“Obese” isn’t just a diagnosis anymore. It’s an insult.

It’s the word that keeps millions from going to the doctor, not because they don’t need help, but because they don’t want shame.

Though clinically defined as excess body fat that impairs health, obesity’s cultural meaning has long eclipsed its medical one. What started as a health condition has become a character judgment, a label that implies laziness, lack of willpower, even failure.

For many, being called obese doesn’t feel clinical.

It feels like a verdict that’s not in your favour.

Obesity today doesn’t just describe bodies. It blames them.

A 2020 global survey published in The Lancet found that 69% of people living with obesity experienced stigma from healthcare professionals. Many said it directly affected whether they sought medical care. Think about that: the word that’s supposed to flag a need for help is often the reason people don’t ask for it.

And the stigma isn’t just in hospitals. It’s everywhere.

In films, fat characters are often the punchline. In the workplace, overweight women earn up to 12% less than their average-weight peers, even with identical resumes. In schools, kids pick up on the bias before they can spell “metabolism.”

So when a doctor says, “You’re obese,” it doesn’t land like useful information.

It lands like an accusation.

This is precisely why medical communities are rethinking the word itself; not to downplay the health risks of excess fat, but to separate biology from bias.

Words aren’t just words, especially in medicine.

They’re diagnoses. They’re doors to treatment.

Or they’re walls that keep people out.

And when the word stops opening doors and starts slamming them shut, it’s time to reassess.

That’s exactly what doctors around the world are doing with the word “Obesity”. Instead of labeling patients “obese,” many are now shifting to a new term: ABCD

It may sound like medical jargon, but it’s a critical shift.

ABCD stands for Adiposity-Based Chronic Disease, a new clinical term proposed by the American Association of Clinical Endocrinology in 2017.

Unlike “obesity,” which centers on weight and body size, ABCD focuses on how fat functions in the body; where it’s distributed, how it behaves, and how it impacts long-term health. This means:

By shifting the lens from appearance to biology, ABCD reframes excess fat as a complex, long-term medical condition shaped by genetics, environment, and metabolism. It’s a move from blame to biology — from shame to science.

The shift away from “obesity” also signals a broader issue: BMI is broken.For decades, BMI has been the standard diagnostic tool. But BMI is a crude measure. It doesn’t account for fat distribution, muscle mass, metabolic health, or ethnic differences. 

For instance, Asians often develop metabolic diseases at lower BMIs, while athletes may have high BMIs but low fat percentages.

This has led many global medical bodies to rethink obesity as a chronic condition defined by fat function, not just fat quantity.

Doctors now advocate for assessments that go beyond the weighing scale  like waist-to-height ratios, insulin sensitivity tests, inflammatory markers, and scans that measure visceral fat.

Weight is just a number and not a diagnosis

Health isn’t about how you look, it’s about how your body works.

That’s why many countries are now rethinking how they define and treat obesity.

Globally, the shift to ABCD-like frameworks is already underway:

In each of these regions, the same realization is taking hold:

Obesity isn’t about what people look like. It’s about how their fat tissue works.

Changing “obesity” to “ABCD” isn’t just about swapping one word for another.

It’s about redesigning the moment a person meets their diagnosis and making sure that moment feels safe enough for them to keep going.

Because here’s the truth: medical labels are part of healthcare’s interface.

They’re the first touchpoint between a person and the system that’s supposed to help them. If that touchpoint stings, shames, or alienates, the journey can end before it begins.

Design can change that.

This isn’t just a healthcare challenge and the shift is already happening in other industries. 

In finance, “bad credit” is being reframed as a “credit rebuilding stage,” inviting people to see a path forward instead of a dead end. 

In education, “remedial classes” are becoming “foundation programs,” focusing on growth instead of deficiency. 

Even in workplaces, the dreaded “performance improvement plan” is being rebranded as a “growth plan,” turning a punitive label into an opportunity for development. 

Obviously, design can’t solve every problem. But it can make the first step feel possible and sometimes, that’s the difference between someone walking away and someone walking in.

Because stigma isn’t just a cultural issue. It’s a design flaw we can fix.

Changing a name might seem like surface work, but in healthcare, language is part of the system design. It’s the interface people first encounter when they enter care.

Dr. Jeffrey Mechanick, a leading voice in the field and former president of the American Association of Clinical Endocrinology, explains:

It’s not just semantics. It’s experience design. 

A global consensus published in Nature Medicine called for ending weight stigma in healthcare and reframing obesity as a chronic condition shaped by genetics, environment, and biology, not just personal willpower.

Because you can’t bully someone into health.And shame doesn’t create change, it creates avoidance.

When the first words someone hears about their health are designed with empathy instead of judgment, they’re more likely to stay engaged, follow through on treatment, and trust the system that’s helping them. 

That’s not just a cultural win. That's a clinical impact by design.

Not on its own.

ABCD won’t dismantle fatphobia. It won’t rewrite every fat joke in a sitcom, stop workplace bias, or undo decades of shame-based health messaging. 

Critics rightfully worry that ABCD, while well-intentioned, still centers the medicalization of fatness and may just be a more sanitized way to pathologize certain bodies. And unless this change comes with deep reform in how fat people are treated by doctors, policymakers, and pop culture. The word swap risks being cosmetic.

But it’s a step. And in a system that’s been stuck in shame for too long, a step toward science and compassion matters.

Dr. Francesco Rubino, chair of the Lancet Commission on Obesity, puts it clearly:

That’s what ABCD aims to do: replace shame with science. And perhaps, over time, shift our collective response from ridicule to responsibility.

Because words shape systems. And the word obesity has stopped helping people. It has become a wall between patients and care, between diagnosis and empathy.

The move to ABCD is a signal, however small, that medicine is beginning to reckon with its own biases. At its best, this shift isn’t just about changing terminology. It doesn’t erase the problem. It reframes it: clinically and compassionately.

At its best, this shift changes the question from: “How do we make people thinner?” to “How do we help people live healthier lives, in the bodies they have?”

It’s not a silver bullet. 

But it’s a start and a signal that medicine is finally beginning to see patients as people, not just numbers on a scale.