Obesity

Should Obesity Be Treated as a Disease?
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Obesity, according to the World Heath Organization, is the “abnormal or excessive fat accumulation that presents a risk to health.” Obesity has long caused debate, from historical views of obesity as a vice of the rich, a result of their greed and sloth, to the “fat acceptance” or “body positivity” movements that began in the 1960s to promote an acceptance and celebration of diverse body types, even ones dangerously overweight. But however one views it, obesity is becoming an increasingly serious concern, as studies show a prominent tie between obesity and a host of potentially fatal health issues.[1][2][5][6][7]

Obesity and BMI

Body mass index (BMI) is an estimate of total body fat. A BMI of 30 or more is considered obese in adults age 20 or older, BMI’s of 25 to 29.9 are considered overweight, and BMI’s of 40+ are classified as severely obese. [1][2]

BMI is just one way to estimate total body fat. According to Encyclopaedia Britannica, “BMI is defined as weight in kilograms divided by the square of the height in metres.” The number, however, is not a direct measure of body fat, and a skinfold caliper, a hand-held device that pinches the skin and measures body fat, can offer a quick, affordable, and often more accurate measurement. While BMI has been used in clinical settings for years, in 2023 the American Medical Association urged healthcare professionals not to rely solely on BMI as a measure of a patient’s health. [3][4]

You may calculate BMI at the CDC website.

BMI, first known as the Quetelet Index, was created by Belgian astronomer, sociologist, and statistician Adolphe Quetelet in 1832 to determine the “homme moyen,” or the “average man.” Quetelet was not looking to diagnose health concerns in relation to body weight for individuals. He was, instead, making calculations of population health for the government to allocate resources, and based those calculations on a group of western European white men. [44][45][46][47][48][49][50][51][52][53]

The idea of “normal” weight was promoted in the United States by Louis I. Dublin, a statistician and vice president of Metropolitan Life Insurance Company, in the 1950s. The company saw that heavier people were filing more insurance claims and thus established weight tables for clients, placing them in small, medium, and large categories. Ancel Keys, a physiologist, coined “body mass index” in 1972. He analyzed 7,426 “healthy” men released a study emphasizing the ease of using BMI in population studies. Keys, however, like Quetelet, did not promote the idea of using BMI as an individual health marker.[44][45][46][47][48][49][50][51][52][53]

In 1985, the National Health and Nutrition Examination Survey (NHANES) combined health insurance weight tables and BMI to produce the calculations we all know today. BMI is used by health professionals to determine if a person over age 20 is underweight (a BMI under 18.5), a healthy weight (between 18.5 and 24.9), overweight (between 25.0 and 29.0), or obese (30.0 and over). But any have found the use of BMI as the primary indicator for body fat problematic because the measurement fails to consider the individual. As journalist Keith Devlin notes, BMI “makes no allowance for the relative proportions of bone, muscle and fat in the body. But bone is denser than muscle and twice as dense as fat, so a person with strong bones, good muscle tone and low fat will have a high BMI. Thus, athletes and fit, health-conscious movie stars who work out a lot tend to find themselves classified as overweight or even obese.” BMI also does not take into consideration waist circumference, race, gender, or age.[44][45][46][47][48][49][50][51][52][53]

Obesity Rates

In the mid-1970s, the obesity rate for the United States was about 14 percent (meaning 14 percent of the population was categorized as obese). The Centers for Disease Control and Prevention (CDC) first collected data on weight from each U.S. state individually in 1994 when the obesity rate was 19 percent or lower in each state. During the COVID-19 pandemic, the U.S. obesity rate rose by 3 percent between March 2020 and March 2021. By 2023, all U.S. states and territories had an obesity rate over 20 percent; the Midwest (36 percent) and South (34.7 percent) had the highest rates of obesity, followed by the West (29.1 percent) and the Northeast (28.6 percent); and three states (Arkansas, Mississippi, and West Virginia) had obesity rates of 40 percent or greater (West Virginia had the highest, at 41.2 percent). As the CDC reported in 2024, more than 2 in 5 U.S. adults (40 percent of the adult population) are obese.[8][9][10][11][12][56][58]

As Trust for America’s Health explained, “Obesity is multifactored and involves more than individual behavior.” Among the factors it cites for contributing to obesity is living in communities (so-called “food deserts”) with many fast-food establishments and convenience stores but limited access to healthier, affordable food options as available in full-service supermarkets, meaning many lower-income families in lower-income towns and neighborhoods must eat food that costs less but is also high in calories and low in nutritional value. [13]

According to the WHO’s World Bank calculations for 2022, the United States was the 15th most obese jurisdiction in the world. This calculation, however, separated U.S. territories from the main American calculation, which is significant, because islands rank among the most obese areas of the world. In fact, the 11 locations in the world with the highest obesity rates are all islands: American Samoa (75.2 percent), Tonga (71.7 percent), Nauru (69.9 percent), Tuvalu (64.2 percent), Samoa (62.4 percent), French Polynesia (48.1 percent), the Bahamas (47.3 percent), Micronesia (47.1 percent), Kiribati (46.3 percent), Marshall Islands (45.9 percent), and St. Kitts and Nevis (45.6 percent). Overall, according to the WHO, 82 of the 196 jurisdictions of the world, or 41.8 percent, had obesity rates over 25 percent. [14][57]

The WHO organization declared obesity a “global epidemic” in 1997, stating “obesity is a chronic disease, prevalent in both developed and developing countries, and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concerns, including malnutrition and infectious disease, as one of the most significant contributors to ill health.” Given the rising rates of obesity, the epidemic is only getting worse. [15]

To help battle this epidemic in the United States, President Donald Trump signed an executive order on July 31, 2025, reinstituting the Presidential Fitness Test and the Presidential Fitness Award in public schools; the test and award had been discontinued by President Barack Obama in 2012.[59]

Obesity Defined as a Disease

By 2013, most major health organizations and agencies had defined obesity as a disease, including American Academy of Family Physicians, American College of Cardiology, American College of Gastroenterology, American Heart Association, American Medical Association (AMA), Food and Drug Administration (FDA), National Institutes of Health (NIH), and Obesity Society. Even the Internal Revenue Service (IRS) allows Americans who are medically diagnosed as obese to claim tax deductions for doctor-prescribed treatments. [16][17][18] [19][20][21][22][23]

However, as recently as January 2025, the definition of obesity as a disease was not put into practice widely. An international commission of 58 experts by the The Lancet Diabetes & Endocrinology journal found

Despite evidence that some people with excess adiposity have ill health due to obesity, obesity is generally considered a harbinger of other diseases, not a disease in itself. The idea of obesity as a disease remains therefore highly controversial. In addition, current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about health at the individual level. [54][55]

Few observers now doubt that obesity is a global epidemic. The question more frequently debated is whether obesity should be treated as a disease. Is treating obesity as a “disease” a good thing for the patient? A good thing for society? And the best way to address this global epidemic?

Pros and Cons at a Glance

PROSCONS
Pro 1: Obesity is widely defined as a disease by medical groups. Read More.Con 1: Medicalizing obesity discourages people from taking responsibility for unhealthy choices. Read More.
Pro 2: Treating obesity as a disease lowers the risk of other diseases. Read More.Con 2: Obesity alone is not an indicator of ill health. Read More.
Pro 3: Treating obesity as a disease has social value by lowering the stigma associated with being “fat.” Read More.Con 3: Treating obesity as a disease irresponsibly glorifies unhealthiness. Read More.

Pro Arguments

 (Go to Con Arguments)

Pro 1: Obesity is widely defined as a disease by medical groups.

The FDA, the American Medical Association (AMA), the National Institutes of Health (NIH), American Heart Association, American College of Cardiology, the Obesity Society, the World Health Organization (WHO), the American College of Gastroenterology, the American Academy of Family Physicians (AAFP), and other medical organizations have all defined obesity as a disease. [16][17][18][19][20] [21][22][23]

“Individuals with obesity have an increased accumulation of fat not always attributable to eating too many calories or lacking physical activity. They experience impaired metabolic pathways along with disordered signaling for hunger, satiety (the feeling of fullness), and fullness (the state of fullness),” according to the Obesity Medicine Association. “For many, efforts to lose weight are met with unyielding resistance or disappointing weight regain…. [In fact,] 90 percent of people who lose weight will regain most of it.” [24]

Some 42 percent of Americans, according to the WHO, suffer from obesity, and yet only 4 percent of people with the disease seek treatment. Treating obesity as a disease like cancer or diabetes would increase recourse to needed medical treatment. [25]

Further, “the rise of new obesity medicines … helps to frame it more as a disease. The general public tends to think of a disease as having a corresponding medication to treat it. As more patients come in asking about these medications, it can help to explain to them that this disease warrants a multi-pillared approach, which can mean addressing lifestyle factors too,” according to the Obesity Medicine Association. [24]

“We need to accept that obesity is a disease. And since it’s a chronic disease, every person with obesity has to be diagnosed, and in each case a treatment needs to be defined. This is the future,” says Daniel Weghuber of the Paracelsus Medical University in Salzburg. [26]

Pro 2: Treating obesity as a disease lowers the risk of other diseases.

“Obesity is an inflammatory disease in which adipose tissue, or fat cells, release toxins known as cytokines into the bloodstream. These toxins can damage critical organs, contributing to conditions like fatty liver disease, diabetes and heart disease,” according to Christopher C. Thompson, a Harvard professor of medicine. Obesity is linked to 30-53 percent of new diabetes cases in the U.S. every year, reports the Journal of the American Heart Association. [10][29]

Obesity also increases the risk for around 200 other diseases, including arthritis, asthma, cancer, gallstones and gallbladder disease, high blood pressure, high cholesterol, osteoarthritis, and sleep apnea. Obesity triples the likelihood that COVID-19 will be severe. Mental illnesses including anxiety and depression are also linked to obesity. Obesity was a factor in almost 12 percent of American deaths in 2019. [26][27]

A 2025 study by the Jersey Shore University Medical Center reveals that obesity-associated cancers have tripled nationwide over the past two decades. For the study, the center examined more than 33,000 deaths from obesity-related cancers; the sharp increases in cancer deaths were especially prominent among women, older adults, and Native and Black Americans. Based on data from the CDC, reports the Endocrine Society, “Obesity is associated with a higher risk of developing 13 types of cancer. . . . These cancers make up 40% of all cancers diagnosed in the United States each year.”[60]

Doctors and researchers are also finding that patients are more compliant in taking new drugs specifically targeting weight, compared to taking drugs for treating the effects of obesity, such as statins for reducing cholesterol. New prescription weight-loss drugs, such as Ozempic, Wegovy, and Zepbound, effectively treat obesity, thus lowering the risk of and damage done by other diseases. [28]

By treating obesity like the disease it is, patients can benefit from better health care, better health, and fewer related diseases, which can improve their quality of life and lengthen their lifespans.

Pro 3: Treating obesity as a disease has social value by lowering the stigma associated with being “fat.”

“The societal stigma of being seen as ‘fat’ is a paralyzing barrier. So many still view obesity as a character flaw, or the result of someone not having enough willpower or being lazy. As best-selling author and social researcher Brene Brown explains, ‘shame is the most powerful, master emotion.’ Shame is killing people,” explains Christopher C. Thompson, a Harvard professor of medicine. [29]

The idea that a person’s caloric consumption and physical activity are solely responsible for their weight is outdated and incorrect. Further, the idea that weight-loss management drugs and other interventions are “vanity medication” or “the easy way out,” is “rooted in weight bias and the principle that people with obesity are solely responsible for reversing their condition,” says William H. Dietz of George Washington University. [30]

Dietz continues, “imagine, for any other chronic disease, foregoing medications that could spare a patient the risks and complications of major surgery, increase mobility, improve mental health, ease physical pain and financial burden, and begin to relieve the harms of that disease –all due to a bias that isn’t supported by the research or medical literature, but is held at every level of society.” [30]

Treating obesity as a disease gives more patients access to interventions. As family doctor Mara Gordon explains, drugs like Ozempic may help “if you’re facing hatred and fatphobia on a daily basis, if you can’t do the things you need to do because the chair at your office isn’t the correct size…. I wish we lived in a less superficial society. But my job is to take care of the patient right in front of me.” [31]

Treating obesity medically can not only help the patient but help minimize the stigma associated with being overweight.

Con Arguments

 (Go to Pro Arguments)

Con 1: Medicalizing obesity discourages people from taking responsibility for unhealthy choices.

Our increasingly sedentary lifestyles have contributed greatly to the obesity epidemic, and treating obesity as a disease – as something out of our control – simply encourages many patients to ignore responsibility for choices contributing to their ill-health.

Clearly, now that much of our work, school, and interpersonal relationships have gone digital, we have a reduced societal need to move our bodies. Unsurprisingly, a study found “a causal relationship” between four sedentary behaviors – leisure screen time, watching TV, computer use, and driving – and obesity. [32][33]

A correlation between digital gaming addiction, decreased physical activity, and obesity has also been found. As the study’s authors noted, “regular physical activity should be encouraged, digital gaming hours can be limited to maintain ideal weight. Furthermore, adolescents should be encouraged to engage in physical activity to reduce digital game addiction.” [34]

Similar results, revealing a positive correlation between digital addiction and obesity among college students, was confirmed by a separate study. And yet another study found a correlation between Internet addiction, obesity, and sleep disorders in children aged 7-10. [35][36]

Treating obesity as a disease often back-fires. Obesity treatments and drugs are expensive and not covered by some insurances; their long-term effects are not known, and stopping the drugs can have immediate consequences including regaining the lost weight. Common-sense changes like increasing physical activity, monitoring our choices, and improving access to healthier food options can go a long way toward improving health, regardless of weight. [37]

Con 2: Obesity alone is not an indicator of ill health.

“We can be obese but remain healthy,” says Ruth Loos, an epidemiologist who studies the genetics of obesity at the University of Copenhagen. [38]

Automatically treating obesity as a disease can mean both over- and under-diagnosing patients. As physiologist Lindo Bacon explains, “it’s very clear that there are a lot of people in that category called obese [who] don’t have any signs of disease and live long, healthy lives.” Without ill-health, obesity doesn’t necessarily need to be treated. [38]

Bacon recounts “my father and I both went to orthopedic surgeons because we were having bad knee pain…. My father went to his death with knee problems” because he was diagnosed as obese and only told to lose weight rather than receiving treatment for knee pain. Bacon’s father “could have benefited from stretching, strengthening, [and] knee surgery. He didn’t get that.” Lindo Bacon, however, was of “normal” weight and thus offered surgery to correct the knee problems. [38]

When there is ill-health, obesity is frequently only the side-effect of another disease or medical condition that should be treated. In these cases, treating obesity as the primary problem could result in doctors missing underlying problems like arthritis causing decreased mobility and exercise or polycystic ovary syndrome (PCOS) causing hormonal imbalances. Automatically treating obesity as a disease can mean treatments capable of relieving pain and helping patients get frequently overlooked and under-considered. [38][39]

Con 3: Treating obesity as a disease irresponsibly glorifies unhealthiness.

Treating obesity as a disease has had unintended consequences. Not only have people been discouraged from thinking about how their lifestyles may be unhealthy, but obesity and unhealthiness have now been glorified. The “fat acceptance” movement has encouraged people, especially kids and teens, to be pleased with their weight no matter what, which is “toxic positivity.” 

The movement has encouraged people to suppress negative emotions about weight and to pretend to be happy with extra pounds and the related physical and mental health issues. “Toxic positivity is toxic! To deny and avoid acknowledging and expressing our authentic negative emotions, including fear, disappointment, anger, betrayal, etc. keeps us in a world of illusion and fantasy and inevitably harms our physical, emotional, and mental wellbeing,” explains therapist Beatty Cohan. [41]

“No one should be subject to ridicule or teasing because of her weight,” says journalist Danielle Crittenden. “But it’s one thing to be compassionate, [and] quite another to glamorize what amounts to a dangerous health epidemic. In many ways, the current campaign to endorse female heaviness reminds me of the old smoking advertisements. Even as evidence accumulated that smoking could cause cancer and other diseases, tobacco companies continued to push their products as tickets to coolness, sophistication, and even a great way to get sex. Then, as now, they were not beneath marketing to children.” [42]

Journalist Lizzie Cernik agrees, saying, “suggesting that being a size 30 is just as healthy as being a size 12 isn’t a body-positive message either – it’s an irresponsible form of denial.” Treating obesity as a disease out of an individual’s control and the body-positivity efforts have not yielded good results. Rates of mental and physical health issues related to obesity have not decreased. Overweight and obese people deserve good healthcare, but that healthcare will not be sought without honest assessments of their true medical condition and how it arose.[40][43]

U.S. Obesity Levels by State

Obesity is usually determined by BMI (body mass index) measurements. Someone with a BMI of 30 or more is considered obese. According to the State of Childhood Obesity, adult obesity rates exceeded 35 percent in 23 states in 2023, meaning 35 percent of the adult population in a state was obese. In 2011, the oldest comparable data, no state had an obesity rate over 35 percent, though Mississippi was just below the threshold at 34.9 percent

2023 Rank 2023 Obesity Rate State 2011 Obesity Rate 2011 Rank
State of Childhood Obesity, “Adult” (accessed July 28, 2025),  stateofchildhoodobesity.org
1 41.2 percent West Virginia 32.4 percent 3
2 40.1 percent Mississippi 34.9 percent 1
3 40.0 percent Arkansas 30.9 percent 7
4 39.9 percent Louisiana 33.4 percent 2
5 39.2 percent Alabama 32.0 percent 4
6 38.7 percent Oklahoma 31.1 percent 6
7 37.8 percent Indiana 30.8 percent 8
8 37.8 percent Iowa 29.0 percent 18
9 37.6 percent Tennessee 29.2 percent 15
10 36.6 percent Nebraska 28.4 percent 21
11 36.4 percent Ohio 29.6 percent 13
12 36.0 percent Illinois 27.1 percent 29
13 36.0 percent South Carolina 30.8 percent 8
14 36.0 percent South Dakota 28.1 percent 23
15 35.9 percent Kansas 29.6 percent 13
16 35.9 percent Wisconsin 27.7 percent 27
17 35.7 percent Delaware 28.8 percent 19
18 35.6 percent North Dakota 27.8 percent 25
19 35.4 percent Michigan 31.3 percent 5
20 35.3 percent Missouri 30.3 percent 12
21 35.3 percent New Mexico 26.3 percent 34
22 35.2 percent Alaska 27.4 percent 28
23 35.0 percent Georgia 28.0 percent 24
24 34.4 percent Texas 30.4 percent 10
25 34.3 percent Virginia 29.2 percent 15
26 34.1 percent Maryland 28.3 percent 22
27 34.0 percent North Carolina 29.1 percent 17
28 33.6 percent Oregon 26.7 percent 31
29 33.3 percent Minnesota 25.7 percent 36
30 33.3 percent Wyoming 25.0 percent 39
31 32.8 percent New Hampshire 26.2 percent 35
32 32.6 percent Maine 27.8 percent 25
33 31.9 percent Arizona 24.7 percent 40
34 31.6 percent Rhode Island 25.4 percent 37
35 31.0 percent Idaho 27.0 percent 30
36 30.8 percent Nevada 24.5 percent 42
37 30.6 percent Washington 26.5 percent 33
38 30.5 percent Montana 24.6 percent 41
39 30.2 percent Utah 24.4 percent 45
40 30.1 percent Florida 26.6 percent 32
41 29.4 percent Connecticut 24.5 percent 42
42 28.9 percent New Jersey 23.7 percent 47
43 28.8 percent Vermont 25.4 percent 37
44 28.0 percent New York 24.5 percent 42
45 27.7 percent California 23.8 percent 46
46 27.4 percent Massachusetts 22.7 percent 49
47 26.1 percent Hawaii 21.8 percent 50
48 24.9 percent Colorado 20.70percent 51
49 23.5 percent District of Columbia 23.7 percent 47
n/a no data Kentucky 30.4 percent 10
n/a no data Pennsylvania 28.6 percent 20

Global Obesity Levels

The United States territory American Samoa was the most obese jurisdiction in the world with obesity affecting 75.2 percent of the adult population in 2022, according to the most recent data available from the World Health Organization (WHO). Vietnam was the least obese country with 2.0 percent of the adult population classified as obese.

Global Rank Country Obesity Rate
Source: World Bank Group, “Prevalence of Obesity Among Adults (%)” (November 18, 2024), humancapital.worldbank.org
1 American Samoa 75.2 percent
2 Tonga 71.7 percent
3 Nauru 69.9 percent
4 Tuvalu 64.2 percent
5 Samoa 62.4 percent
6 French Polynesia 48.1 percent
7 Bahamas, The 47.3 percent
8 Micronesia 47.1 percent
9 Kiribati 46.3 percent
10 Marshall Islands 45.9 percent
11 St. Kitts and Nevis 45.6 percent
12 Egypt 44.3 percent
13 Qatar 43.1 percent
14 Belize 42.3 percent
15 United States 42.0 percent
16 Kuwait 41.4 percent
17 Palau 41.1 percent
18 Puerto Rico 41.1 percent
19 Saudi Arabia 40.6 percent
20 Iraq 40.5 percent
21 Chile 38.9 percent
22 Jordan 38.5 percent
23 Barbados 38.0 percent
24 West Bank and Gaza 37.6 percent
25 Libya 36.7 percent
26 Bahrain 36.1 percent
27 Panama 36.1 percent
28 Mexico 36.0 percent
29 Argentina 35.4 percent
30 Georgia 34.7 percent
31 Romania 34.0 percent
32 Syrian Arab Republic 33.9 percent
33 Fiji 33.8 percent
34 Jamaica 33.8 percent
35 Nicaragua 33.6 percent
36 New Zealand 33.6 percent
37 St. Lucia 33.5 percent
38 Uruguay 33.3 percent
39 Turkiye 33.3 percent
40 Antigua and Barbuda 33.3 percent
41 St. Vincent and the Grenadines 33.2 percent
42 Bermuda 33.0 percent
43 Paraguay 33.0 percent
44 Malta 32.3 percent
45 United Arab Emirates 32.1 percent
46 Brunei Darussalam 31.7 percent
47 Hungary 31.7 percent
48 Costa Rica 31.4 percent
49 Dominica 31.3 percent
50 Oman 31.1 percent
51 El Salvador 30.9 percent
52 South Africa 30.8 percent
53 Croatia 30.6 percent
54 Grenada 30.3 percent
55 Australia 30.2 percent
56 Eswatini 30.1 percent
57 Uzbekistan 30.0 percent
58 Lebanon 29.8 percent
59 Honduras 29.5 percent
60 Seychelles 29.4 percent
61 Dominican Republic 29.3 percent
62 Suriname 29.0 percent
63 Bolivia 28.7 percent
64 Guyana 28.5 percent
65 Ireland 28.3 percent
66 Brazil 28.1 percent
67 Trinidad and Tobago 28.1 percent
68 Greece 28.0 percent
69 North Macedonia 27.5 percent
70 Poland 27.5 percent
71 Ecuador 27.4 percent
72 Peru 27.3 percent
73 Greenland 27.0 percent
74 Tunisia 26.8 percent
75 Slovak Republic 26.8 percent
76 United Kingdom 26.8 percent
77 Guatemala 26.8 percent
78 Kyrgyz Republic 26.6 percent
79 Azerbaijan 26.5 percent
80 Canada 26.2 percent
81 Czechia 26.0 percent
82 Lithuania 25.4 percent
83 Armenia 24.5 percent
84 Latvia 24.3 percent
85 Iran 24.3 percent
86 Russia 24.2 percent
87 Mongolia 24.1 percent
88 Algeria 23.8 percent
89 Tajikistan 23.8 percent
90 Ukraine 23.6 percent
91 Colombia 23.6 percent
92 Albania 23.4 percent
93 Pakistan 23.0 percent
94 Moldova 23.0 percent
95 Cyprus 22.9 percent
96 Venezuela 22.7 percent
97 Mauritania 22.7 percent
98 Solomon Islands 22.6 percent
99 Serbia 22.5 percent
100 Israel 22.5 percent
101 Estonia 22.2 percent
102 Malaysia 22.1 percent
103 Portugal 21.8 percent
104 Morocco 21.8 percent
105 Cuba 21.8 percent
106 Finland 21.5 percent
107 Turkmenistan 21.4 percent
108 Belarus 21.4 percent
109 Vanuatu 21.3 percent
110 Iceland 21.2 percent
111 Bosnia and Herzegovina 21.2 percent
112 Gabon 21.0 percent
113 Lesotho 21.0 percent
114 Bulgaria 20.6 percent
115 Papua New Guinea 20.5 percent
116 Germany 20.4 percent
117 Belgium 20.0 percent
118 Slovenia 19.4 percent
119 Mauritius 19.2 percent
120 Afghanistan 19.2 percent
121 Norway 19.1 percent
122 Luxembourg 18.4 percent
123 Kazakhstan 18.4 percent
124 Botswana 18.3 percent
125 Andorra 18.1 percent
126 Montenegro 18.0 percent
127 Equatorial Guinea 17.7 percent
128 Maldives 17.3 percent
129 Italy 17.3 percent
130 Liberia 17.0 percent
131 Sudan 17.0 percent
132 Namibia 17.0 percent
133 Sao Tome and Principe 16.5 percent
134 Comoros 16.3 percent
135 Cabo Verde 15.8 percent
136 Spain 15.7 percent
137 Thailand 15.4 percent
138 Austria 15.4 percent
139 Sweden 15.3 percent
140 Gambia 14.9 percent
141 Cameroon 14.9 percent
142 Somalia 14.6 percent
143 Netherlands 14.5 percent
144 Zimbabwe 14.2 percent
145 Singapore 13.9 percent
146 Yemen 13.7 percent
147 Denmark 13.3 percent
148 Ghana 12.9 percent
149 Tanzania 12.6 percent
150 Kenya 12.4 percent
151 Nigeria 12.4 percent
152 Bhutan 12.2 percent
153 Switzerland 12.1 percent
154 Cote d’Ivoire 11.6 percent
155 Togo 11.6 percent
156 Angola 11.5 percent
157 Guinea-Bissau 11.5 percent
158 Mali 11.4 percent
159 Djibouti 11.3 percent
160 Indonesia 11.2 percent
161 Benin 11.2 percent
162 Zambia 11.1 percent
163 North Korea 10.8 percent
164 Haiti 10.7 percent
165 Sri Lanka 10.6 percent
166 Mozambique 10.3 percent
167 Senegal 10.2 percent
168 France 9.7 percent
169 Guinea 9.5 percent
170 Central African Republic 9.3 percent
171 Philippines 8.7 percent
172 South Sudan 8.6 percent
173 Republic of the Congo 8.5 percent
174 China 8.3 percent
175 Laos 8.0 percent
176 Uganda 7.9 percent
177 Malawi 7.7 percent
178 Myanmar 7.4 percent
179 South Korea 7.3 percent
180 India 7.3 percent
181 Sierra Leone 7.1 percent
182 Nepal 7.0 percent
183 Burkina Faso 6.7 percent
184 Chad 6.7 percent
185 Democratic Republic of the Congo 6.6 percent
186 Niger 6.0 percent
187 Japan 5.5 percent
188 Bangladesh 5.3 percent
189 Burundi 5.0 percent
190 Rwanda 4.9 percent
191 Eritrea 4.8 percent
192 Cambodia 4.4 percent
193 Madagascar 4.3 percent
194 Ethiopia 2.8 percent
195 Timor-Leste 2.4 percent
196 Viet Nam 2.0 percent

1-minute Survey

After reading this debate, take our quick survey to see how this information affected your opinion of this topic. We appreciate your feedback.

Discussion Questions

  1. Should obesity be treated as a disease? Why or why not?
  2. Should obesity be treated with medication? Why or why not?
  3. How can we treat obesity socially? Consider transportation seat sizes, meal portions, and clothing size availability, among other factors that make navigating the world difficult for some. Explain your answer.

Take Action

  1. Consider the pro position of the Obesity Society.
  2. Explore the topic of obesity at the World Health Organization (WHO) website.
  3. Analyze the con position of Dr. D.L. Katz.
  4. Consider how you felt about the issue before reading this article. After reading the pros and cons on this topic, has your thinking changed? If so, how? List two to three ways. If your thoughts have not changed, list two to three ways your better understanding of the “other side of the issue” now helps you better argue your position.
  5. Push for the position and policies you support by writing U.S.  senators and representatives.

Sources

  1. World Health Organization, “Obesity” (accessed July 8, 2024), who.int
  2. National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases, “Overweight and Obesity Statistics” (September 2021), niddk.nih.gov
  3. Encyclopaedia Britannica, “Body Mass Index” (July 7, 2023), britannica.com
  4. Dani Blum, “Medical Group Says B.M.I. Alone Is Not Enough to Assess Health and Weight” (June 15, 2023), nytimes.com
  5. Becca Muir, “Opinion: Women with Obesity Are Often Restricted from IVF. That’s Discriminatory” (January 14, 2024), npr.org
  6. Museum of London, “Fat and Social Identity” (accessed July 3, 2024), museumoflondon.org.uk
  7. Linda Gerhardt, “The Rebellious History of the Fat Acceptance Movement” (accessed August 14, 2024), centerfordiscovery.com
  8. CDC, “Adult Obesity Prevalence Maps” (September 21, 2023), cdc.gov
  9. CDC, “Adult Obesity Facts” (May 14, 2024), cdc.gov
  10. Emily Laurence, “Obesity Statistics and Facts in 2024” (January 10, 2024), forbes.com
  11. CDC, "Adult Obesity Facts” (March 28, 2014), cdc.gov
  12. National Bureau of Economic Research (NBER), "Economic Explanations of Increased Obesity” (accessed April 24, 2014), nber.org
  13. Trust for America’s Health, “State of Obesity 2022: Better Policies for a Healthier America” (September 27, 2022), tfah.org
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fast food, mass-produced food product designed for quick and efficient preparation and distribution that is sold by certain restaurants, concession stands, and convenience stores. Fast food is perhaps most associated with chain restaurants—including such prominent brands as McDonald’s, Burger King, and Taco Bell—that typically offer take-out and drive-through services, as convenience and speed are prioritized. Common fast foods include hamburgers, hot dogs, french fries, pizza, tacos, burritos, salads, and sandwiches.

Critics say the production of fast food often subordinates quality to efficiency, affordability, and profit. Fast-food products are often highly processed and precooked or frozen and may contain artificial preservatives in addition to high levels of sodium, cholesterol, saturated fats, and refined grains and sugars. Thus, the term fast food has come to carry negative connotations regarding health, and it raises ethical issues in the fields of agriculture and labour. However polarizing, fast food remains highly popular internationally for its convenience and flavour.

History

The concept of quick ready-to-eat meals dates back millennia. Evidence that people have been eating food on the go can be found as far back as Pompeii before the eruption of Mount Vesuvius in 79 ce. Throughout the early 20th century, self-serve food establishments known as Automats and “smash-and-grabs” gained popularity with busy customers who sought a quick meal. In 1921 the first White Castle—often considered the original American fast-food chain—opened in Wichita, Kansas. Known for its five-cent burgers, it paved the way for the fast-food chains of the future with an assembly line that allowed for efficient service and consistent output.

Chef tossing vegetables in a frying pan over a burner (skillet, food).
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The fast-food industry flourished after World War II with the rise of suburbia, interstate highways, and other car-forward infrastructure. The drive-through model was a natural successor of the drive-in restaurants that had materialized across the United States in the decades before the war. Drive-throughs, which required fewer employees than drive-ins, were more financially lucrative for fast-food businesses and catered to traveling customers and those who did not want to stop for a sit-down meal. The California-based chain In-N-Out Burger is generally credited as the first to implement the modern drive-through—which features two-way speakers—in 1948. The fast-food industry expanded rapidly in the latter half of the 20th century. In the early 21st century there were nearly 200,000 fast-food restaurants in the United States alone, and corporations such as McDonald’s, Subway, and Starbucks had thousands of international locations. In 2021 American fast-food restaurants collectively generated more than $250 billion in revenue.

As technology evolved, so did the convenience and efficiency of the fast-food experience. Implementation of self-order kiosks in various restaurants allow customers to order and pay for their food on a screen, while increasing sales and decreasing labour. The rise of third-party delivery services such as Uber Eats, Grubhub, and DoorDash allows for even greater convenience than the drive-through.

Criticism and response

The growth of the industry has reverberated across other fields. McDonald’s became one of the biggest buyers in the world of beef and potatoes, and KFC is often cited as the world’s largest purchaser of chicken. The high demand for such products has driven a large percentage of industrial livestock production. Critics refer to this as “factory farming” and consider it an inhumane and environmentally unsustainable way of producing food. The fast-food industry is, consequently, often cited for its large carbon footprint. Some companies have responded by launching initiatives to reduce emissions at their restaurants and in their suppliers’ production of beef.

After fast-food chains permeated suburban America, corporations shifted their focus to urban areas. Today fast-food restaurants saturate cities and are known to play a role in the “food desert” phenomenon of low-income urban neighbourhoods that have little or no access to nutritious food. Convenience stores that carry prepared fast foods such as sandwiches, pizza, and hot dogs are also common in food deserts. Because reliance on fast food as a primary source of sustenance is linked to increased risks of heart disease, diabetes, and other health issues, people residing in food deserts are disproportionately affected.

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Fast food is especially associated with the rise in obesity, particularly in the United States. American filmmaker Morgan Spurlock’s 2004 documentary, Super Size Me, is perhaps the best-known work to closely examine fast food and its effects on the human body. Spurlock documented a month of his life in which the only food he consumed was from McDonald’s. By the end of the experiment, he had experienced a weight gain of more than 20 pounds (9 kg) and a deterioration of health that shocked even his doctors. The film was a wake-up call for the general population and health experts alike on the negative bodily effects of fast food. As a result of this and other efforts, many fast-food chains began to eliminate trans fat from their foods, and they began expanding their menus to include healthier choices, such as salads, low-fat milk, and fresh fruit.

Fast-food corporations have also garnered criticism for their labour practices. Many fast-food workers earn low wages and are given limited benefits, including health insurance. Employees thus often receive aid from public-assistance programs, which has led to charges that taxpayers are essentially subsidizing fast-food chains. In addition, some cite dangerous work conditions that can lead to injuries. Efforts to unionize the industry have faced strong opposition.

Aware of the negative connotations of the term fast food, various chains have shifted the language around their service models. For example, American sandwich chain Arby’s adopted the descriptor “Fast crafted” in the mid-2010s, and ice-cream chain Dairy Queen revealed the slogan “Fan food, not fast food” about the same time. The industry itself largely uses the term quick-service restaurant, or QSR.

Emily Kendall