By Ena Kjerland
Photo by Omar Encarnacion on Unsplash
The World Health Organization (WHO) has since the 1990s labeled the rise of obesity an epidemic. Since obesity globally is on the rise, they are now calling it “globesity” (1). Big pharma, like Novo Nordisk, has been lobbying for obesity to be considered a chronic illness and has set out on the mission to defeat obesity (2). But is that the truth? Is obesity an urgent public health threat to be defeated?
Labeling obesity as an epidemic suggests that it is dangerous, something that must be contained and eradicated. This rhetoric fuels fear and reinforces the notion that obese bodies are inherently unhealthy. Alongside this, the WHO tends to use pictures of people with obesity that do not show their faces. This “headless fatty” trope, while popular in global health campaigns, strips people of identity and limits them to being an overweight body (3). However, by limiting individuals to simply being body parts, there is an implied shame and loss of agency. The subtext along with these campaigns is clear: obesity is something shameful, a personal failure – that needs to be fixed (3). The solution: restrictive diets, exercise, or now, costly medications.
Anti-Fat Bias
When discussing fatness today, it is usually in relation to health. However, looking back, the shift toward a preference for thinness, especially in white women, emerged in the 18th and 19th centuries at the same time as the rise of racial categorization and scientific racism (4). European elites constructed whiteness in a way that it was not just a racial category, but it was the bodily ideal. Black and Indigenous peoples were stereotyped as more indulgent, and physically excessive. As a way of showing superiority, and for white people to distance themselves from Black and Indigenous peoples, thinness became the ideal; a marker of discipline, civility, and Christian purity. Having created this racial framing of body size with a clear moral and bodily contrast, this meant thin white bodies were seen as superior, while fatness was associated with colonized and racialized people. Racial categorization thus didn’t just “other” Black and Indigenous peoples; it justified their marginalization by tying body size to assumptions of laziness, lack of self-control, and moral inferiority. Fatness, then, became a tool in broader systems of racial and colonial domination (4). Today, no one questions the push for weight-loss interventions. But if we strip away these racial, moral, and capitalist influences, we are left with an important question: Is weight really the best predictor of health?
The Relation of Health and Weight
If weight loss is the key to better health, we would expect strong consistent evidence showing that losing weight significantly reduces the risk of chronic disease. While large population studies do show correlations between higher BMI and conditions like cardiovascular disease and diabetes, correlation does not equal causation.
Correlation vs. causation – Image credit: © IFLScience
When looking at weight loss intervention studies, positive health outcomes often occur alongside changes in diet, physical activity, and other health behaviors, which makes it difficult to isolate the effect of weight loss itself. When similar lifestyle interventions are implemented without resulting in significant weight loss, many of the same health benefits, like improved insulin sensitivity, blood pressure, and cholesterol, are still observed (7,8). Major studies have found that when individuals engage in the four health-promoting behaviors: eating fruits and vegetables, engaging in moderate physical activity, limiting alcohol intake, and not smoking, there was no difference in mortality across BMI categories (7,8). In other words, health behaviors, not weight, are the strongest predictors of health.
So why does higher weight often correlate with poorer health outcomes? Returning again to a look at colonization, racism, and the structural and systemic factors these have created. Communities disproportionately affected by poverty and systemic racism, are more likely to live in areas with food deserts, food swamps, and physical activity deserts, and are less likely to receive quality healthcare, and accurate health information (9). These conditions can contribute to both increased weight and greater risk of chronic illness—not because one causes the other, but because both are shaped by the same oppressive systems (10,11). However, weight tends to be studied in isolation from these broader societal structures, which is why we risk blaming individuals for their body size while overlooking the deeper systemic issues driving health disparities. It is also important to consider that the scientific field is affected by cultural biases. Fatness being linked to poor health only gained traction after fatness had already been framed as undesirable. This introduces the possibility of confirmation bias in scientific studies of bodies. Instead of studying whether fatness is harmful, studies have been designed based on the assumption that it must be, and trying to explain why (4).
Even when taking into account that higher body weight is associated with health risks, the dominant intervention, weight loss, often introduces its own harms. Let us take a look at weight cycling, or yo-yo dieting. This is a vicious cycle where individuals repeatedly lose weight through restrictive dieting, but this is not sustainable in the long-term, so the weight is regained, and sometimes even more – then the cycle starts again. This has been linked to increased risk of cardiovascular issues, metabolic disruption, and long-term health decline, which is more harmful than the maintenance of a higher weight (13).
Photo by Eric Prouzet on Unsplash
The pressure of losing weight often leads to restrictive dieting, and psychological distress, both of which have serious health consequences. These harms are compounded by weight stigma, which itself has been linked to higher stress levels, increased inflammation, and worse health outcomes—independent of body size (14).
This stigma—and its impact—deserves closer attention.
Weight Stigma
Weight stigma refers to the prejudice and discrimination directed against a person due to their weight (15). This becomes abundantly clear in the way people with obesity experience unfair treatment in society, along with high rates of discrimination and bullying, because of their weight. Being subjected to weight bias can lead to negative health outcomes and internalization of weight-biased attitudes (16). Internalized weight bias is associated with severe self-blame, body dissatisfaction, and emotional distress (17). Stigma is the outcome of the deeply ingrained belief that individuals have full control over their body size – a misconception rooted in centuries of racial, religious, and class-based ideologies (4). By reducing weight to a matter of lifestyle or willpower, public health narratives reinforce stigma and obscure the broader systemic forces that are at play. The true public health emergency is not obesity, but the effect of weight stigma.
Looking Forwards
If we are to talk about “globesity” as a global health crisis, then the real emergency is not body size but rather the harmful individual and societal effects of weight stigma. If the aim of global health truly is to improve well-being, it needs to move away from a weight-centric approach and instead move towards creating environments where all people, regardless of size, can thrive.
This means that we have to address the underlying causes of health inequities, such as, but not limited to, securing equitable access to nutritious food, improving housing, healthcare, education, and mental health services. It also means having to confront long-term stressors of poverty, racism, and social exclusion, all of which impact health outcomes, including weight.
It’s time to change the question from: how can we get people to lose weight? To: how can we ensure that all individuals have equal access to the resources, care, and respect they need to be healthy?
References
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2. Novo Nordisk. Our mission to defeat obesity [Internet]. [cited 2025 Mar 11]. Available from: https://www.novonordisk.com/disease-areas/obesity/our-mission-to-defeat-obesity.html
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4. Strings S. Fearing the black body: the racial origins of fat phobia. 1st ed. New York: New York University Press; 2019. 283 p.
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15. Pearl RL, Dovidio JF. Experiencing weight bias in an unjust world: Impact on exercise and internalization. Health Psychol [Internet]. 2015 Jul 1 [cited 2024 Nov 10];34(7):741–9. Available from: https://pubmed.ncbi.nlm.nih.gov/25401685/
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