The Unhealthy Weight Epidemic

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Not long ago, in England, a local government made international news by considering whether to ban the word “obesity” from use in the literature and media presentations of its pro-health campaigns. It’s not clear whether anything ever officially happened, but the big question is, why did the Liverpool City Council ever put this on the table in the first place?

Murray Wardrop reported on how the idea originated with the Liverpool Schools’ Parliament, a PTA-like organization that had been asked to suggest ways to improve the lives of children. Wardrop writes,

If the idea goes ahead, the words ‘obese’ and ‘obesity’ would be dropped from all schemes and strategies aimed at improving children’s diets and health.

Why was a new rule asked for? Apparently, the word “obesity” affects overweight young people in two ways. First, it is felt to be offensive to them. Second, it causes them to be stigmatized in the eyes of others and victimized by the unfavorable public opinion.

It was proposed to replace the word “obesity” with two other words, “unhealthy weight.” Aside from creating some grammatically awkward sentences, the switch would be pointless, in the opinion of the opponents. The substitution would trivialize the issue, like calling a melanoma a freckle. To avoid calling someone obese is a way of enabling the person’s self-destruction. The self-esteem issue is irrelevant when someone is on the track to morbid (which means “deadly”) obesity. The cost of health care for obesity-related illnesses comes out of everybody’s pocket.

The people who thought the whole idea was ridiculous found an ally in the chairperson of the Child Growth Foundation, a charity organization dedicated to preventing obesity. Tam Fry came out in favor of teaching school children the realities of life, saying,

If you’re obese you’re obese… If you have a problem, particularly when it’s as serious as this, it needs addressing.

Of course, this article in The Telegraph drew many comments. One reader observed that on the streets of Britain, it’s more socially acceptable to be drunk or some other kind of wasted than to be overweight. A joker suggested other euphemisms, like “gravitationally endowed” or “short for their weight.” A satirist (or possibly he was quite serious) named Mark Bigelow was inspired to lay out the case in the rudest terms:

Why take away the shame and stigma of being fat? Again the liberals-in-charge want to ban foods we wish to eat because we need to lose weight but on the other hand take away the best motivation for losing pounds. These kids need to know that being a corpulent beast will not get you that spot on the team, the cute girl/boy or the great job. Instead we will hide reality from them and have disillusioned university grads living on the dole because of their ‘disability’.

Don’t hold back, sir! Tell us how you really feel!

Now, from the other side of the broad Atlantic ocean, Dr. Pretlow talks about the difference between overweight and obesity:

‘Obesity’ in kids is defined as a BMI or body mass index above the 95th percentile, and ‘overweight’ is defined as a BMI over the 85th percentile. First of all we have to be clear about the term ‘childhood obesity epidemic.’ In talking about it, journalists usually note that one-third of the kids in the United States are either overweight or obese. This means kids who are ‘overweight’ but not obese are also included in the childhood obesity epidemic.

Childhood overweight/obesity is on a continuum, in terms of addiction to foods. Overweight kids are likely only partially addicted, but obese kids are likely fully addicted. Obese kids struggle the most to try to lose weight. Therefore, by definition, addiction is only part of the problem in the childhood obesity epidemic, as not all the kids involved are fully addicted.

I’ve been seeking cases of obese children, who struggle to lose weight, but who do not satisfy at least three DSM-4 substance dependence (addiction) criteria, yet I haven’t found any. But this excludes obese children who do not struggle to lose weight. There may be obese children and adolescents who are perfectly happy being obese and could lose weight simply by deciding to do so. So called ‘gainers’ are an example. Nonetheless, I’ve personally not encountered any children or adolescents who are truly happy being obese and do not wish they were thinner.

Your responses and feedback are welcome!

Source: “Council considers banning word ‘obesity’ to avoid offending overweight children,” The Telegraph, 04/12/10
Image by colros (Sandra Colin-Rose and Colin Rose), used under its Creative Commons license.

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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