The Difference between Being Big and Having Obesity
The difference between being big and having obesity is both subtle and great. It complicates many conversations about obesity when it gets blurred by fuzzy thinking. A prime example is the argument still simmering about so-called “healthy obesity.”
The argument is a stupid one, but people get sucked into it because they gloss over the distinction between being big and having obesity. They equate obesity with a BMI value. Obesity is a disease of excess adiposity. Defined as such, the notion of “healthy obesity” is nonsense. It’s a strawman concept of a healthy disease state — a contradiction in terms.
People with dramatically opposing views will take up the argument because they think of obesity as a disease of excess size. Some folks with a fat acceptance or health-at-every-size agenda are happy to accept the definition of obesity as being a simple function of excess size. It serves the purpose of facilitating their argument that obesity is a bogus disease, concocted solely for the purpose of marginalizing people who don’t conform to an arbitrary norm of body size.
At an opposite extreme, people with strong weight bias are willing to accept obesity as a disease of size and take up the argument that the ultimate goal of obesity treatment and prevention is to achieve a BMI of 25 or less for all. Such thinking spawns wellness penalties for people who can’t meet a BMI goal of 25 — even though it will never happen.
Having obesity means having excess adiposity that is causing illness. Because obesity is a chronic disease, the goal of treatment is to manage the condition for optimal health. That means setting achievable goals for a healthy weight, diet, physical activity, and management of the complications of obesity.
No one can diagnose obesity by sizing you up or merely asking you to step on a scale. People who want to argue that obesity is simply a matter of size are wasting our time.
They are blocking the way forward to address obesity objectively as a matter of health.
photograph © / flickr
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