We hear plenty about the “obesity epidemic” and the dangers of being overweight. But having a larger body does not mean someone is unhealthy. In fact, a person’s body size may not be an issue at all.
About 40% of Americans qualify as “obese” based on their body mass index (BMI) — an imperfect measure of health based on body size. Health experts around the world have worked to reduce this number through countless weight-loss campaigns. Yet, these programs have had minimal success.
One large study found that less than 1% of people with an “obese” BMI were able to achieve or maintain a “normal” weight during the 9-year study period. One reason is that many people don’t have as much control over their body size as we’re led to believe.
Research shows your BMI is largely determined by your genetics and environment — not your personal choices about what to eat or how much you exercise. In fact, restrictive diets and weight loss regimens can lead to serious health threats, like:
Malnutrition
Disordered eating
Mental health conditions
Long story short, body size is complicated. Despite this, people with larger bodies are often exposed to harmful weight bias and discrimination.
We’ll never tell you what’s best for your body, weight, or health. Instead, we want to help give you a clearer picture about what it means to have a larger body size, especially if:
You’re tired of diet culture or weight bias.
You have never been able to lose weight and maintain it.
You just want to focus on accepting the body you have.
You’d like guidance on healthy habits that aren’t all about weight loss.
There isn’t a single cause of having a larger body size. But we do know that your body size is largely determined by genes and the world around you. These factors are often completely outside of your control.
Research suggests that genetics are up to 80% responsible for your body size. And researchers have identified hundreds of potential genetic factors that may be associated with larger body size.
Perhaps an even more important contributor to your body size is your environment. This is especially true if you experience negative social determinants of health.
Social determinants of health include things such as:
Access to nutritious food
Clean drinking water
Safe places to exercise outdoors
Financial resources
Education level
Access to healthcare
Community safety
Racial and gender discrimination
For example, people who have limited financial resources may opt for ultra-processed foods, because these foods are usually more affordable than more nutritious ones. Or, if you live in a community that lacks a park or is exposed to a lot of pollution, you may not have a safe outside area to exercise.
And negative environmental factors can turn on genes that predispose you to a larger body size. This is called epigenetics, which refers to how your environment influences your genetic risk for characteristics (like body size) or health conditions.
Here’s one example of epigenetics. Say a pregnant mother can’t afford enough nutritious food. As a result, her baby develops permanent changes to their insulin metabolism while they’re still in the womb. This change is designed to help the baby survive, but it also makes them more likely to have a larger body size as they grow.
It’s common to hear about the way weight contributes to certain health conditions. But weight discrimination and fat bias can pose more health risks than weight itself. Here are some examples of how weight bias or discrimination have a proven negative effect on people with larger bodies:
Discrimination — or unjust treatment — may increase the risk of people with larger bodies dying earlier. This risk has nothing to do with weight.
People who experience weight stigma are over twice as likely to experience anxiety and depression as people who don’t.
Weight bias can contribute to additional weight gain.
Dieting and weight loss are strong predictors of future weight gain.
People with larger bodies often have negative experiences with healthcare providers. They may feel disrespected or embarrassed because of how their provider talks about their body. Or they may experience “medical gaslighting,” in which a provider dismisses their health concerns because of their weight.
In some cases, people with larger bodies do not receive adequate — or any — care from healthcare providers. As a result, it’s common for people with larger bodies to avoid seeking medical care and preventative screenings altogether.
In addition, extreme weight loss efforts can have serious negative effects. For example, people who experience high rates of weight fluctuation may be more at risk of heart attack or stroke. And restrictive dieting can lead to eating disorders.
Fast weight loss — such as through crash diets or after bariatric surgery — increases the risk for gallstones. Losing and then gaining weight repeatedly (weight cycling) similarly increases this risk.
Regardless of body size, there are steps everyone can take toward living a healthy life. Yes, these include eating nutritious food and getting regular exercise. But it’s also important for people to enjoy the things they eat and the way they move their bodies.
Below are seven evidence-backed suggestions to improve your well-being at any size.
Focus on incorporating plenty of fruits and vegetables, add in whole grains when possible, and don’t forget protein. But keep in mind that you need some fat in your diet, too.
Experts recommend getting at least 2.5 hours of aerobic exercise — such as walking, bicycling, or jogging — each week. It’s also beneficial to build in some strength training twice a week.
If you have been diagnosed with a health condition, keep up with your regular provider visits and medications.
Staying on top of preventive care is essential for good health. This includes getting vaccinations, cancer screenings, and tests for high blood pressure or diabetes.
Be skeptical about any weight-related claims you see from advertisers, influencers, and people on social media. There’s a good chance their claims may be false or misleading.
Connect with others and build your social network. Strong relationships, especially with people you can trust, help you manage stress.
Your mental health is just as important as your physical health. Rely on your social network for support and reach out for professional help if you need it.
Want to learn more about weight, body size, and your health? Below is a collection of resources with a range of perspectives you can explore. Just remember: You get to decide what’s best for you and your body.
National Association to Advance Fat Acceptance (NAAFA): social justice organization dedicated to eliminating weight discrimination
Association for Size Diversity and Health (ASDAH): supports the inclusive “health at every size” model of weight
National Organization of Lesbians of Size Everywhere (NOLOSE): works to eliminate fat discrimination for all people
The Body Is Not an Apology: dedicated to helping people love whatever body they’re in
The Body Positive: nonprofit organization working to counter the harmful impacts of negative body image
Obesity Action Coalition (OAC): nonprofit with a large membership that views obesity as a “disease”
The Obesity Society: aims to increase access to weight loss treatments for those with large body sizes
American Obesity Foundation (AOF): provides services to support habits for weight loss and to combat the “obesity epidemic”
“Maintenance Phase” podcast: debunks common wellness myths, especially those that contribute to weight discrimination
“Food Psych” podcast: challenges diet culture and is hosted by a registered dietician
Body neutrality: a movement that aims to help you focus on what your body can do, rather than what it looks like
Healthism: a concept that implies you are morally obligated to be healthy, one of the arguments used to support weight loss
“Fearing the Black Body: The Racial Origins of Fatphobia” by Sabrina Strings: a book tracing the intertwined history of racism and weight discrimination
Alberga, A. S., et al. (2019). Weight bias and health care utilization: A scoping review. Primary Health Care Research & Development.
American Psychological Association. (2022). Manage stress: Strengthen your support network.
Brandkvist, M., et al. (2019). Quantifying the impact of genes on body mass index during the obesity epidemic: Longitudinal findings from the HUNT study. BMJ.
Centers for Disease Control and Prevention. (2022). How much physical activity do adults need?
Daly, M., et al. (2017). Does knowing hurt? Perceiving oneself as overweight predicts future physical health and well-being. Psychological Science.
Fildes, A., et al. (2015). Probability of an obese person attaining normal body weight: Cohort study using electronic health records. American Journal of Public Health.
Friedman, J. M. (2019). Obesity is in the genes. Scientific American.
Fryar, C. D., et al. (2018). Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960-1962 through 2015-2016. Health E-Stats.
Hatzenbuehler, M. L., et al. (2009). Associations between perceived weight discrimination and the prevalence of psychiatric disorders in the general population. Obesity.
Jacquet, P., et al. (2020). How dieting might make some fatter: Modeling weight cycling toward obesity from a perspective of body composition autoregulation. International Journal of Obesity.
Loos, R. J. F., et al. (2021). The genetics of obesity: From discovery to biology. Nature Reviews Genetics.
Memon, A. N., et al. (2020). Have our attempts to curb obesity done more harm than good?Cureus.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Dieting & gallstones.
Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health.
Rey-López, J. P., et al. (2014). The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used. Obesity Reviews.
Stahl, L. (2023). Promising new weight loss medication in short supply and often not covered by insurance. 60 Minutes.
Stanford, F. C. (2018). Obesity: It’s more complex than you think. YouTube.
Sutin, A. R., et al. (2015). Weight discrimination and risk of mortality. Psychological Science.
Tirthani, E., et al. (2022). Genetics and obesity. StatPearls.
Tomiyama, A. J., et al. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Medicine.
U. S. Department of Health and Human Services. (2022). Preventive care.