For decades, obesity has been treated primarily as a biomedical problem that must be solved through the reduction of body weight. Diets, medications, and bariatric surgery have become the standard tools used to address what many health institutions describe as a global epidemic. However, an increasing number of researchers argue that this approach may be insufficient to understand the complexity of living with obesity. Beyond the numbers on the scale or the body mass index (BMI), obesity is also a human, social, and emotional experience that raises significant ethical questions.
A new perspective proposes understanding obesity through the concept of the “lived body,” developed in the phenomenology of the philosopher Maurice Merleau-Ponty. This way of thinking allows us to see the body as the place from which people experience the world, their relationships, and their own identity. From this perspective, the way individuals live and perceive their bodies can profoundly influence their health, autonomy, and well-being.
The Weight of Stigma
One of the most significant problems faced by people living with obesity is social stigma. In many Western societies, excess weight is interpreted as a personal failure or as the result of a lack of willpower. These perceptions generate feelings of shame, guilt, and blame toward those who live with obesity (Gómez-Pérez, Ortiz, and Saiz 2017).
Research shows that this stigmatization affects people’s self-esteem and their relationship with the healthcare system. Many individuals with obesity experience discrimination or disrespectful treatment in medical settings, which may lead them to avoid seeking medical care or treatment (Puhl and Heuer 2010). Furthermore, stigma can create the feeling that life is “on hold,” as if certain projects or experiences can only be pursued after losing weight (Haga et al. 2020).
At the same time, the dominant medical discourse often focuses on quantitative indicators such as BMI, reinforcing a view of the body as something that can simply be measured and corrected. Excess weight is primarily presented as a risk that must be urgently controlled (Tremmel et al. 2017). However, this approach may overlook essential aspects of human experience, such as psychological well-being, body perception, and the social conditions that influence health.
The Body as the Center of Experience
The philosophy of Maurice Merleau-Ponty offers tools for thinking about the body in a different way. In his work Phenomenology of Perception, the philosopher argues that the body is not merely something we have—it is also something we are. Our body is the starting point from which we perceive the world, act within it, and relate to other people (Merleau-Ponty and Landes 2013).
This idea is known as the concept of the “lived body.” It means that the body, in addition to being a biological structure, is also a subjective experience. For instance, the way a person moves, feels, or perceives themselves is deeply connected to their personal history, their social environment, and their relationships with others.
From this perspective, health cannot be understood solely in biomedical terms. It must also take into account how people experience their own bodies and how that experience affects their ability to participate fully in everyday life.
Autonomy Beyond Rational Decision-Making
One of the central principles of bioethics is autonomy—the right of individuals to make decisions about their own health. Traditionally, this principle has been understood as the ability to make rational and informed decisions.
However, when the concept of the lived body is taken into account, autonomy acquires a broader meaning. The ability to decide does not depend only on rational thought but also on how individuals experience their bodies and their surroundings. The body forms part of identity and of our capacity to act in the world.
For this reason, some authors propose the concept of “embodied autonomy,” a form of autonomy that recognizes that our decisions are deeply linked to our bodily experiences and our relationships with others (Lewis and Holm 2023). In the context of obesity, this means that decisions about treatments—such as dieting or bariatric surgery—cannot be evaluated solely from a medical standpoint. They must also consider how the individual experiences their body, their expectations, their fears, and their life projects.
Well-Being Is Not Only About Losing Weight
Another principle of bioethics is beneficence, which implies acting in the best interest of the patient. In the treatment of obesity, this principle is often interpreted as achieving significant weight reduction. However, from the perspective of the lived body, well-being cannot be measured solely in kilograms.
A person may lose a considerable amount of weight and still experience a conflicted relationship with their body or with food. In some cases, even after bariatric surgery, individuals continue to face challenges related to body image or persistent eating habits (MacLean et al. 2015).
For this reason, some specialists suggest that the goal of treatment should focus more on improving quality of life and overall well-being rather than reaching a specific weight. This idea is also reflected in proposals such as the “Health at Every Size” paradigm, which prioritizes physical and psychological well-being over weight loss as the primary health goal (Tylka et al. 2014).
A More Human Medical Relationship
The phenomenological approach also invites us to rethink the relationship between doctors and patients. In many cases, medical care can become impersonal or centered exclusively on clinical indicators. This may cause patients to feel reduced to their diagnosis or their weight.
However, when the concept of the lived body is recognized, the clinical encounter can be understood as a relationship between two people who share a human experience. The physician does not simply observe a body but interacts with a person who has a history, emotions, and expectations.
This shift in perspective can encourage more empathetic communication and a more collaborative therapeutic relationship. Listening to patients’ experiences and acknowledging their concerns can help build trust and improve the effectiveness of treatments (Bąk-Sosnowska et al. 2022).
The Social Dimension of Obesity
Understanding obesity through the lens of the lived body also means recognizing that health does not depend solely on individual decisions. Factors such as the social environment, access to healthy foods, and the availability of safe spaces for physical activity significantly influence people’s health.
Various studies show that obesity is closely related to social determinants such as socioeconomic status, access to resources, and living conditions (Baez et al. 2023). Therefore, an ethical approach to obesity treatment cannot be limited to the clinical sphere. It must also consider public policies and social conditions that shape health outcomes.
To achieve this, it is essential to combat stigma, promote healthy environments, and ensure respectful treatment within healthcare systems. These steps are fundamental to improving the well-being of people living with obesity.
Toward an Ethics of the Lived Body
The concept of the lived body reminds us that health is a complex human experience. People do not live their bodies as machines that must simply meet medical parameters. Instead, the body is the place from which individuals feel, act, and build their identity.
Rethinking obesity from this perspective implies a paradigm shift—from an approach focused exclusively on weight control to a broader vision that recognizes bodily experience, dignity, and personal autonomy.
Ultimately, understanding obesity as an embodied experience does not mean abandoning medicine or prevention. Rather, it means enriching them with a more humane perspective. An ethics grounded in the lived body can help foster more respectful treatments, more just public policies, and a more inclusive society.
Referencies
Baez, A. S., et al. 2023. Social determinants of health, health disparities, and adiposity.
Bąk-Sosnowska, M., et al. 2022. Patient-centered care and the “people first” principle as a tool to prevent stigmatization of patients with obesity.
Gómez-Pérez, D., M. S. Ortiz, y J. L. Saiz. 2017. Estigma de obesidad, su impacto en las víctimas y en los equipos de salud.
Haga, B. M., et al. 2020. Putting life on hold: lived experiences of people with obesity.
Lewis, J., y S. Holm. 2023. Towards a concept of embodied autonomy.
MacLean, P. S., et al. 2015. The role for adipose tissue in weight regain after weight loss.
Merleau-Ponty, M., y D. Landes. 2013. Phenomenology of Perception.
Puhl, R. M., y C. A. Heuer. 2010. Obesity stigma: important considerations for public health.
Tremmel, M., et al. 2017. Economic burden of obesity: a systematic literature review.
Tylka, T. L., et al. 2014. The weight-inclusive versus weight-normative approach to health.