SSA removed obesity as a discrete listing in the Listing of Impairments in 1999 in an attempt to more closely align allowances made for obesity with applicants’ ability to engage in substantial gainful activity. Obesity prevalence in the United States has risen at a rapid rate in recent decades, a time during which applications to federal disability programs have also increased substantially. Similar to applications, the majority of allowances among those with obesity impairments were recorded under the Musculoskeletal System. In contrast, allowance rates at the initial level for those with obesity impairments in other body system categories rose (albeit at a slower rate). Among applicants with obesity recorded as an impairment, allowance rates at the initial determination fell dramatically after the 1999 delisting, with the largest decline for those in the Endocrine System category.In addition, because adjudicators still found it to be an important component of reduced functional capacity for many applicants, there was a large increase in applications with obesity in the Unknown Body System category. The largest share of applications with obesity recorded as an impairment are in the Musculoskeletal System category. After 1999, relatively few applications with an obesity impairment were categorized in the Endocrine System, the body system under which obesity was listed in the years before the policy change.

By the end of our observation period, the number and share of applications with a recorded obesity impairment were at or above pre-1999 levels. Despite this initial decline, obesity has increasingly been recorded as an impairment since that time (although predominantly as a secondary impairment). After the 1999 rule change, there was an immediate and sharp decline in the number of applications with obesity recorded as the primary impairment.

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