Federal food assistance in the USA is an agglomeration of programs, the legacy of charitable and needs-based approaches that have been in place since the 1930s. Moving toward a rights-based approach would overcome many of the problems of these programs, such as the stigma attached to receiving assistance, the fragmentation of different programs with different eligibilities and the disconnect between monitoring and strategies to reduce food insecurity. Although the USA has not accepted its obligations to respect, protect, promote and fulfill the right to adequate food and nutrition, steps can be taken regardless toward a rights-based approach at the federal, state and municipal levels. With federal recognition of the right to adequate food and nutrition and incorporation within the Nutrition Title, however, a complete reshaping of federal food policy would be possible.