing obesity as well as insurance coverage of these approaches must also shift, particularly in the Medicaid program.