Text Link

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

The real problem with “obesity”

Over the last few decades, several headlines have claimed that “obesity” has increased nearly threefold in America since 1975, declaring an “obesity epidemic."1 Articles detail the purported health risks of carrying excess body fat, such as high blood pressure, and offer losing weight as the ultimate solution.

So why is "obesity" a problem?

This type of framing works to pathologize fatness, essentially marking it as part of the “disease” of obesity. But the problem isn't as much in people's body size as the weight of the stigma they must endure.

Evidence suggests that stigmatizing people in larger bodies is not an effective public health tool. Instead, it's been found to threaten people's health and interfere with adopting healthy eating behaviors.2

 minutes read
Last updated on 
May 3, 2024
man on a computer doing research
In this article

"Obesity" and the BMI

The word “obesity” is pervasive and entrenched in our society. In many cases, it even holds a medical connotation, as it represents one of the categories in the body mass index (BMI), a widely used tool in the medical community.

The BMI is a mathematical equation determined by a person’s weight-to-height ratio. The result is then compared to a table of averages—the index—which determines someone's "category," including:19

  • Underweight
  • Normal weight
  • Overweight
  • Obese

Despite being originally designed to create estimates across large groups or even entire populations, the BMI has gained traction as a measure for individual health in recent years, with physicians potentially basing specific recommendations on someone's results.19

However, some experts are beginning to push back against such widespread reliance on the measure. For starters, a person’s BMI doesn’t consider muscle mass, bone density, fat distribution, biological and environmental factors, and racial and sex differences, which all account for a much fuller picture of someone's overall health.19

Concerns with the BMI as a measure of health

A batch of recent studies have also worked to chip away at the usefulness of the BMI as a tool for individual health recommendations.

A 2013 study indicated that those with a BMI of 30-35 (i.e., classified in the “overweight” range) did not have a higher risk of death than their counterparts within the so-called “normal” weight range.3 While not widely accepted by many public health professionals, the results of this study have been repeated several times.

Furthermore, research has shown that a higher body weight can be a protective factor in certain populations. This includes individuals with respiratory disease, kidney disease, cardiovascular disease, and cancer. Higher-weight individuals have reduced mortality rates with chronic conditions like hypertensive heart disease and after certain surgeries like coronary artery bypass surgery.4,5,6

Some research has found correlations between very high or very low BMI and increased risk of death or certain illnesses. However, this research rarely controls for the impact of weight stigma, fat shaming, weight cycling, and substandard medical care, which disproportionately impact people in higher weight bodies on health risks.7,8 Without considering these critical factors, correlations between BMI and health risk cannot be considered causative. 

Additionally, some studies have shown that the statistical relationship between BMI and disease risk differs significantly between Black and White cisgender women.9,10 This is important as most research into weight and health risks is carried out with predominantly white populations. 

In addition to unfounded weight stigma, Black women are often subjected to a variety of dehumanizing and racist assumptions from the medical system, including dangerously neglectful pre and postnatal care and reduced access to pain management.11,12,13

"Obesity" as a “disease” pathologizes fat people

Framing fat people as having a disease or medical condition for simply being fat pathologizes—or treats as medically abnormal—these individuals. It contributes to the message, already made pervasive by diet culture, that being fat is inherently bad, immoral, and unhealthy.

Referring to excess weight as a disease gives people an excuse to discriminate against individuals living in higher-weight bodies, allowing them to leverage their discrimination as a concern for the person’s health.

When fat people go to the doctor, they are frequently undertreated or mistreated by members of the healthcare community who misattribute any physical complaint or medical risk factors to the patient’s weight. Doctors may also spend less time with fat patients, provide them with less medical information, ignore symptoms or health complications, and attempt to convince fat patients to lose weight or even go as far as recommending weight loss surgery.14

Harmful effects of pathologizing "obesity"

Pathologizing “obesity” is known as weight bias, weight stigma, or weight-based discrimination. And it’s extremely common, harmful, and stigmatizing.

According to research:15,16

  • Between 2006 and 2016, weight stigma increased by 66%
  • Approximately 53% of higher-weight women reported medical providers making inappropriate comments about their weight or recent weight gain
  • About 52% of women said their weight has been a barrier to receiving quality healthcare
  • Approximately 79% of people in larger bodies reported using food as a coping mechanism to deal with weight stigma in healthcare

Weight discrimination can deter many people in larger bodies from seeking both preventative and responsive medical care, which may be responsible for future medical issues or the development of serious health complications, as well as the speed of disease progression. These factors are frequently blamed on weight itself. 

App-based recovery

Online therapy sessions
Meal kit deliveries
Remote vitals monitoring

We will help get the most out of your insurance.

Weight stigma leads to shame and mental health consequences

When fat bodies are framed as a medical problem instead of just part of natural body size variation, people living in larger bodies become stigmatized. Many fat people experience bullying, inappropriate comments related to their weight, hostility, and discrimination, all of which can lead to profound shame.

Pathologizing fat bodies and the subsequent weight stigma can cause many harmful effects, such as:2,16,17

In essence, making assumptions about a person’s health status based solely on their body weight, size, or shape only causes further issues—particularly in terms of mental health—which could be prevented by embracing body diversity.

Intentional weight loss is harmful and ineffective 

Another issue with pathologizing "obesity" is the related idea of "treating obesity." This makes someone's body shape or weight a thing to be conquered or carefully controlled, which feeds into dangerous messaging in toxic diet culture around maintaining a "healthy diet" and "healthy weight" at all costs.

There is plenty of evidence that proposing strict diets and workout regimens actually achieves the opposite. Weight stigma increases disordered eating behaviors, including binge eating.17 Even dieting attempts that do not result in the development of eating disorders almost always result in individuals gaining back all the weight that was lost or even more.18 

At the end of the day, pathologizing fatness is not only harmful and stigmatizing but also ineffective. Instead of medicalizing fatness, the medical community and society at large need to understand that weight is not a predictor of health and instead focus on eliminating weight stigma and creating a cultural and physical environment that better accommodates the existing diversity of human bodies.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. World Health Organization. (n.d.). Obesity and overweight. World Health Organization. Retrieved June 29, 2023.
  2. Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American Journal of Public Health, 100(6), 1019–1028. 
  3. Flegal, K. M., Kit, B. K., Orpana, H., & Graubard, B. I. (2013). Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA, 309(1), 71–82. 
  4. Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J.-P., Gordon-Larsen, P., Lavie, C. J., Lear, S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., & St-Onge, M.-P. (2021). Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 143(21). 
  5. Consequences of obesity. (2022, July 15). Centers for Disease Control and Prevention. Retrieved June 29, 2023.
  6. Amundson, D. E., Djurkovic, S., & Matwiyoff, G. N. (2010). The obesity paradox. Critical Care Clinics, 26(4), 583–596. 
  7. Harrison, C. (2019a, August 26). “It’s the way we were all born eating.” The New York Times. Retrieved June 29, 2023.
  8. Donini, L. M., Pinto, A., Giusti, A. M., Lenzi, A., & Poggiogalle, E. (2020). Obesity or BMI paradox? beneath the tip of the iceberg. Frontiers in Nutrition, 7. https://doi.org/10.3389/fnut.2020.00053
  9. Fat phobia and its racist past and present. (2020, July 21). NPR. Retrieved June 29, 2023.
  10. Katzmarzyk, P. T., Bray, G. A., Greenway, F. L., Johnson, W. D., Newton, R. L., Ravussin, E., Ryan, D. H., & Bouchard, C. (2011). Ethnic-specific BMI and waist circumference thresholds. Obesity, 19(6), 1272–1278. 
  11. Working together to reduce Black Maternal Mortality. (2023, April 3). Centers for Disease Control and Prevention. Retrieved June 29, 2023.
  12. Robeznieks, A. (2021, May 24). Examining the black U.S. maternal mortality rate and how to cut it. American Medical Association. Retrieved June 29, 2023.
  13. Sabin, J. A. (2020, January 6). How we fail black patients in pain. AAMC. Retrieved June 29, 2023.
  14. Lawrence, B. J., Kerr, D., Pollard, C. M., Theophilus, M., Alexander, E., Haywood, D., & O'Connor, M. (2021). Weight bias among health care professionals: A systematic review and meta-analysis. Obesity (Silver Spring, Md.), 29(11), 1802–1812. 
  15. Fruh, S. M., Nadglowski, J., Hall, H. R., Davis, S. L., Crook, E. D., & Zlomke, K. (2016). Obesity stigma and Bias. The Journal for Nurse Practitioners, 12(7), 425–432. 
  16. Schvey, N. (2010). Weight bias in health care. AMA Journal of Ethics, 12(4), 287–291. 
  17. Weight stigma. (2019, June 27). National Eating Disorders Association. Retrieved June 29, 2023.
  18. The dangers of dieting & "clean" eating. (2018, February 26). National Eating Disorders Association. Retrieved June 29, 2023.
  19. Shmerling, R. H. (2023, May 5). How useful is the body mass index (BMI)? Harvard Health Publishing. Retrieved February 2024.


Further reading

The real problem with “obesity”

Over the last few decades, several headlines have claimed that “obesity” has increased nearly threefold in Ame

What is fatphobia?

In a world that's long been deeply influenced by the ideals of diet culture, people with certain body...

The devastating effects of fat shaming

Some biases around weight have become so deeply ingrained in society that they’ve almost become invisible...

What is the difference between body positivity and body neutrality

Demonizing or singling people out for their body weight, shape, or size is not only cruel but can...

How to overcome emotional eating after a loss

Loss and grief affect us in profound ways and can lead to emotional eating. Whether you’ve lost a loved...

10 body image affirmations

Eating disorders are often recognized by their physical symptoms, but some of the most harmful aspects of...

Medical fatphobia: Weight-based discrimination in healthcare settings

Weight-based discrimination and fatphobia are incredibly prevalent in medical settings. Many healthcare...

Diet culture is rooted in racism, white supremacy, and colonialism

Toxic diet culture is a pervasive and insidious influence on our lives. Many people may recognize its...

Blind weigh-ins and how to say "no" to being weighed

Getting weighed and having your blood pressure taken are often the first two things you do when you go to...

Eating disorder awareness

Eating disorders are believed to affect at least nine percent of the population worldwide, with an...

22 body neutral affirmations

Loving how your body looks can feel difficult or impossible when living in a cultural environment where...

Cheat meals linked to eating disorders in teens and young adults

A new study published by the Journal of Eating Disorders has found a connection between "cheat meals"...

Disproving the obesity paradox: Why it’s not a paradox at all

The “obesity paradox” is not only a fatphobic and stigmatizing term, but it’s also misleading since...

How body positivity can exclude trans people

Although some people find hope, acceptance, and empowerment within the body positive movement...

“Perfecting” perfection - uncovering problematic celebrity photoshopping

Perfection does not exist; therefore, it is an unattainable standard. Why are we so focused on labeling...

12 non-diet New Year’s resolutions

With the winter holidays just around the corner, you may have begun....

Why you shouldn’t ring in the new year with a diet

As we approach the holidays, you may feel pressure to kick the new...

HAES in the LGBTQ+ community

The LGBTQ+ community, much like the rest of our Western society, is rife with anti...

Why listing calories on menus can be harmful

England recently passed a policy requiring all restaurants, cafes, and takeaways...

Weight stigma in healthcare settings

Weight stigma, which is often referred to as weight bias, is discrimination...

Why using the word "obese" is a problem

How often have you seen in the news a proclamation that “obesity is the largest...

Why am I eating so much?

Anyone can have a complicated relationship with food, particularly in American culture...

What is thin privilege?

Many of us are bombarded daily with messages and images glorifying specific bodies, usually a thin and/or...

What is diet culture?

You’ve probably heard of the term “diet culture” if you’ve spent any time immersed in...

Unrealistic beauty standards and body dysmorphic disorder treatment

Over the last 100 years, the notion of what qualifies as attractive has varied...

Understanding picky eaters

Many young children are very selective about which foods they will eat. Although...

How to deal with and overcome body insecurity

Your body image is how you see your own body, and how you feel about what you perceive...

Can the effects of negative body image lead to an eating disorder?

Body image influences a number of things about the way we feel and act, for better...

Learning the intuitive eating principles

Intuitive eating is an approach to eating based on responding to the body’s...

How diet culture can lead to eating disorders

Diet culture is all around, from advertisements and food labels to social media and influencers. It is so...

Harmful outcomes of the pro-ana movement

Imagine that there were websites that encouraged people not to get treatment for...

Why body weight isn’t an indicator of health

In an age overrun by diet culture, it may be easy to believe that someone's body weight, shape, and size...

What is health at every size?

Health at Every Size (HAES) is an alternative approach to healthcare that proposes...

The racist history of fatphobia and weight stigma

Fatphobia and weight stigma are insidious forces in our society. Fatphobia...

The devastating effects of Instagram and body image

A recent study has revealed that social media apps, such as Instagram and...

Improving your body image in bulimia recovery

Improving body image is one of many individuals’ most challenging parts of bulimia...

How gender dysphoria affects body image

‍Gender presentation, identity, and body image are inherently linked. This...

Fat is not a bad word

The word fat is not a bad word. It is a descriptor, just like thin. Yet society has...

Healthism: When a focus on healthy living becomes problematic

Healthism refers to a set of attitudes and beliefs that health is the most...

Fatphobia is alive and rampant in the gay male community

Fatphobia and weight stigma are unfortunately rampant in among gay men, in...

What is body neutrality and why is it important in eating disorder recovery?

Many people have heard of the body positivity movement, a campaign encouraging people—though primarily...

Binge eating disorder and the trauma of weight stigma

Someone who is struggling with binge eating disorder experiences recurring...

Further reading

No items found.