A recent U.S. proposal to restrict visas for individuals with obesity or chronic metabolic conditions has intensified a global debate: Is health becoming a tool for exclusion? This policy has been framed as a protective measure for national resources and security, but it also signals the rise of “health nationalism”-a phenomenon in which health status becomes a criterion for belonging, mobility, and value within and across borders. Health nationalism isn’t monolithic.

It takes economic, securitised, and ideological forms. Economic protectionism includes measures like drug pricing reforms aimed at cutting national healthcare costs. Securitised health nationalism restricts access based on perceived health risks. Ideological nationalism treats the health of certain populations as a marker of national identity. The U.S. approach blends the first two, creating domestic benefits but raising ethical and global red flags. To understand why this decision matters, it is essential to look beyond politics to the underlying drivers.

The United States faces one of the highest obesity rates in the world, with more than 40% of American adults meeting criteria according to the Centres for Disease Control and Prevention (CDC). The worldwide prevalence of obesity, according to the World Obesity Federation, has more than tripled between 1975 and 2022, and it is now recognised as one of the most important public health problems facing the world........

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