Is "obesity" an offensive term?

If you are living in a larger body whilst simultaneously living on the internet, you may have come across a growing movement that considers the terms "Obesity" and "Over-Weight" offensive. There's a growing movement online attempting to destigmatise the word Fat, whilst denigrating the O-words.

The argument you may hear on TikTok is that "Fat is a Neutral Term" like tall or short, but words like "obesity" are soaked in moral judgement.

Are they though?

A big driver for starting this blog was to wade through the nonsense and present my findings so, before getting into my personal opinion, let's see what the research says.

The Research

Obese is very, very fat, kind of grotesque, um . . . someone that has completely let themselves go An obese woman, quoted by Ellis et al

I am not offended by the word obese but as a woman with a BMI of 35.9, I do take issue with the idea that I am grotesque. Understandably so, you might argue. 

The above quote is taken from Ellis et al's paper, Meaning of the Terms "Overweight" and "Obese" Among Low-Income Women, published in 2013.

In this piece of research, 145 low-income women were interviewed and asked to share what the terms obese and overweight mean to them in semi-structured interviews, with their responses transcribed and themes identified using the constant comparative method. 59% of these women were obese and 21% were overweight as defined by the BMI.

Three themes emerged:

  1. The terms are offensive and describe people who are unmotivated, depressed and do not care about themselves
  2. Obese is an extreme weight (eg 500 pounds and being immobile)
  3. Being overweight is a matter of opinion; if a woman is "comfortable in her skin" and "feels healthy she is not overweight" 

What's really interesting about this study in particular is that it shows how othering people find the words overweight and obese , and that's before we even begin to contemplate the potential for weight stigma and bias. Regardless of their BMI, many of the women interviewed did not identify as obese - the word was offensive, mocking, extreme - it didn't represent their bodies. As the authors point out, because many people who were overweight and obese were not identifying as such (at the time, it was 9 years ago so it would be interesting to see how things have changed) there was potential that messaging pertaining to the risks of having a BMI of 25 or higher wasn't reaching the people it needed to. 

For a reminder of what those health risks are, the US's National Institute of Diabetes and Digestive and Kidney Disease has published this article.

With such strong negative perceptions of the word obese, it's easy to see why people are pushing for it to be retired. More recent research, such as Fernández et al's Words Matter: What do Patients find Judgemental or Offensive in Outpatient Notes?, showed that patients still feel offended at being labelled obese. Does that mean a person's weight isn't worth noting medically? I don't believe so, it's still something that can impact our health - similarly to how some patients also felt judged for smoking cigarettes. In her systemic review of studies examinging preferences for weight related terminology, Rebecca M. Puhl found preferences tended to be towards more neutral language - "healthy weight" and "unhealthy weight", as opposed to terms like obese.

When trying to pinpoint where and how the stigma associated with the word obese started, it generally seems to boil down to the medicalisation of body size, the origins of the word obese (from the latin word obesus, meaning "to have eaten until fat"), and criticism of the BMI - but these are different topics in their own right.

My Thoughts

I personally favour the terms overweight and obesity to "fat" or "living in a larger body". For me I find that the O-words give me an element of control, something I can address. If I'm overweight or obese, it's in my power to change. If I'm fat, it's destiny.

Reading through the above studies, I questioned whether I'm in the minority for believing this, or if I've been influenced by my aversion to the Fat Acceptance movement's messaging and their constant assertion that weight loss is impossible for 95% of people. Many of them reject the term obesity and embrace the term fat, so maybe subconsciously I'm doing the opposite.

I guess I also like the categories. I find motivation that soon, hopefully, I'll move from Obese Level 2 to Obese Level 1. Then hopefully by the end of this year the Overweight category will be in sight.

Before starting this blog post I had assumed that the majority of people were as familiar with the BMI and classifications of obesity as I was. I always find it mildly perplexing when people tell me I'm not obese, I'm just a little chubby because - as I mentioned earlier - my BMI is currently 35.9, putting me in the Obese Class 2 category. After reading Ellis et al's study, I asked one of these loving individuals what does the word obesity mean to him and he said "it's debilitating, right?". This for me really highlighted the distance between how the medical profession view the word obese, versus the general population.

So maybe we do need a new word. At the very least, we need better education on the meaning of obesity so we can begin to remove the stigma associated with it.