Public Perceptions and Clinical Realities of Obesity Care, With Pooja Singhal, MD

Obesity continues to rise across the United States, affecting more than 100 million adults and reshaping how clinicians, policymakers, and the public think about chronic disease. At the same time, breakthroughs in pharmacotherapy and the widespread adoption of GLP-1 receptor agonists have accelerated conversations about how obesity is defined and treated.1,2

Even as therapeutic tools rapidly evolve, public understanding and perceptions remain a powerful force influencing stigma, access to care, and policy priorities. A new survey from the American Gastroenterological Association (AGA) offers insight regarding how Americans view obesity as a condition, as a risk factor, and as a treatable disease, with findings shedding light on both encouraging progress and persistent gaps.

“Perceptions lead to stigma. Perceptions are stigma,” Pooja Singhal, MD, a gastroenterologist, hepatologist, and obesity medicine specialist at Oklahoma Gastro Health and Wellness, told HCPLive. "When we talk about obesity, I feel like this is one disease state where stigma has really been deeply entrenched.”

Singhal notes that obesity remains one of the most stigmatized chronic diseases, in part because society has long been taught to see it as a matter of personal responsibility, and explains that understanding public perceptions is essential for addressing barriers to care as well as informing advocacy efforts and driving payer and policy attention toward meaningful coverage.

She describes several findings from the AGA survey she finds particularly striking and encouraging, including the 63% of US adults who recognize obesity as a chronic condition. Singhal also highlights the growing awareness that obesity increases the risk of other chronic diseases, noting that clinicians have spent years managing complications such as hypertension and diabetes rather than addressing obesity itself.

Additionally, Singhal calls attention to the 85% of respondents who reported believing insurance should cover obesity treatment. Despite improved understanding of obesity as a chronic disease, she says cost remains the greatest barrier to care, with more than 80% of respondents citing out-of-pocket expenses and limited insurance coverage as major obstacles.

While public and clinical perspectives are aligning in some areas, such as recognizing obesity as a chronic disease requiring long-term management and increased openness to anti-obesity medications, including GLP-1 receptor agonists, Singhal notes key misalignments remain that must be addressed moving forward.

“I think the public sees it as a medication problem, while the reality is that obesity is very complex. We need proper nutrition, proper exercise, proper sleep, proper mental health. There are so many social determinants that also play into obesity,” she said. “We clinicians see it as a multidisciplinary approach dealing with the long-term management of obesity. I think that's the biggest misalignment we still have.”

Looking ahead, Singhal points to major opportunities, including transformative pharmacotherapy, promising endoscopic interventions, and advances in digital health, while stressing that insurance coverage, stigma reduction, and improved clinician training remain critical to closing the gap between need and access.

Editors’ Note: Singhal reports no relevant disclosures.

References

1. American Gastroenterological Association. Most Americans view obesity as a chronic disease deserving insurance coverage. November 19, 2025. Accessed December 11, 2025. https://gastro.org/press-releases/most-americans-view-obesity-as-a-chronic-disease-deserving-insurance-coverage/

2. US Centers for Disease Control and Prevention. Adult Obesity Facts. May 14, 2024. Accessed December 11, 2025. https://www.cdc.gov/obesity/adult-obesity-facts/index.html