The Trump administration has reportedly issued new guidance instructing U.S. visa officers to consider applicants’ health more strictly, including rejecting those who are obese or who have certain medical conditions. A State Department memo sent on 6 November advises embassies and consulates worldwide that applicants may be denied a visa if their health issues could make them a potential burden on the U.S. healthcare system.

The memo lists a wide range of conditions—cardiovascular and respiratory diseases, cancers, diabetes, metabolic and neurological disorders, and mental health conditions—as potentially costly. It singles out obesity, highlighting its links to asthma, sleep apnea, and hypertension, and directs officers to assess whether applicants have the financial means to cover long-term medical care without relying on public assistance.

Immigration lawyers have criticized the policy for being overly broad and potentially disruptive. Sophia Genovese noted that considering conditions like diabetes or heart disease in this way represents a significant expansion of current practices. Charles Wheeler from the Catholic Legal Immigration Network added that visa officers lack medical training and should not be expected to make health-based predictions that could be influenced by personal bias.

The new guidance frames obese applicants as possible “public charges,” raising concerns about fairness and discrimination. Meanwhile, U.S. health data shows obesity is already widespread domestically, with more than two in five American adults classified as obese and related medical costs nearing $173 billion in 2019.