More than 40% of U.S. adults live with obesity. That makes it one of the most common chronic diseases in any workforce. Yet only 23.5% of employer representatives say their organization treats obesity as a disease, compared with 62.8% for type 2 diabetes.

On Oct. 22, 2026, 1,505 HR and benefits leaders joined the Health Action Alliance (HAA) for Health for EveryBODY: Coverage, Culture, and Accommodations for Employees Living With Obesity, part of HRCI's Alchemizing HR webinar series. The session was presented in partnership with the Alliance for Women's Health and Prevention (AWHP), which leads the EveryBODY Covered campaign. Speakers included:

• Sarah Rauzin, Director of Health Strategy and Insights at HAA
• George Huntley, CEO of the Diabetes Leadership Council
• Robyn Pashby, PhD, Clinical Health Psychologist and Founder of Health Psychology Partners

The session was moderated by Alchemizing HR’s host, Clarissa Peterson.

Rauzin, Huntley, and Pashby made the case that obesity care is a business issue, a mental health issue, and a workplace design issue. You can watch the full recording here through Nov. 22. 

Weight Bias Shapes Hiring, Pay, and Access to Care

HAA's Sarah Rauzin opened by framing obesity as a chronic, treatable disease shaped by genetics, medications, environment, and life events like pregnancy and menopause, not by willpower. Yet weight bias shapes careers before an employee's first day. In a 2026 survey of 1,000 U.S. hiring managers, nearly one in five said they are less likely to hire a candidate they perceive as overweight, and 17% said they had given employees with higher weights smaller raises. Women living with obesity earn up to 9% less than other women. And a new National Bureau of Economic Research working paper found that out-of-work women who started a GLP-1 medication were 27 percentage points more likely to be employed later than women who had not yet started. As Rauzin noted, the medication did not change their skills or experience, only the hiring managers’ impression of them.

Stigma also keeps people from care. Nearly one in three U.S. adults with higher weight have avoided healthcare, and each stigmatizing experience raised the odds of avoidance by 34%. 

That is why AWHP’s EveryBODY Covered campaign's open letter to employers, signed by 68 organizations, calls on businesses to recognize obesity as a chronic disease, review benefits to better support obesity care, and work against weight bias at every level of the company.

The Business Case for Comprehensive Obesity Care

George Huntley, who spent more than 25 years administering self-insured health plans, made the case in CFO terms: Gaps in obesity care are already costing you. In a Peterson-KFF analysis of large-employer plans, members with an obesity diagnosis averaged $12,588 in annual health spending, compared with $4,699 for members without one. Most of that spending goes to related conditions like diabetes, heart disease, and kidney disease. 

And a significant portion of healthcare spending for obesity is likely going unnoticed. Because obesity care often isn't covered, providers will frequently code comorbid conditions instead, which hides the true cost from employers. In the 2018 ACTION study, only 55% of adults living with obesity reported receiving a diagnosis, and only a quarter had any follow-up care.

Huntley urged employers to cover obesity like any other chronic disease, with comprehensive coverage across nutrition therapy, intensive behavioral therapy, FDA-approved medications, and bariatric surgery. 

Newer medications are changing what’s possible for obesity care, and have been shown to improve outcomes across many of employers’ top cost drivers. In one three-year trial, a dual GIP/GLP-1 medication lowered the risk of developing type 2 diabetes by 94%, and in the SELECT trial, a GLP-1 medication reduced major cardiovascular events for adults with heart disease by 20%. Results are strongest when medication is paired with lifestyle support. Among more than 98,000 veterans with type 2 diabetes, those who used a GLP-1 medication and kept six to eight healthy habits had a 43% lower risk of serious cardiovascular events than those who only engaged in a few healthy habits with no medication use.

Huntley warned against cutting off care once treatment works. "It's just like blood pressure medicine," he said. "When you stop taking it, the blood pressure goes back up." In the STEP 1 trial extension, people who stopped a GLP-1 medication regained about two-thirds of lost weight within a year. 

Coverage also shapes recruitment: 85% of women and nearly half of Gen Z workers said coverage for obesity benefits affects their job decisions. And, earlier this year, Bank of America’s CEO, Brian Monihayn, endorsed coverage for obesity care as “the right thing to do for your teammates”.

Huntley offered five questions to bring to your next broker or carrier meeting:

1. Is obesity a covered condition in our plan?
2. Does the plan cover the full range of care, including nutrition therapy, behavioral therapy, medications, and surgery?
3. What restrictions apply to medications, such as prior authorization, step therapy, BMI cutoffs, or required program enrollment?
4. What happens when an employee's BMI drops below the threshold, or a new hire is already in treatment?
5. Where are employees getting stuck? Ask your carrier for data on denials and unfilled prescriptions, and ask your employees directly.

Weight Stigma and Mental Health Shape How People Engage With Care

Robyn Pashby, PhD, a clinical health psychologist and nationally recognized obesity expert, focused on the mental health side of obesity care. The relationship runs both ways. For example, people with obesity have 55% higher odds of later developing depression, and people with depression have 58% higher odds of later developing obesity. Weight stigma also acts as a biological stressor, linked to higher stress hormones, inflammation, and worse blood sugar control. This means that a benefit that treats the body and ignores mental health is only treating half the condition.

And while newer research shows a promising impact of GLP-1 use on mental health outcomes, including food and alcohol addiction, treatment doesn't end judgment. It simply changes the script from "no willpower" to "the easy way out." "Medication changes the physiology," Pashby said. "It does not erase the imprint of the stigma."

Pashby asked employers to consider what people living with obesity carry into work, including:

• Wellness weigh-ins and time-bound team weight-loss challenges that are largely ineffective and can create stress and shame for people who have struggled with their weight for years.
• Seating, travel accommodations, and protective equipment that don’t fit. These are safety and liability issues, and also send a message that people with larger bodies don’t belong.
• Stereotypes represent obesity as a personal failing, which can lead to a lack of psychological safety and disengagement in the workplace.
• Lost earning potential and thousands of dollars in out-of-pocket costs to get the healthcare they need. In 2021, patients with an obesity diagnosis paid an average of $1,487 in out-of-pocket costs compared to $698 for patients without an obesity diagnosis.

Pashby urged employers to stop celebrating pounds lost and before-and-after photos and to track outcomes that matter instead, such as blood pressure, A1C, cholesterol, quality of life, and continued engagement in care, measured in aggregate through the plan.

How Employers Can Build a Workplace for EveryBODY

Rauzin closed by encouraging employers to consider the policies and environments employees navigate every day in the workplace. Legal protections for people living with obesity remain uneven in the United States. The Americans with Disabilities Act covers obesity only in some cases, while EEOC guidance treats severe obesity as an impairment, and places like Michigan, New York City, and Washington state go further to protect the rights of workers living with obesity. Because the legal floor depends on location, inclusive design is the most reliable way to stay compliant everywhere. 

Rauzin offered a simple test: "Can every employee get through a normal workday, including a business trip, without having to ask for something special?"

For example, standard office chairs are only tested for users up to 253 pounds and standard fall protection harnesses fit workers up to 310 pounds. Employers can work with their procurement teams to ensure seating options include ergonomically strengthened seating for workers with larger bodies up to 400 pounds with sturdy arms, and ensure safety gear is outfitted appropriately to each worker’s size. As of January 2025, OSHA now requires construction employers to provide protective equipment that fits each worker. 

Rauzin covered additional recommendations to help employers think expansively about creating workplaces that are inclusive and support healthy choices for workers:

• Use person-first language when talking about clinical care and benefits for employees living with obesity. In everyday employee communications, adopt the American Psychological Association’s Inclusive Language Guidelines, using neutral terms like “higher or lower weight” and avoiding unsolicited comments about body size or changes in the workplace.
• Support access to healthy, affordable food options, build real breaks and movement into the day, and provide paid time off for medical appointments.
• Support caregivers and new parents. Paid family leave and flexible schedules help employees show up for their own care and their families. And longer breastfeeding is linked to less weight gain later in life, yet women living with obesity often face more barriers to breastfeeding. Dedicated lactation spaces are now required in the U.S., and covered support can make this a more viable option for working parents.
• Talk about obesity benefits openly, without judgment, and with privacy protected.

Ready to Take Action? 

Bringing it all together, Rauzin outlined tiered steps employers can consider to take in the next 90 days: 

Essential: Start by reviewing your plan's coverage across the full range of evidence-based obesity treatments, including evidence-based, FDA-approved medications, behavioral and mental health therapy, nutritional counseling, and bariatric surgery. 

Enhanced: To go further, promote the obesity care benefits you already offer and add size and weight to your anti-discrimination policy and trainings. 

Comprehensive: For employers who are ready to take comprehensive steps, train managers on weight bias, audit workplace design and accommodation policies, and replace weigh-ins and weight-loss challenges with programs that reward healthy habits.

Explore Free Tools and Help Shape Our Next Resource

You don't have to build an obesity care strategy from scratch. AWHP’s EveryBODY Covered Employer Hub includes:

• The business case for covering obesity care
• An employer fact sheet on the impacts of obesity on women's health
• Principles for employers prioritizing obesity care
• And a suite of free partner tools, including how-to guides and benefits checklists

HAA and AWHP are building a new FAQ tip sheet shaped by the questions attendees submitted during the webinar, to be released later this fall. If you’d like to submit a question for consideration in the tip sheet, email us at hello@healthaction.org.