Reconceptualizing obesity and the modern definition of disease

The debate over whether obesity constitutes disease reveals a fundamental limitation in biomedical disease models. We propose a bio-biographical framework recognizing that disease emerges when biological processes and biographical context, including for example lived experience, social position, chronic stressors, trauma, couple together to generate present or potential harm meaningful to the person. Biography is not external to disease but constitutive of it, shaping causation, expression, and trajectory through embodied mechanisms. This reconceptualization applies beyond obesity to cancer, cardiovascular disease, neurodegeneration and more, offering a new foundation for medicine that acknowledges both biological mechanisms and disrupted human lives.