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Headlines deriding the "obesity" epidemic or declaring "obesity" a major problem are sadly common. But it's time these declarations start using another word for "obese."
While it has some roots as a medical term, "obese" is a harmful phrase, with evidence connecting its increasing use—and the focus it puts on weight loss as the ultimate or only solution—to real physical and mental health concerns for people in larger bodies.1
In reality, it's possible to be healthy at any size, and rather than insisting on a literal one-size-fits-all solution, it may be more beneficial to understand the various ways mental, emotional, and physical health can all contribute to an overall sense of well-being.
Many people may wonder why is "obese" a slur or why they should use another word for "obese" if the word is a medical term.
It's true that in 2013, the American Medical Association (AMA), one of the most influential medical groups in the United States, voted to officially recognize "obesity" as a disease. This was done for many reasons, including opening up more avenues to research the issue, despite subgroups within the AMA itself raising concerns about a lack of evidence to support the claim.10
The medical term for "obese" also has ties to the body mass index (BMI), where "obese" is used as a category representing someone with a BMI of 30 or higher. This BMI designation has historically been associated with people in larger bodies and at higher risk of particular health concerns. However, neither of those connections has been proven consistent.9
None of these counterpoints have been enough to stop the term from widespread use, giving people the idea that "obese" is a medical term for overweight. But treating "obesity" as a medical condition also pathologizes someone's body size, opening up the idea that there should be distinctive treatments for solving this "problem." Again, this needs to include the larger picture, in which body composition is just one factor of overall health.
Why is “obese” offensive?
The word “obesity” is derived from the Latin obesus, which means “having eaten until fat.” This is both hurtful and not necessarily true, as various factors, including genetics and health conditions, influence body weight in humans.4
Like many other words considered offensive or a slur, "obese" is othering, reducing a person to a single characteristic: their body weight. It plays into the harmful idea, long perpetuated by Western culture, that there is a "correct" body weight or size and insinuates that anyone who doesn't achieve it is lazy, weak, or a failure in some regard.
This way of thinking is often referred to as weight bias.11 It frequently leads to weight stigma or active prejudice against people in larger bodies. Indeed, people considered "obese" have reported high levels of harassment, criticism, bullying, and other negative experiences.11
Sadly, even people in larger bodies can have these types of thoughts, internalizing the weight bias they experience and feeling "less than" as a result.11 And when a word or phrase can make a person's weight seemingly the only thing about them that matters, it might be time to find a new word for "obese."
Medical issues with the word "obesity"
Aside from the cultural implications, there are real questions and concerns around the view of "obesity" as a medical condition.
To start, the source of the medical term for "obese"—the BMI—is hugely problematic. Despite being heavily relied on by doctors and health insurance companies to indicate someone's physical health, the BMI was never designed for this purpose. The system was originally meant to create a bell curve of average human height-to-weight ratios, and the designations it uses—including categories like "normal weight" and "overweight"—have been changed over time, making the terms ultimately arbitrary.5
Adopting the mindset that "obesity" is a medical issue that requires "prevention" or "treatment" also involves framing someone's body weight as the sole or primary problem. This can lead to fat bias within the medical world, which is a noted and real problem. Doctors have reported attaching the same prejudiced ideas about fat people—that they're lazy, stupid, or worthless—when examining patients in larger bodies, among other signs of stigmatization.3
It also may encourage doctors to become preoccupied with the number on the scale rather than looking at the whole of the person and other aspects of their lifestyle that contribute to their well-being. Recommending weight loss as a "solution" to the "problem" of "obesity" is extremely harmful, often leading to unhealthy fixations on food and body image, cycles of dieting, and lower self-esteem.1 Ultimately, these issues are more harmful than someone's body weight alone and can lead to even more significant problems, like the development of eating disorders.
Social issues with the word “obesity”
Another reason to find another word for "obese" is that the term can have real and harmful social impacts on people in larger bodies.
One of the major problems is that the word "obesity" perpetuates the myths that body size is a behavior and that health is determined by body size. Neither of these things is true, and they ignore the role of genetics in influencing both body size and health and structural factors, including the social determinants of health.7
The conditions in which people work, live, and play, their income, their access to health care, and their experiences of oppression affect their health outcomes to a much larger degree than their behaviors, including what they eat and their activity levels.
Yet, the stigma associated with body size can lead to people in larger bodies making less money, having a more difficult time dating, having their health concerns ignored or blamed on their weight, and experiencing interpersonal bullying and violence.2 And while people of all genders experience stigma and oppression based on body size, this is often more extreme for women and transgender individuals.6
Asking questions like "What is the definition of obese," is an excellent way to start thinking about the issues involved in why "obese" is offensive. But it's also essential to take a proactive approach to fight against the stigma attached to the word.
One of the simplest ways to do this is to use another word for "obese." This can help ease the stigma around the idea, stop othering people, and deemphasize the concept of using a medical term for "obese" when talking about people's body weight, shape, or size.
Fat has become an acceptable word for people usually referred to as obese. The idea is part of a campaign to take the word back and help people claim autonomy over how they're perceived and described.
You can also say people in larger bodies, bigger people, or people of higher weight. These phrases separate the term "obese" from the person, helping emphasize the concept that body weight is only one factor that makes up the whole person and far from the most important thing about them.
Health at Every Size (HAES)
Learning more about the Health at Every Size (HAES) movement is another way to support the fight against fat stigma.
The organization is working to shift the medical focus away from higher weight as a primary problem and help people of all sizes receive more competent, holistic care for their medical needs. HAES seeks to end weight discrimination, promote health equity, and boost access to quality healthcare regardless of size or weight.
The HAES principles reinforce the idea that health status or weight should never be used to oppress, judge, or determine the value of a person.8
HAES principles
Weight inclusivity: Accept the diversity of body shapes and sizes and reject the pathologizing and idealizing of certain body weights.
Health enhancement: Improve access for all to services that improve physical and mental well-being, with a focus on the physical, social, economic, and emotional needs of the individual.
Eating for well-being: Learning to eat based on nutritional needs, hunger, satiety, and enjoyment rather than following a restrictive eating plan aimed at weight suppression.
Respectful care: Work towards ending weight discrimination, stigma, and bias and support environments that address these issues.
Life-enhancing movement: Encourage and support enjoyable movements that allow people of all shapes and sizes to participate at a level they choose.
Research has shown that the HAES principles improve health habits, psychological well-being, metabolic health, and self-esteem, regardless of weight.
The bottom line
Weight stigma is a real, documented problem with negative consequences for people who experience it. The brunt of the issues falls on people in larger bodies, who are frequently singled out for their body weight, shape, and appearance.
The problem is systemic and deep-seated and won't go away overnight. But raising awareness around the stigma people in larger bodies face, the truth that larger people aren't automatically less healthy, and the harmful aspects of the word "obese" is a good place to start.
Major societal shifts take time, but every thoughtful approach to this conversation can add up to make a big difference.
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.
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