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Learn more about the results we get at Within

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Why using the word obese is a problem

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How often have you seen in the news a proclamation that “obesity is the largest threat to public health”? These sensationalizing headlines not only fail to acknowledge that weight stigma and oppression are much greater risks to public health than weight itself, but also contribute to this form of prejudice.

There is increasing evidence that it is the fear mongering around weight stigma and eating disorders that causes higher weight individuals to have an increased risk of certain health conditions frequently misattributed to their weight. (1)

Forcing shame on larger bodies is damaging to people of all sizes, especially those at the higher end of the weight spectrum. Stigma and oppression based on body size 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) This form of prejudice also increases the prevalence of eating disorders, both in people in larger bodies trying to escape weight stigma and in people in smaller bodies who have been taught to fear gaining weight. (3)

When the medical community, culture, and social media consistently push the idea that “obesity” is bad, unhealthy, or undesirable, it is physically and psychologically damaging.

Last updated on 
October 27, 2022
In this article

The problem with the word “obesity”

The word “obesity” is harmful and stigmatizing. It is derived from the Latin word obesus which means “having eaten until fat.” This is both stigmatizing and inaccurate, as body weight in humans is influenced by a variety of factors, including genetics, health conditions, and history of dieting. (4)

The classification of “obesity” is based on body mass index (BMI), which is a mathematical equation calculated based on a person’s height and weight. BMI was designed as a statistical tool to compare members of a population, and was never intended to assess individual health status. Categories based on BMI such as “normal weight”, “overweight”, and “obese” are arbitrary and have been changed over time. (5) 

In a 2013 study, researchers found that many individuals classified as “obese” based on BMI did not have a higher risk of death than those with lower BMIs. (9)

While this study was not well received by many public health professionals, many of whom are deeply invested in perpetuating weight stigma, these results have been replicated many times, with the conclusion being that “obesity” is not a valid word to refer to a medical condition.

Social issues with the word “obesity”

In a social and cultural sense, the term “obesity” carries substantial stigma, which has been repeatedly perpetuated through recent public health campaigns. While people of all genders experience stigma and oppression based on body size, this is often more extreme for women and transgender individuals. (6)

The institutionalization of the term “obesity” - as evidenced by social media, the medical industrial complex, and even government departments responsible for “obesity” - has medicalized and pathologized body size. This is not based on science and is extremely damaging. 

 People who are classified as “obese” by the inaccurrate and racist BMI equation are constantly subjected to dire warnings about their health and pressured to change their bodies. 

One of the major problems of the word “obesity” is that it perpetuates the myths that body size is a behavior and that health is determined by body size. Neither of these things are true, and they ignore the role of genetics in influencing both body size and health, as well as 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 individual behaviors - including what they eat and their activity levels. Increasing access to affordable food, accessible healthcare, and safe housing is essential for improving public health and decreasing inequality.

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Health at every size (HAES)

The Health at Every Size (HAES) movement shifts the focus off weight change and on to helping people of all sizes receive competent care for their medical needs without being told to manipulate their weight. 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.

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 doesn’t and will never change people’s body sizes or improve public health outcomes. Of course, the problems of stigmatization and prejudice won’t disappear by getting rid of this problematic word. Removing this word from public health and health care usage is one important part of reframing the current understanding of body size and health and moving towards a more supportive and health promoting paradigm.

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.

Resources

  1. Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(1). https://doi.org/10.1186/1475-2891-10-9 
  2. Wu, Y.-K., & Berry, D. C. (2017). Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. Journal of Advanced Nursing, 74(5), 1030–1042. https://doi.org/10.1111/jan.13511 
  3. Puhl, R. M., & Lessard, L. M. (2020). Weight stigma in youth: Prevalence, consequences, and considerations for clinical practice. Current Obesity Reports, 9(4), 402–411. https://doi.org/10.1007/s13679-020-00408-8 
  4. Dubois, L., Ohm Kyvik, K., Girard, M., Tatone-Tokuda, F., Pérusse, D., Hjelmborg, J., Skytthe, A., Rasmussen, F., Wright, M. J., Lichtenstein, P., & Martin, N. G. (2012). Genetic and environmental contributions to weight, height, and BMI from birth to 19 years of age: An international study of over 12,000 Twin Pairs. PLoS ONE, 7(2). https://doi.org/10.1371/journal.pone.0030153 
  5. Nuttall F. Q. (2015). Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutrition today, 50(3), 117–128. https://doi.org/10.1097/NT.0000000000000092
  6. Puhl, R. M., Himmelstein, M. S., & Watson, R. J. (2019). Weight-based victimization among sexual and gender minority adolescents: Findings from a diverse national sample. Pediatric obesity, 14(7), e12514. https://doi.org/10.1111/ijpo.12514
  7. Social Determinants of Health. Social Determinants of Health - Healthy People 2030. (n.d.). Retrieved June 10, 2022, from https://health.gov/healthypeople/priority-areas/social-determinants-health 
  8. The health at every size® (HAES®) principles. ASDAH. (2022, April 22). Retrieved June 10, 2022, from https://asdah.org/health-at-every-size-haes-approach/ 
  9. 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. https://doi.org/10.1001/jama.2012.113905

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