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Childhood Obesity – FAQ

Is obesity a disease?

Obesity is recognized as a disease by the World Health Organization and major health bodies around the world. But that does not mean that all individuals classified as obese based on Body Mass Index (BMI) suffer from metabolic ilnnesses. A 2016 study found that half of those in the “overweight” and a quarter of those “obesity” categories had healthy metabolic measures while over 30% of those in the “normal” weight category had unhealthy metabolic measures. Thus, while obesity may be classified as a disease, it may be more useful to understand it as a possible risk factor for illnesses.  

Is being overweight or fat bad for your health?

Certain types of body fat are causally associated with type 2 diabetes (T2D)  in European and American populations. For children, the rates of type 2 diabetes are rising, but the primary risk is adult metabolic diseases. But not all types of fat as measured by weight or BMI cause metabolic illnesses, and studies in South Asian populations show T2D phenotypes that have different BMI correlations and appear to work along a different physiological path—illustrating the dangers of extrapolating out from U.S. and European population studies (where the overwhelming amount of T2D research has been conducted).

Is thin the universal body ideal?

No, but it is a Western ideal that has had enormous influence around the world through colonial history, and currently it is overtly found in advertising and media. Still, there is great diversity in body sizes across the world and cultural insights show that different societies assign different meanings to being thin or fat. There is no universal ideal body nor a single size for good health.

Is fat discrimination a problem?

Yes. Anti-fat bias is widespread, even among health providers, and detrimental for health and wellbeing. Weight discrimination is itself a significant health risk factor: one study found a 60% increased risk of mortality independent of BMI for those reporting weight discrimination. Weight-based stigmatization has a severe impact on children and youth, reproducing weight prejudices and normalizing hostile environments for young people.

Is body size a personal choice?

Diet and physical activity play a role in body size, but they are not the only factors, and often not the most important. Genetic predisposition, gut microbiome, hormonal and other physiological conditions as well as the commercial food environment contribute to fat accumulation and body size. Eating a healthy diet and getting physical activity is good for all, but for many, dieting does not work, so we need to be careful in putting the burden on individual choice. There is great diversity in body sizes across the world, and they are embedded in different historical legacies, cultural values, health approaches and structural conditions.

Is “healthy food” a neutral category?

No, healthy foods can be found across all types of cultural food traditions. Reducing “healthy foods” to those that belong to a single culture or society, is not just impractical but harmful. Public health strategies need to approach local diets to find sustainable recommendations that go beyond specific nutrients, like Brazil’s dietary guidelines that provide overarching principles that focus on the cultural and commercial aspects of food and eating.