You won’t hear me say “obesity” or “overweight” in a session. It’s on purpose, and since it surprises people, especially if they’ve heard those words from doctors for years, I want to explain why.
BMI was never meant for this
Both words come from BMI, a formula a Belgian mathematician created in the 1830s to study populations. It was never designed to measure one person’s health. It can’t tell muscle from fat, and it knows nothing about your blood pressure, your labs, your sleep, or how you actually feel.
Medicine is starting to agree. In 2023, the American Medical Association said BMI shouldn’t be used on its own to make clinical decisions. In 2025, a Lancet commission recommended diagnosing obesity based on real signs of illness rather than body size alone.
Words change the care people get
“Overweight” assumes there’s a correct weight you’re over. “Obesity” turns body size into a disease by itself. That framing follows people into exam rooms, where symptoms get blamed on weight and “lose weight” stands in for a real workup. A lot of people in larger bodies start putting off appointments because of it, which helps no one.
If those words are in your chart
If you’re on a GLP-1, “obesity” may well be written in your chart. Often it has to be, because that diagnosis is how insurance decides whether to cover your medication. That’s fine. Use whatever language gets you the care you need. In our sessions, we’ll focus on what you’re actually dealing with, like energy, hunger, side effects, and how eating feels day to day.
What I say instead
Usually “larger body” or “higher weight.” I also use “fat” as a plain description, the way you’d say tall or short. Some people find that freeing right away, and others need time. Your body, your words. I’ll follow your lead.
If you want a dietitian who takes your health seriously without making your weight the whole conversation, you can read more about how I work with chronic conditions or GLP-1 nutrition support.
