Breaking the stigma: Understanding obesity as a chronic disease

Approximately 42% of U.S. adults are living with obesity, and its prevalence continues to grow. By 2035, an estimated 54% of adults will be overweight or living with obesity. I Despite the prevalence of obesity, several myths about the disease as a “lifestyle choice” (such as an unhealthy diet or lack of exercise) have led to harmful stigmas and undertreatment.

Living with obesity is a lifelong struggle that involves suffering on different levels. Unlike what is believed by many people and countries, obesity is a chronic disease, and patients need ongoing support. Patients need medical advice and help handling weight stigmatization.

On World Obesity Day, our team at Fortrea recently interviewed Sarah Le Brocq, who shared with us her experience living with obesity. There is a need to change the paradigm, and both healthcare professionals and society must engage with this change.

Living with obesity

Fortrea: Can you share your personal journey with obesity, including when it began and your treatments?

For much of my life, I believed I had always lived with obesity. But looking back at childhood photos, I now realize that wasn’t the case. I started puberty early, which made me feel different from my peers and led to negative thoughts about my body. This triggered a cycle of dieting, starting with restrictive eating in my mid-teens. At 16, I tried my first 800-calorie milkshake diet, which was just the beginning of many attempts to control my weight.

By the time I left university, I was living with obesity and spent my 20s trying every possible diet: low-carb, calorie-restrictive plans, fitness programs, and even diets based on blood type. In my late 20s, I participated in a weight-loss TV program, where I trained intensely and lost approximately 55 kgs (121 lbs). I believed I had finally found the answer.

However, despite maintaining an active lifestyle, my weight slowly returned to the previous size. This led me to feel frustrated but also triggered the need to explore the science behind obesity, where I learned about metabolic adaptation and set-point theory. It was eye-opening to realize that obesity isn’t just about willpower—there are biological factors that make long-term weight management incredibly challenging.

Experiencing bias in healthcare

Fortrea: As you visited healthcare providers, did you feel that your disease was treated with respect and understanding?

Throughout my journey, I’ve never truly felt that obesity was recognized as a chronic disease by healthcare professionals. Instead, it was often treated as a lifestyle issue—something I was simply expected to "fix" on my own.

Most medical advice I received was limited to recommendations like seeing a dietitian or adjusting my food choices, as if I just wasn’t getting it right. At one point, I was offered medications like Orlistat (a fat binder that prevents absorption of fat), but beyond that, the message was always the same: “Eat less, move more.”

There was little understanding, support or acknowledgment of the complexity of obesity. Instead, I often felt dismissed, as if my struggles were entirely my own responsibility. This lack of compassion made the journey even more isolating, reinforcing the idea that real medical help simply wasn’t available for people living with obesity.

Understanding the changes needed in obesity treatment

Fortrea: While progress is being made in recognizing obesity as a chronic disease, there is still limited awareness of obesity as a disease. In your opinion, what changes are needed to improve how obesity is treated and supported?

To truly improve how we treat and support people living with obesity, we must first recognize it as a chronic disease—something that many countries still fail to do. For example, the EU has yet to classify obesity as a chronic condition, which reinforces the outdated perception that it is simply a lifestyle choice rather than a complex medical issue.

A major shift is needed in education and awareness. People must understand that obesity is influenced by far more than just diet and exercise. Factors like genetics, environment, socioeconomic status, and access to healthcare all play a significant role. Until we acknowledge these complexities, stigma will persist, and those affected will continue to feel blamed for their disease.

Beyond awareness, access to proper care and treatment must improve. Right now, there is a lack of investment in obesity care, and many people struggle to access the medical support they need. Without proper funding and resources, meaningful change will be difficult to achieve. A comprehensive, systems-based approach is essential to ensure that individuals receive the care and support they deserve.

Shifting the focus to support

Fortrea: Is there anything else you’d like to share about your experience living with this chronic disease?

I’d like people to understand that living in a larger body is not a choice. For those of us living with obesity, it’s not just about the physical aspects—it’s about the daily struggles and the emotional toll it takes. We need more empathy and support, not judgment.

For years, I felt like I had to justify my existence because of the body I live in, and that’s exhausting. The constant shame and judgment aren’t helpful. What’s needed is kindness and a recognition that obesity is a chronic disease. We need to shift our focus to supporting those living with it rather than stigmatizing them. It’s time to approach the situation with understanding, not condemnation.

Fortrea’s role in addressing misconceptions about obesity

At Fortrea, we believe it is time to accept obesity as a chronic, complex disease that requires proper care and understanding. Like many other metabolic diseases, the consequence of a genetic predisposition and an obesogenic environment. While health coverage for obesity remains limited worldwide, the recent publication of the definition of “clinical” obesity is expected to help in future policy changes and health coverage. We need more education at all levels with the help of the scientific and medical community.

Patients with obesity deserve better. Let’s stop the stigma, start the conversation and focus on treatment and care.

Learn more about our experience in advancing obesity drug development: https://www.fortrea.com/therapeutics/obesity