The weight dilemma: a range of philosophical perspectives

The aim of this paper is to present a wide range of professional and lay viewpoints on obesity. Different perspectives surrounding how obesity is viewed, primary etiological factors contributing to obesity and intervention aims are brought together for review and discussion. Factors which may contribute to different perspectives include: familiarity with the scientific data showing the health risks associated with obesity, personal experience with weight and weight control, experiences encountered in working with clients in weight management, and professional training. In addition to describing and comparing the different approaches, possibilities for reconciling their differences and drawing from each of their strengths, are explored. The predominant viewpoint among health professionals regarding the etiology of obesity is that multiple factors contribute to its onset and progression. However, viewpoints tend to differ with regard to the main contributing factors and range from those in which the major focus is on genetic factors, to those which focus more on familial and/or individual choices regarding behavioural implementation. Although the predominant viewpoint on obesity in western societies is not a positive one, there is a growing size acceptance movement which has had a significant impact on both the fashion industry and on the health field. Aims of treatment may vary in accordance with beliefs about key etiological factors leading to obesity (for example, primarily genetic vs primarily behavioural) and with opinions regarding potential consequences and benefits of obesity. Aims of treatment may include weight loss, healthy eating and exercise, weight maintenance, improved self-esteem, fat accepTance and/or advocacy for decreased weight discrimination. An increased awareness, understanding and openness towards different philosophical perspectives surrounding weight issues may be the first step towards working with colleagues and clients whose viewpoints on weight-related issues differ from our own.