The Scientifically Shaky Definitions of "Obesity"

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!

In their zeal to medicalize and pathologize higher-weight bodies for profit, the weight loss industry (and the advocacy groups they fund, and the elements of healthcare they influence) have worked hard to claim that “ob*sity” is a disease and then manipulate the definitions of ob*sity to their best interest. Let’s look at some:

The CDC:

“Weight that is higher than what is considered healthy for a given height is described as overw*ight or ob*sity. Body Mass Index (BMI) is a screening tool for overw*ight and ob*sity.”

How much higher? Considered by whom to be healthy? By what definition of “healthy”

The NIH:

“There are no specific symptoms of overw*ight and ob*sity. Your healthcare provider may diagnose overw*ight and ob*sity based on your medical history and high body mass index (BMI).

Your BMI is a measure of body fat based on your weight and height. It is important to know that body mass index is a screening tool and does not necessarily diagnose body fatness. Other related measures, such as waist circumference, are used to evaluate a person’s health and risk of overw*ight and ob*sity.”

No specific symptoms? “May” diagnose? A “measure of body fat” that “does not necessarily diagnose body fatness”?

The World Health Organization

“Overw*ight and ob*sity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overw*ight, and over 30 is ob*se.”

Abnormal or excessive by what definition? Compared to what? What is the definition of a “risk to health”? What does the second sentence have to do with the first sentence?

While there is no shame in having a disease of any kind, “ob*sity” simply does not qualify as a disease and these sloppy, amorphous, unscientific definitions show why. None of these is a remotely scientific way to define a disease, let alone a disease that the weight loss industry has claimed (and the FDA has agreed) is so supposedly dangerous that it’s worth giving people treatments that risk their lives and quality of life.

I was recently on a panel with someone representing an organization that claims to be an advocacy group but is, in truth, almost fully funded by and lobbying for the interests of the weight loss industry (something they did not disclose to the panel.)

This person expressed the belief that “ob*sity” is only a disease if your “excess fat” impacts your health.

This, friends, is a definition only the weight loss industry could love.

It makes no scientific sense to suggest that you can only diagnose one disease if someone has another disease. This definition means that the diagnostic criteria for the “disease” of “ob*sity” is having health issues that people of all sizes get. Said another way, two people can have the exact same BMI, weight, accumulation/percentage of body fat, waist circumference etc., but only the person who happens to have another health condition (one which has its own diagnostic criteria and which people of all sizes get) has the “disease” of  “ob*sity”. Thus, the “disease” of “ob*sity” becomes simply “having health conditions while existing in a larger body.”  It would be like saying that someone is just tall, but if they develop a health condition then they are “medically over tall.”

This does not have the ring of sound science.

Why define it this way? Because it’s an excellent way give lip service to the truth that diagnosing a body size (whether we’re talking about BMI, waist circumference, weight, adiposity, etc.) as a “disease” is pure nonsense without losing any of your current market and, in fact, expanding it.

One of the pushes we’re seeing from the weight loss industry, in particular Novo Nordisk and Eli Lilly with their new weight loss drugs (Wegovy and Zepbound) is the desire to expand their market to as many people as possible. This is part of what has been a very long game. Getting “ob*sity” declared a disease, expanding the definition and “diagnostic” criteria, and doing an end-run around science to get a massive number of health conditions labeled as “weight-related” using shoddy correlational research.     

Now they bring it all together. Those who are higher-weight but don’t have a health condition need “treatment” preventatively. Those who have health conditions while existing in a higher-weight body need “treatment” for their “disease,” those who are lower-weight but have “weight-related conditions” will be pushed to qualify based on the ever-expanding definitions of “ob*sity.”

The solution here isn’t to cast about for new and progressively more nebulous ways to pathologize simply existing in a higher-weight body. The solution is to question and then dismantle the weight-centric paradigm altogether. Only after we stop trying to make everyone thin (or, more accurately, make them a client of the weight loss industry) can we begin actually supporting the physical and mental health of higher-weight people. If you’re interested in digging more into this, there is a list of research here to get you started.

Did you find this post helpful? You can subscribe for free to get future posts delivered direct to your inbox, or choose a paid subscription to support the newsletter (and the work that goes into it!) and get special benefits! Click the Subscribe button below for details:

Liked the piece? Share the piece!

More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.