Obesity is not a personal failure. It’s a chronic, complex disease, not a choice. While it’s often linked to weight, it’s really about how the body stores and uses energy. That means managing obesity is about more than just eating less or moving more.
What Science Tells Us
Obesity is influenced by many factors that go beyond willpower:
- Genetics: Some people are biologically wired to store more fat or feel hungrier due to how their genes work. For example, genes like MC4R and FTO can affect appetite and metabolism.
- Hormones and Brain Signals: Hormones like leptin and ghrelin help regulate hunger and fullness. In obesity, these signals can get disrupted, making it harder to feel satisfied after eating.
- Environment and Chemicals: We live in an “obesogenic” environment, where high-calorie foods are easy to get, and physical activity is harder to fit in. Some chemicals in our environment may also affect how our bodies store fat.
- Body Function Changes: Over time, obesity can affect how organs like the heart, liver and lungs work. It can also lead to inflammation and increase the risk of diseases like diabetes, heart disease and certain cancers.
These factors show that obesity is not about laziness or lack of discipline. It’s a medical condition shaped by biology, environment and more.
A New Way to Define Obesity
Experts now recommend thinking about obesity in two categories:
- Preclinical Obesity: A person has excess body fat but no current health problems. However, they may be at risk for future issues like diabetes or heart disease.
- Clinical Obesity: Excess fat is already affecting health, such as causing joint pain, breathing problems or organ dysfunction.
This new approach helps doctors offer better care and avoid blaming people for their condition.
Why Language Matters
When we call obesity a disease, it shifts the conversation. Instead of asking, “Why can’t you just lose weight?” we ask, “How can we support your health?” That opens the door to real solutions, not shame.
What Treatment Looks Like Today
Obesity care is more advanced than ever. It may include:
- Lifestyle Support: Help with nutrition, movement, sleep and stress.
- Medications: GLP-1 drugs like semaglutide and tirzepatide can reduce hunger and improve blood sugar. These medications can lead to 15–21% weight loss and also help with heart and kidney health.
- Surgery: Bariatric procedures like gastric bypass or sleeve gastrectomy can lead to long-term weight loss and improve or even reverse conditions like type 2 diabetes. In fact, surgery often results in five times more weight loss than medication alone.
Treatment should be personalized and not based on a number on the scale, but on what your body needs to thrive.
Final Thought
Obesity is a disease. It’s not about blame, it’s about biology, environment and getting the care you need. Understanding it as a disease helps us move toward better treatment, more respect and real hope.
By Cassie Story, RD, Nutrition Subject Expert
