Is there room for us all? Obesity, rights and the failure of public policy in VenezuelaIn Venezuela, health and dignity seem to have a weight limit. Currently, 54% of adults in the country have a high body mass index (BMI), a reality that points to an unprecedented health emergency: by 2030, this condition will affect 10.52 million people, according to the World Obesity Atlas 2025 report.

For this growing majority, public spaces have become an obstacle course and the healthcare system a dead end. This research reveals a combination of exclusionary infrastructure and non-existent public policies which, together, violate human dignity and condemn citizens to silence and institutional segregation.

Living at the mercy of indifference: The trail of a system that excludes

The story of Luis Beltrán Lara is the most painful testimony of how the lack of hospital infrastructure amounts to a death sentence. In 2016, Luis weighed over 140 kilos, facing complications from diabetes and high blood pressure. He achieved a personal victory by losing 56 kilos, but his environment never gave him a break. He confessed to his family that he avoided going to the stadium or entertainment venues because the seats were uncomfortable and he feared inconveniencing others; there was simply no room for him.

Years later, after regaining weight and reaching 120 kilos, Luis suffered a stroke in August 2023. It was then that institutional exclusion revealed its most technical and cruel face: although he urgently needed an MRI scan, he was unable to have one because in Venezuela the MRI machines cannot exceed a weight limit of 99 kilos. The medical justification was that the equipment’s wheels, all imported, could not withstand any greater load. The struggle continued with kidney failure and transfers in unsuitable ambulances that turned his pain into extreme physical discomfort. Luis Beltrán died in June 2025 of a heart attack. His son, Beltrán Humberto Lara, says the family suffered due to the restrictions Venezuela imposes on overweight people.

This ordeal is shared by Ramón Veliz, who, weighing 174 kilos, experienced exclusion in everyday life: “I had to pay for two seats on public transport because there are no seats for an obese person; it was quite uncomfortable. It also limited my ability to go out; I turned down invitations because in bars and restaurants, there aren’t always chairs that can support the weight,” he said.

Marcos Lucena recounts how bullying and a lack of oxygen to the brain led him into critical situations, whilst those around him stigmatised him: “I went to psychologists; I was in psychiatric treatment. They started calling me ‘fat’ and it hurt my pride; it was difficult to sit on a plastic chair.” Marcos adds his voice to that of his mother, a surgical nurse, who sees every day how patients feel as though they are suffocating on stretchers that cannot support them.

Even emigrating is a terrifying experience, as Anthony Rauseo admits, who used to think about what his flight would be like weighing 168 kilos. He also recounts the difficulties of his experiences in healthcare centres. “Getting access to tests is very difficult and the staff aren’t prepared for these cases; they often mistreated my arms to draw blood.”

This physical vulnerability described by patients aligns with the technical stance of the medical profession. Endocrinologist Félix Saavedra maintains that class III obesity must be understood as a condition requiring special needs, as the physical environment in Venezuela is not designed for body diversity. “These are patients who face difficulties in their daily lives – putting on T-shirts and trousers, finding suitable clothing, getting into vehicles and using toilets,” he explains.In the healthcare sector, Saavedra warns that the current hospital infrastructure lacks reinforced equipment.

“If you have a stretcher rated for 80 or 90 kg, you cannot place a 120 kg patient on it because there is a risk that it will fail and injure the patient. You have to know exactly where you are going to position the patient and approximately how many kilos your stretcher can bear,” he explains.

Beyond the physical obstacles, the doctor emphasises that the lack of suitable spaces fuels social stigma: “Even getting into a swimming pool is a challenge for them because then they ask: ‘Is it a ship’s ladder?’ If so, then no. All these kinds of things have caused the patient to feel very stigmatised.”

The legal framework: A social right that is not upheld

If the physical infrastructure is unsuitable for citizens with obesity, it is because the legal framework has allowed a gap in protection. The irony is that Venezuelan laws promise what the system denies. The Constitution (Art. 83) defines health as a fundamental social right, but Isandra Villegas, a specialist in public management and mobility, points out that spaces are designed based on average sizes that ignore reality:

“Benches, transport, parks and seats in restaurants or cinemas are often narrow, causing discomfort for people with obesity”.

Villegas warns that the Law for Persons with Disabilities (2007) does not explicitly include those living with obesity, which limits its application. She adds that COVENIN Standard 1588-88 on street furniture remains rooted in measurements that offer no adaptations. When comparing with other countries, Villegas highlights the lag:

“Globally, some countries are making progress on inclusion: in the United States, inclusive ergonomics standards are applied in transport and airports; in the United Kingdom, transport and parks include priority and wider seating; Canada incorporates minimum dimensions into building codes; and Australia adapts seating in hospitals, schools and transport. These practices highlight the gap in Venezuela”.

This legislative void is confirmed by Engineer Gustavo Farache, president of the Carabobo State Chamber of Construction: “We are supporters and we back any proposal that will help the country, but there is no such thing, as far as I can recall, related to or addressing obesity in the country,” he said.María Isabel Agostini, president of the Venezuelan Association for the Study of Obesity, asserts that the country has not kept pace with the care required for people living with this condition.“Recently, the endocrinology department at the Military Hospital opened a separate unit for patients living with obesity, but the technology is very basic. They don’t have many options.”

Hunger and excess weight: The paradox of malnutrition

This lack of infrastructure and legislation clashes head-on with an epidemiological emergency. Dr Ronnie Villasmil, a bariatric surgeon, warns that obesity now affects 30% of Venezuelans and in recent years has surpassed child malnutrition. For Dr Marianella Herrera, director of the Venezuelan Health Observatory, this is the “double burden of malnutrition”: overweight bodies suffering from severe anaemia due to a diet based on what their pockets allow them to buy.

Due to low purchasing power, Venezuelans have replaced proteins with low-cost carbohydrates, according to Luisa Rodríguez Táriba, president of Sinergia, who reports that the crisis has led to soft drinks replacing water — due to a lack of gas to boil it — and pasta water replacing milk in baby bottles, normalising the sight of “chubby” yet malnourished children. She also highlights that Venezuela’s social structure and security issues have exacerbated the lack of physical activity. “The issue of insecurity has caused people to shut themselves away in their homes, which equates to less mobility and less physical activity.”

Obesity is accompanied by hypertension and non-alcoholic fatty liver disease, complications which Villasmil warns cannot always be resolved even with bariatric surgery, which is why he makes an urgent call to step up screening: over the last three years, his team has operated on more than 300 patients, the majority of whom are aged between 35 and 45.

Villasmil proposes that Venezuela should follow the lead of countries such as China or the US, implementing specific public policies to guarantee mandatory treatment and exercise programmes: “a path towards which the entire Venezuelan healthcare sector should be striving”.

Healing the relationship with the body and the environment

But the damage caused by an exclusionary system is also measured in terms of mental health. Venezuelan society “lives in an atmosphere of unkindness” towards those who are overweight, notes psychologist Anyibeth Sequera. Chronic stress raises cortisol levels and drives sugar consumption as a survival mechanism: “It is no secret that the Venezuelan population is subjected to a burden of stress and uncertainty that evidently raises cortisol levels, pushing people to seek out sugar”.

Sequera argues that the lack of basic amenities brings life to a standstill: “Halting an individual’s daily activities—such as lacking access to public services, public transport, chairs, clothing, or facing criticism, mockery and bullying. We must rescue people with obesity from this narrative... which is really about survival.” She advocates for the public system to offer refuge and tools for emotional regulation: “It is important to offer techniques and spaces that foster a sense of safety so that people can find refuge, calm, kindness and self-compassion.”

Psychologist Scarlet Celis agrees that weight gain often masks old wounds or traumas managed through the immediate gratification of food. Without comprehensive support, the patient ends up being their own judge in a punitive social environment.

For this reason, sports nutritionist Luis Guillermo Ojeda emphasises that prevention cannot be separated from human rights: “We need better infrastructure, adapted medical equipment and training for healthcare staff with a more humane and holistic approach. It is not just about weight, but about understanding the person’s full context and helping them improve their health without losing sight of their dignity”. Ojeda, who identifies the root cause in an educational culture that rewards with junk food, proposes a multidisciplinary model that guarantees dignified treatment.

Based on the statements and testimonies from this research, it is concluded that it is urgent to stop viewing obesity through the lens of blame and start treating it with science and sensitivity. The State’s Special Plan for Health and Life 2026 mentions infrastructure improvements, but the question remains: will people with obesity be taken into account? Is there room for us all in this Venezuela, or will we continue to build a country where body size determines who has the right to healthcare?

This article is written as part of the Forus journalism fellowship programme. Learn more here