There are many words we can use to refer to bodies, including body size. When deciding how to talk about fat bodies, two words I’ve stopped using are “obesity” and “overweight.” (Except in certain circumstances, in specific ways, such as what I just did in this sentence by putting them in quote marks.) Most of the time I use words like “fat,” “fat bodies,” “larger bodies,” or “bigger bodies,” And when I have to use the O-words, I use them carefully.
- I leave out a letter (ob*sity or ov*rweight) when creating social media posts or writing on platforms I own (my blog and my newsletter)
- I put them in quote marks when I’m writing for a publication that wouldn’t let me leave out a letter, or when I’m writing about weight research (“obesity,” “overweight” or “the obesity epidemic”). This signifies that these words aren’t my choice, but I have to use them.
- Sometimes, I’ll throw in a “so-called” (“the so-called ‘obesity epidemic'”) or get super specific (“people with BMIs in the ‘obese’ range”).
This isn’t just a linguistic choice. There are deep reasons why I choose the words I do. You might also want to think about the words you use to describe body size.
What’s in a word: looking at meaning
If you want to get literal about it, the word “obesity” comes from the Latin words “obesitas,” which means “fatness,” and “obesus,” which means “something that’s eaten itself fat.” How rude and inaccurate is that? Despite what many online trolls believe, there are many, many reasons that some people are thin and some people are fat. Many of those reasons are well beyond even our current scientific understanding. Do some people “eat themselves fat”? Yes. Do some people “starve themselves thin”? Yes. But that does not mean that everyone who is fat overeats, or that everyone who is thin isn’t eating enough.
When I hear the word “overweight,” the first question that comes to my mind is “over WHAT weight?” You might say, “Well, over the top ‘normal’ weight on the BMI charts.” Technically, that’s true, but there’s also some flamingly big problems baked into that.
One is that BMI, or body mass index, as developed back in in 1835 by Adolphe Quetelet, a Belgian mathematician, astronomer, sociologist and statistician, was never intended to be a measure of individual health. He wanted an easy way to measure the degree of fatness in the general population, but the formula he came up with has no basis in human physiology.
In fact, not only did Quetelet manipulate the formula to try to match the data (which is very shoddy work) that he collected from exclusively white European men, he explicitly said that his formula should not be used to gauge the level of fatness in an individual human. After all, he was not an expert on the human body, even to the limited extent we understood the human body back then.
Basing a definition on a shaky foundation
Two, the “normal BMI” goal posts have moved, and that movement was supported by pharmaceutical companies that had weight loss drugs to sell. In 1998, the National Institutes of Health moved the upper cutoff for having a “normal” BMI from 27.8 (for men) and 27.3 (for women) to 24.9 for everyone, making millions of people “overweight” overnight. Their health didn’t change overnight, but they were affixed with a new label, a label that means nothing and everything at the same time.
So, what does the medical field say “ob*se” means? Depending on the source, you might find something like, “Weight that is higher than what is considered healthy for a given height” (CDC, referring to both OW and OB), “A complex disease involving an excessive amount of body fat” (Mayo Clinic, referring to OB), “Abnormal or excessive fat accumulation that presents a risk to health” (WHO, referring to both OW and OB) or “A person who has excess body fat” (NHS, referring to OB).
Notice that of that random sample, only the Mayo Clinic and WHO definitions imply something more than just being in a bigger body. That’s because what some researchers and doctors understand is that it’s not just about how much body fat someone has, but it’s also about what those fat cells are doing. It appears that some people have “dysfunctional” fat cells that increase levels of inflammation in the body, and that this may be related to a genetically determined “personal fat threshold.” That threshold may be relatively low for some people, and quite high for others. Just one more reason that diagnosing “ob*sity” based on BMI is bunk.
Why person-first language is sometimes dumb
Despite the medical weight loss industry (and to some extent the commercial weight loss industry) trying to “destigmatize” the word ob*sity, it’s in fact very stigmatizing. Just ask any fat person (usually a woman) who has been trolled by a stranger (in person or online) saying “You’re unhealthy,” or even “You’re going to die,” despite knowing nothing about the health of the person they’re trolling.
This is why I roll my eyes so hard they practically fall out of my head when I hear ob*sity doctors or researchers use the person-first phrases “people with ob*sity” or “person with ob*sity.” (“Person with ov*rweight” sounds even more ridiculous.)
Person-first language started sometime in the 1960s in the disability community as a way of linguistically putting a person before their disability or illness. So, “people with disabilities” instead of “disabled people,” or “person with diabetes” instead of “diabetic.” This idea picked up steam in the 1980s, and while there are good intentions behind it, like many things with good intentions, the impact ended up being less-than-good.
First, as it relates to body weight, I’ve witnessed many, many, many people in the health professions who have clear anti-fat bias insist on using person-first language as if that’s a get-out-of-jail-free card. Like, “I use the ‘right’ language, so I don’t have to examine my biases or the ethics of promoting weight loss.”
In fact, many people who are supposedly the benefactors of person-first language don’t agree with it. One big reason is that while, yes, we are all people first, when you…
…have a disability (especially one that’s visible and affects mobility)…
…are neurodivergent (as with autism spectrum disorders or ADHD)…
…or have a mental illness…
…that colors your experience of your world. It is not all you are, but it is very much part of you. It’s not separate. Of course, each person has their own preference, but I know many people who prefer being referred to as disabled (or differently abled) or autistic or depressed. Not only are those characteristics an integrated part of them, but they feel that to separate them from their condition or circumstance, as with person-first language, is actually stigmatizing. And there should be no stigma about having a disability, or being neurodivergent, or having a mental illness.
What’s wrong with “fat”?
Similarly, being in a larger body colors one’s experience of the world, and your body size is an integrated part of you. Many people who are ov*rweight or o*bese reject person-first language but also reject the o-words because they have become medicalized, and most people who slot into those ranges on the BMI chart do not have health problems caused by having extra body fat.
If you read my Seattle Times columns, you may have noticed that I generally use the word “fat.” After the first time I use it in a column, I include the disclaimer: (I use “fat” as a neutral descriptor, like “short” or “tall.”) I do that because “fat” is not the preferred term of everyone in a larger body, and because many people who are not immersed or well-versed in fat acceptance and body liberation assume that the word “fat” is always a slur.
One of my dear friends, a weight-inclusive, Health at Every Size-informed dietitian who was my instructor, mentor and one of my internship preceptors in grad school (and who introduced me to Intuitive Eating), asked a question at a recent dietetic conference session about weight, and she referred to “fat patients.” The speaker (a dietitian I know semi-well…well enough to know that she is personally and professionally invested in diet culture, with all the anti-fat bias that comes with it) corrected my friend’s language like you might correct a naughty child: “We say PEOPLE WITH OB*SITY!” Tsk, tsk.
How to talk about fat bodies
First of all, I think we collectively talk about bodies more than we need to, and more than we should. Why can’t we just say things like “You look great” or “It’s so good to see you” instead of “You look so skinny in that dress!” or “Have you lost weight since I last saw you?”? Just a few reasons to NOT comment on bodies include:
- Some people are uncomfortable having attention obviously directed at their bodies.
- Some people may have lost weight because they’re grieving or sick.
- Some people may welcome comments about their weight loss without realizing that those comments are going to trigger (or feed) an eating disorder.
- Some people may simply prefer to be complemented on their intelligence, kindness, generosity of spirit or their sparkling wit.
I know gracious, caring people who genuinely think that referring to someone using the O-words is neutral or even kind. If that’s you, consider this: is the use of that word even accurate (especially ob*sity…because does that person have fat cells that are malfunctioning?). Is it neutral, really? Is it actually kind?
Many people are afraid to use the word “fat,” whether as applied to their own body or other people’s bodies. Certainly, “fat” has been used as insult many, many times. But if, as the medical weight loss industry is trying to claim, ob*sity is a chronic disease, not an appearance-based descriptor, and of not all people in fat bodies have problems with their fat cells (having a lot of fat cells doesn’t mean those fat cells are dysfunctional), and if you can’t tell what’s happening with someone’s fat cells by looking at them, why would we call fat people “ob*se”?
Reclaiming “fat”
More and more people are reclaiming the word “fat” as a neutral descriptor, like “thin” or “short” or “tall” or “blue-eyed” or “brunette.” While talking about bodies less would be a good thing, there are times when describing or referring to someone’s body size is fine or even necessary. And we need words to do that.
“Fat” is certainly better than a lot of the silly euphemisms that have popped up over the years: “chunky,” “curvy,” “zaftig,” “plump,” “round,” “fluffy,” “bountiful,” and “generous” are a few that come to mind. And “plus-size” is a weird one…yes, it refers to certain clothing sizes, but just as “overweight” begs the question “over WHAT weight,” “plus-size” makes me think, “why are we invoking mathematics?”.
Here’s one final bit of food for thought: If you need to refer to someone’s body size, whether they are a patient, a client, a family member or a friend, why not just ask them what words they use when talking about their own body. What do they prefer?
Carrie Dennett, MPH, RDN, is a Pacific Northwest-based registered dietitian nutritionist, journalist, intuitive eating counselor, author, and speaker. Her superpowers include busting nutrition myths and empowering women and men to feel better in their bodies and make food choices that support pleasure, nutrition and health. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.
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