We’ve made significant strides in the way we talk about obesity and weight in society—discouraging yo-yo fad diets and weight bias online and in the media, and advocating for body acceptance and size representation.

But accepting obesity as a chronic disease across the lifespan is an entirely different story.

The early warning signs of obesity

My struggle with obesity began in my teenage years when I was prescribed a form of hormonal birth control that caused very quick and stubborn weight gain. What started with simply needing a bigger dance costume for my school performances soon became gaining not the “Freshman 15” but the “Freshman 50” in college.

It wasn’t until my early 20s that I was diagnosed with polycystic ovarian syndrome (PCOS), which explained my excruciating periods and the subsequent weight gain when I started hormonal birth control. A hallmark of PCOS is insulin resistance, which for me manifested as consistent weight gain despite being an active teenager. It wasn’t until I received that diagnosis that I finally understood that my hormones were working against me.

I was prescribed several medications to control the symptoms. The regimen was partly about controlling symptoms, but also largely about the negative fertility impacts PCOS can have on women. Getting this diagnosis in my 20s guided my choice to start a family early. While I ended up having two healthy pregnancies, the journey was filled with miscarriages and fertility struggles, and I had to undergo fertility treatments for my second pregnancy.

The extra hormones from the treatments, combined with the stress of trying to manage my weight and being a mom, caused even more weight gain. I was trying everything to keep the weight off, including every fad diet in the book and the “miracle pills” I saw on television. I joined a medical weight loss program that helped me lose 60 pounds, but, when I could no longer afford it, those 60 pounds and even more came right back on.

How I battled weight stigma

By the time I reached my 30s, I was on 14 different medications for all my comorbidities of obesity, from prediabetes to joint pain to asthma. My body was physically breaking down from carrying excess weight, but nothing I tried was stopping the weight gain or keeping it off. At this point, my endocrinologist suggested bariatric surgery to help with my severe obesity and the huge toll it was taking on my health.

Throughout this decades-long journey, weight stigma was everywhere I turned. My primary care provider told me I wasn’t trying hard enough and didn’t need surgery, even though I had exhausted so many behavioral options. This provider told me to “just put the fork down”—something that I hope no other person with obesity ever has to hear.

Instead of having my obesity treated like the disease that it is, I was being told it was a moral failure that was completely within my control.

Why I'm choosing to advocate for change

We need to stop pretending that obesity is a problem of willpower that will go away with the right diet and exercise. Obesity is a chronic, lifelong disease that has no cure for many people. Yet, Medicare, Medicaid, and private insurance companies do not cover effective treatments like obesity medications and medical nutrition therapy.

Policymakers have deemed it unacceptable to deny people life-saving medications for other chronic conditions, like diabetes or heart disease. Why are they denying care for obesity? Medications are not a cure, but they can alleviate many negative side effects of obesity and help people finally keep weight off.

 I eventually did get bariatric surgery, which helped me lose 100 pounds. Soon after, I ran three half marathons and finally found a care team that did not tell me this was all my fault.

However, my story didn’t end with happily ever after. I still deal with obesity every day and likely will for the rest of my life. I rely on an obesity medication to keep it in check, but my insurance company will only cover it if I have prediabetes.

Like me, many patients with obesity are barred from services and treatments that would help them live fulfilling, active, and healthy lives, including physical therapy, visits with registered dietician nutritionists, and insurance coverage of medications. This is an issue of health equity. Those of us who have been suffering from obesity for years deserve relief, but it is not accessible or affordable.

We must see obesity as a disease across the lifespan that deserves treatment across the lifespan. Half the U.S. population is overweight or obese. Even after dealing with this disease for decades, I am still fighting with my insurance company to get coverage for an obesity medication.

It’s time our lawmakers understand the fight many people go through every day just to get help for a condition that is treatable.

Kristal Hartman is Chair of the Board of Directors for the Obesity Action Coalition, which helps increase education, advocacy, and support for those living with the chronic disease of obesity. Visit OAC’s Physician Finder to search for health care providers in your area who are qualified to care for obesity without stigma.