Why I Will Never Refer to Someone as "Overweight" or "Obese" Again

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There was no problem, or so I thought.

Like almost everyone in our Western culture, I learned overtly through our popular information channels such as television programs, social conversations, and the pamphlets in doctors offices that being "overweight" was bad for your health, and being "obese" was much, much worse. I also learned somewhat more covertly that being overweight was physically undesirable, and being obese was plain disgusting. I came to believe that individuals who fit either of these descriptions more than likely brought this "condition" on themselves, and if they didn't, they were the poor unfortunate victims of some situation or health problem that caused the weight gain. Because our weight is something we have full control over, right?

I mean that is why we have diet and exercise programs and "lifestyle" programs - to give us the tools and information we need to support us in living a healthy "normal weight" lifestyle. With all this help available it would come to reason that if someone is overweight or obese (barring the "out of their control" cases), it's due to laziness, not caring about health, or stupidity - being unable to implement the super easy diet and exercise programs that exist out there (and there are indeed soooo many!)

But then everything I thought I knew to be "fact", changed...

It first began when I learned that the Body-Mass Index (BMI) is bogus. It boggles my mind that people who are of high intelligence (aka the medical community) are continuing to use such a terribly poor diagnostic tool. Many times I had heard the BMI scale was flawed - for example, it doesn't take into account that muscle weighs more than fat so people like athletes would fall into the overweight category, even though they were perfectly healthy. But what I didn't know was the degree to which the scale was flawed.

Firstly - the BMI scale was developed in the 1830's by a man named Adolphe Quetelet who was a Belgian mathematician, astronomer and statistician.

Did you read that right? The BMI chart was developed by mathematician, astronomer and statistician. NOT a doctor. Not anyone in the health field. By a dude who liked math and applied it to study human physical characteristics and social aptitudes. So there's that.

Secondly - around the 1990's the BMI was studied by a U.S. government health task force, and the recommendation from the study was to increase the BMI margins because they were too narrow. However, this was not implemented. Instead the U.S. government wanted to be in alignment with the margins being recommended by the World Health Organization (WHO) and those margins were even lower than what was initially being studied. If you follow the money trail to see who was funding the task force that developed the WHO margins, it was a drug company that held the only weight-loss drug patent at the time.

Let me say it again: a drug company with the only weight-loss drug patent at the time funded the current BMI chart. So what does that mean? Smaller margins means more people who were perfectly healthy became classified as "overweight" or "obese" overnight (which was music to the drug company's ears). So this now even further flawed instrument was adopted by North America and Europe and by insurance companies, and used to determine the state of someone's health. To hear a fascinating story about this, listen to this Life. Unrestricted. podcast episode.

So here we are left with a flawed diagnostic tool that dictates whether someone is "overweight" or "obese", terms that are rather falsely and arbitrarily created. Without this tool, who determines whether someone is overweight or obese? I mean over-what? What magic defining line? Without this scale, would we even use these terms?

Furthermore, the implication that someone is automatically unhealthy if they are overweight or obese is accepted as common knowledge. Yet, there is no actual evidence that proves that weight in and of itself causes illness. So continuing to use these terms perpetuates the idea that bigger bodies are a problem and we are to avoid becoming bigger at all costs. But there are real costs to viewing weight and health in this way.

Which brings me to another reason I refuse to use these terms - we cannot, under any circumstance, determine that someone is healthy or unhealthy solely based on their body size.

I was presenting on this topic at a conference earlier this year and both a thin woman and a fat women approached me after my talk. The woman in the thin body said to me "I just wanted to jump on stage with you and share that I've had cancer three times and a host of other health problems yet to look at me, people would assume I'm healthy". The fat woman said "you know, I've been basically healthy all my life. I have slightly high blood pressure but so does my Mom, it runs in my family, but I've come to just think of myself as unhealthy because I'm assumed to be, because of my body size".

We live in a culture that absolutely fears becoming fat, associates fat with disease, and praises and holds on a pedestal people who are thin (which can be more dangerous than being fat). We have a large portion of the population (no pun intended) who are pathologized and discriminated against. People who are in large bodies experience discrimination much like someone who experiences racism, and this can have severely negative consequences on their health. For those who are thinking "yeah well, obese people are simply unhealthy, end of story". I'm going to tell you that actually, only those who are in the very high end of the obese range begin to experience health issues due to their size, whereas moderately “obese” people have similar longevity to those at weights deemed “normal”.

So two words that I thought were innocuous, are not.

These two words have a real impact on how we understand (or misunderstand) weight and health, and how we treat people who live in large bodies. These classifications encourage us to view larger bodies as not "normal".

So what do I say instead? There are people in the body positive community who prefer to be called "fat", because without the negative implications we place on the word, it's merely a descriptor, much like we say someone is tall or short. So I sometimes may use the word “fat” as a descriptor. Or I may say "big" or "large" like I would say someone is "small".

In the end people are people and we come in all different shapes and sizes, and by continuing to pathologize one body type over another, we are not only falsely perpetuating misinformation, but discriminating against people. And I prefer to treat people with kindness. So when I know better, I do better, and for me ridding my language of "overweight" and "obese" is a good start.