Destigmatizing obesity: From language to the clinical environment

The clinical management of obesity is hindered not only by physiological complexities but fundamentally by deeply rooted linguistic and conceptual frameworks that portray adiposity as a behavioral choice rather than a chronic and relapsing disease. This chapter describes the trajectory of obesity nomenclature from stigmatizing language to precision-based nosology, such as adiposity-based chronic disease (ABCD). It examines the empirical evidence linking weight-biased language to adverse clinical outcomes, delayed diagnoses, healthcare avoidance and lack of access. By dissecting the limitations of anthropometric substitutes like body mass index (BMI), this chapter advocates for a pathophysiological paradigm centered on adipose tissue dysfunction and ectopic fat deposition. Finally, it translates this linguistic and diagnostic evolution into actionable, evidence-based clinical frameworks, including person-first and preference-sensitive communication strategies, multidisciplinary assessment tools, and advanced pharmacotherapeutic paradigms.