Providers have historically lacked reimbursement for obesity management in the primary care setting. In 2011, the Centers for Medicare and Medicaid Services (CMS) released the decision to reimburse qualified primary care providers for obesity counseling. Despite representing an important step in improving the treatment of obesity in primary care practice, we are concerned about the how the policy might adversely impact high-risk groups, namely racial/ethnic minority and socioeconomically disadvantaged populations. Not only does obesity continue to exact a disproportionate toll among high-risk groups,there is limited empirical evidence that we can produce sufficient weight loss in these populations to qualify for reimbursement under current guidelines. We present several suggestions to improve the CMS reimbursement policy and diminish the likelihood of increasing obesity disparities.