Is agreement with the statement “obesity is a disease” helpful or harmful? Insights from a National cross-sectional survey

Abstract

Objective

To evaluate how individuals with different BMI (Body Mass Index) levels respond to the statement “obesity is a disease” in terms of agreement, emotional reactions, and motivation for weight loss.

Methods

A cross-sectional online survey was conducted in January 2024 among 597 Israeli adults (43.3+16.7 years old), stratified by weight status (normal weight (n = 200), overweight (n = 200), obesity (n = 197)) and gender (females (50.1%), males (49.9%)). Participants reported their level of agreement with the statement “obesity is a disease” their emotional reactions to this statement, and weight-related motivation. Multivariate analyses examined demographic and psychological predictors of agreement.

Results

Overall, 47.6% of participants agreed with the disease framing. Agreement was significantly associated with higher BMI, lower religiosity, and poorer self-rated mental health. However, agreement was not associated with greater motivation to lose weight or perceived control over weight. Participants with obesity endorsed more negative emotional responses, to the statement including worry, frustration, helplessness, and pressure versus those with lower weight-status. Positive emotions such as optimism or confidence were not significantly associated with weight status.

Conclusions

Framing obesity as a disease is common and more frequently endorsed by individuals with obesity (versus those with lower weight status), yet it does not appear to enhance motivation for weight loss. This framing is also associated with emotional distress, suggesting that such messaging may unintentionally reinforce internalized stigma. Public health communications should consider these nuanced responses and strive to promote messages that are empathetic, non-stigmatizing, and behaviorally supportive.