Twenty years ago, advocacy for people living with obesity was at ground zero. But now, we are entering a third decade of advocacy for the Obesity Action Coalition. We are in a profoundly different position. So we took the day yesterday to consider with leadership in the OAC community where the next two decades of advocacy will lead.

What once required careful triage of scarce resources is now an organization with scale, influence, and the capacity to think boldly. The question is not whether OAC can do more. Rather, it is how shall we deliberately choose to shape the future of advocacy for people living with obesity.

Building Systems

The next 20 years will demand a shift from filling gaps to building systems. Advocacy will increasingly mean securing seats at decision-making tables where algorithms are designed, coverage policies are written, and narratives are amplified – or challenged. It will require confronting not only external weight bias, but the internalized stigma that keeps too many people from seeking care, community, or voice.

Mental Health

Mental health will emerge as a defining frontier. As obesity treatments evolve, so must training, support, and ethical clarity across medical and mental health professions. Advocacy cannot stop at access to medications. It must extend to understanding, dignity, and care for the whole person.

To make this shift will require a change in the prevailing narrative – to emphasize weight health rather than weight loss. More about the less visible aspects of this disease that have deep implications.

The Indispensable Source

Perhaps most importantly, the future of advocacy will require becoming an indispensable, trusted source of perspective. One that elevates lived experience, equips providers, and insists that people living with obesity are not passive recipients of care, but experts in their own lives. This is a crucial dimension of defining where advocacy for persons living with obesity will lead.

For further perspective, click here, here, and here.

Electrician, painting by Oleksandr Bogomazov / WikiArt