By Dr Glady Ann Thomas, BDS
Obesity is often discussed loudly in society but understood quietly. Many people know it is linked to a multitude of chronic diseases, yet few truly understand how. Even fewer feel supported when navigating it.
Obesity is a chronic health condition influenced by far more than what someone eats. It affects millions of people worldwide and remains one of the most misunderstood conditions in modern healthcare. Research increasingly shows that body weight is shaped by complex interactions between biology, environment, psychology, and social factors — not simply personal choice.
Let’s talk about obesity in a way that is clear, compassionate, and grounded in real science.
Contents
- Obesity myth vs reality
- Is obesity a disease?
- How obesity contributes to lifestyle diseases
- Weight is not the only measure of health
- Small steps create meaningful change
- Why this conversation matters
- Editor’s note
DISCLAIMER: While I am a practising doctor, the information on this site is for educational purposes only. It does not take into account your personal circumstances, which can significantly affect medical decision-making and treatment. This content therefore does not constitute medical advice, and should not be relied upon for diagnosis or treatment. Always consult a qualified healthcare provider regarding any health concerns.
This article was written by a guest writer, and published on the 11/02/2026 using up-to-date sources at that time. Please be aware that medical information and guidelines change often.
Obesity myth vs reality
Myth: Obesity happens because someone lacks discipline or willpower.
Reality: Body weight is heavily influenced by biological and environmental factors.
Studies show that genetics can influence body size as strongly as traits like height or eye colour. Hormones such as leptin and ghrelin regulate hunger and fullness, while chronic stress increases cortisol, which promotes fat storage. Sleep deprivation alters hunger hormones, increasing appetite and cravings. Certain medications, endocrine disorders*, trauma, and access to healthy food also strongly influence weight.
People living with obesity are not failing — they are often navigating a complex physiological and environmental landscape.
*Endocrine disorders are conditions where the hormones in the body are out of balance, and hence affect the functions of the body.
(Sources: Loos & Yeo, 2022; Morton et al., 2014; Spiegel et al., 2004)
Is obesity a disease?
This question has been widely debated in medical science.
Major health organisations, including the World Health Organization (WHO) and the American Medical Association (AMA), recognise obesity as a chronic disease. This recognition is based on evidence that obesity involves physiological changes in metabolism*, inflammation**, hormone signalling***, and organ function — not simply body size.
Viewing obesity as a disease is not about labelling people. It is about reducing stigma, improving access to care, and acknowledging the biology involved.
(Sources: WHO, 2021; AMA, 2013)
*Metabolism refers to the chemical processes that occur within an organism to sustain life. In this context, it refers to the bodily process of turning food and drink into energy.
**Inflammation is the response of the body to an injury or infection.
***Hormone signalling is the process by which hormones communicate with the cells.
How obesity contributes to lifestyle diseases
Obesity does not automatically cause other disease, but it can increase the risk of several chronic conditions because of how excess adipose (fat) tissue affects different systems:
- Blood sugar regulation: Higher risk of insulin resistance and type 2 diabetes. When the cells in the body stop responding properly to insulin (the hormone that helps move sugar from the blood into cells for energy), it is termed insulin resistance. As a result, blood sugar levels stay higher for longer.
- Cholesterol and blood pressure: Increased risk of heart disease and stroke.
- Chronic inflammation: Fat tissue releases pro-inflammatory substances that affect blood vessels and organs. When inflammation is ongoing, it irritates and injures blood vessels, making it harder for blood to flow smoothly. Over time, this affects vital organs and raises the risk of heart disease, diabetes, and organ damage.
- Sleep disruption: Higher likelihood of obstructive sleep apnoea. Obstructive sleep apnea (OSA) is a condition where a person briefly stops breathing many times during sleep, as the muscles in the airways relax and can block the trachea (windpipe). This leads to poor sleep and low oxygen levels, which can affect energy, mood, and long-term heart health.
- Joint health: Increased mechanical strain on knees, hips, and spine, increasing the likelihood of osteoarthritis. Osteoarthritis is a common joint condition where the cushioning between bones gradually wears down. This can cause joint pain, stiffness, swelling, and difficulty moving — especially in the knees, hips, and spine.
Weight is not the only measure of health
Body weight alone is not a perfect indicator of health.
Many individuals in larger bodies can have healthy blood pressure, normal cholesterol levels, and good cardiovascular fitness. Conversely, people in smaller bodies can have significant metabolic disease*. True health is multidimensional and includes physical, mental, emotional, and social well-being.
*Metabolic disease refers to problems with how the body handles sugar and fat for energy. Over time, these problems can lead to conditions like diabetes and heart disease.
(Sources: Tomiyama et al., 2016; Ortega et al., 2018)
Small steps create meaningful change
When conversations move away from blame and toward support, people are better able to engage in more realistic changes that help with obesity:
- Eating balanced, flexible meals instead of restrictive diets.
- Finding movement that feels enjoyable and sustainable.
- Working with healthcare professionals to explore medical and behavioural support.
- Improving sleep patterns and stress management.
These behaviours improve cardiovascular, metabolic, and mental health even when weight loss is modest or absent.
(Sources: Jensen et al., 2014; WHO, 2020)
Why this conversation matters
Weight stigma causes real harm.
Research shows that stigma leads to healthcare avoidance, delayed screening, increased anxiety, depression, and unhealthy coping behaviours. It directly undermines both mental and physical health.
The goal is not perfection. It is dignity, progress, confidence, and quality of life.
By recognising obesity as a chronic, complex medical condition — rather than a character flaw — we create space for understanding, earlier intervention, and long-term well-being.
Editor’s note: Reflection on this article
Many people receive conflicting messages about weight and obesity — particularly from social media, celebrity culture, and online spaces — but this article by Dr Glady Ann Thomas offers a clear reminder that body weight is influenced by many factors. Framing obesity as a simple lack of willpower overlooks the complex biological, psychological, and environmental realities involved.
I attended a conference a few months ago where one talk explored whether obesity should be classified as a disease, reflecting an ongoing and evolving conversation within healthcare. Recognising obesity in this way feels important — not only because of the system-wide effects it can have on the body, but also because, for many people, reframing obesity as a chronic and multifactorial condition opens the door to more supportive approaches, both within healthcare settings and in how we speak to ourselves.
- What surprised you most about how biology, environment, and lifestyle interact to influence body weight?
- Have you ever experienced weight stigma, and how has it affected your health or wellbeing?
- Which small, supportive changes have helped you or could help you feel healthier beyond focusing on the scale?
I’d love to hear your thoughts! Please leave a comment below.
Dr. Glady Ann Thomas is an experienced clinician and medical writer with a background in dentistry, having completed her Bachelor of Dental Surgery (BDS) in 2013 and a postgraduate diploma in clinical research and pharmacovigilance in 2021. She specialises in translating complex medical information into clear, patient-friendly content grounded in evidence and clinical accuracy. With experience across medical communications, health journalism, and digital health platforms, she brings a structured, detail-oriented approach to content development, quality review, and cross-disciplinary collaboration.
Other sources
- Loos, R. J. F., & Yeo, G. S. H. (2022). The genetics of obesity: From discovery to biology.
- Morton, G. J., et al. (2014). Neurobiology of food intake in health and disease.
- Spiegel, K., et al. (2004). Sleep curtailment and appetite regulation.
- American Medical Association (2013). Recognition of obesity as a disease.
- Tomiyama, A. J., et al. (2016). Weight stigma and health.
- Ortega, F. B., et al. (2018). Cardiorespiratory fitness and mortality.
- Jensen, M. D., et al. (2014). AHA/ACC/TOS guideline for overweight and obesity.
The Health and Healing Narrative 
Leave a comment