The State Department under Mr Trump issued guidance recommending that overweight and obese people be denied immigration visas, as part of obesity being one of several medical conditions that could be a part of an expense.

The medical conditions include: "cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental-health conditions."

Immigration officials are told to ask: "Does the applicant have adequate financial resources to cover the costs of such care over his entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense?"

The guidance says being overweight can lead to asthma, sleep apnea and high blood pressure, which, in turn, "can require hundreds of thousands of dollars worth of care" which could put strain on the US healthcare system.

A spokesman for the Trump administration confirmed that the directive was real, telling the Daily Mail: "It’s no secret the Trump administration is putting the interests of the American people first. This includes enforcing policies that ensure our immigration system is not a burden on the American taxpayer."

The directive targets immigrant visas, but not non-immigrant 2-B visas, which are obtained by individuals who can support their own medical treatment and are returning to their country of origin.

The directive is also enhancing standards for those seeking to obtain work visas, such as imposing a $100,000 annual fee on H-1B visas for skilled workers, which companies are struggling to fill.

The visa has been criticised previously, but Mr Trump and his most ardent supporters, including Elon Musk, have claimed that they’re vital for attracting highly skilled global talent. The new order

will only be required for new visa requests, with companies being required to make payments for up to six years.

A new "gold card" was also designed to fast-track certain visas of people who are "willing to make a significant financial gift." Around 80,000 will be made available, with the administration saying that it’s currently in its "implementation phase."

* This article was originally published on Extra.ie.