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I'm medically obese - and totally love my body. Is that okay? Add to ...

The question

I'm medically obese - but totally happy with my body (I swear). Family and friends tell me there has to be something psychologically wrong with me, if I can be truly happy with my body being this large. What's your perspective?

The answer

First, there is nothing "psychologically wrong" with you for truly accepting your body as it is. You sound like a confident person whose self-esteem is not impacted by your physical appearance. The reality is there are a range of physical attributes (e.g., weight, height, facial features, acne, scarring), health conditions (e.g., cancer, HIV) and physical disabilities (e.g., paraplegia, amputations) which could impact self-esteem and confidence.

Unfortunately, the stigma in our society surrounding weight issues is undeniable: I think most people view weight as something that is very much within one's control. The reality is that there is a significant margin of control we can have over our weight through healthy diet and exercise, but some people have a stronger genetic component to their weight, and these individuals can have tremendous difficultly losing weight.

You say you are "medically obese": a body mass index (or BMI) is the measurement that is used to define individuals' weight classification, and involves a ratio between height and weight. Individuals are classified as being "obese" when the BMI exceed 30 kg/m2. By definition, obesity is a medical condition where body fat has accumulated to the point that there may be an adverse impact on health.

I wonder if the concern coming from your family and friends is related to your physical health, not your psychological wellbeing.

There is ample evidence that obesity increases the likelihood of developing a range of serious health conditions, including: heart disease, diabetes, sleep apnea, osteoarthritis, and certain types of cancer. Overall life expectancy is also reduced.

When your family or friends express their concerns to you, you may want to ask them what specifically they are concerned about, as I suspect it has much more to do with these health risks. I also wonder if it may be scary for you to acknowledge the possible negative health effects your weight is having.

Stating your happiness and acceptance of your body/weight to others may possibly be a way for you to avoid facing some of the other negative impacts that exist, as those may be daunting to both face and start to take some action toward.

I would suggest a conversation with either a loved one that you trust, or ideally a health professional: a physician, nutritionist, or dietitian can provide you with useful information on making some changes to your lifestyle - if that is something you feel you want to do.

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Samra.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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