Obesity, Anorexia, Identity, and the Power of Words: 5 Things We Must Understand Before We Use a Label

Last Week, I Wrote About GLP 1, Hunger, and Silence

Last week, I wrote about GLP 1 medications, the silence of hunger, and the importance of not calling something “success” before we understand the full emotional, physical, and psychological experience behind it.

You can read that blog here.

This week, I want to continue that conversation by looking at another part of health that is often misunderstood.

Language.

More specifically, the language we use when we talk about obesity, anorexia, diagnosis, identity, and shame.

A Conversation That Stayed With Me

I recently had a meaningful discussion with Dr. Russell Gura, an Internist who focuses on obesity and weight management in his private practice.

The conversation began with one word:

Obesity.

And then, as many of my conversations do, it became a much deeper discussion about language, identity, stigma, medical terminology, and the power of words.

We talked about the difference between saying:

“Someone is obese”

and saying:

“Someone has obesity.”

Dr. Gura made an important point. He explained that there is nothing inherently wrong with the word obesity. The problem, he said, is often the intention behind the word and the way it is used.

As he explained:

“If you say someone is obese, that is labeling and can feel negative. If you say someone has obesity, you are identifying a medical condition. In that situation, you are not implying anything negative. You are stating a medical fact.”

And I agree with him.

There is a real difference between using a word as an identity and using it as a description of a medical condition.

But the conversation also made me think about something deeper.

Even when we use person first language, such as “a person with obesity,” we still have to ask:

How does the word land on the person hearing it?

Because words are not only medical.

Words are emotional.

Words are relational.

Words carry history.

Words can either create safety, or they can create shame.

This Is Not About Blame

This is not about blaming doctors.

This is not about blaming parents.

This is not about blaming professionals who use medical language.

And it is not about pretending that medical conditions do not need names.

They do.

Doctors need language to diagnose, study, treat, communicate, and support people.

But we also need to remember something very important:

A medical word can still become painful when it is used as a label.

That is where the conversation becomes more complicated.

Because while “has obesity” is very different from “is obese,” the word obesity itself may still carry shame for many people.

And that matters.

This Is Not Only About Obesity

This conversation immediately made me think about my own doctoral research with individuals who have lived with long term anorexia nervosa.

Again and again, participants described the pain of being reduced to the illness.

They did not only describe anorexia as something they had.

Many described how, over time, the illness became attached to their identity.

Not because they chose that identity.

But because of how others spoke to them, treated them, described them, and responded to them.

Words like:

“She is anorexic.”

“That anorexic girl.”

“She looks so anorexic.”

may seem casual to the person saying them.

But to the person hearing them, those words can feel exposing, reducing, and deeply unsafe.

In my research, one of the most important findings was that language does not only describe illness.

Language can shape how individuals experience themselves within the illness.

When people are repeatedly spoken to as if they are the diagnosis, they may begin to feel that the diagnosis is who they are.

That is why language matters so much.

What Is Person First Language?

Person first language means that we name the person before we name the condition.

Instead of saying:

“an obese patient”

we say:

“a patient with obesity”

Instead of saying:

“an anorexic girl”

we say:

“a girl with anorexia”

Instead of saying:

“she is anorexic”

we say:

“she is living with anorexia”

The point is not to make language more complicated.

The point is to make language more human.

Person first language reminds us that a diagnosis is something a person may experience.

It is not who they are.

It is not their whole identity.

It is not the full story of their life.

But Here Is the Question

If we change the sentence, do we also change the experience?

Here are 5 things we must understand.

1. “You Are” Feels Different Than “You Have”

There is a big difference between saying:

“You are obese”

and saying:

“You have obesity.”

There is also a big difference between saying:

“She is anorexic”

and saying:

“She has anorexia.”

“You are” can sound like identity.

“You have” separates the person from the condition.

“You are” can feel permanent.

“You have” leaves room for complexity, support, treatment, healing, and change.

This is why Dr. Gura’s point is so important.

When we say someone has obesity, we are not saying obesity is who they are.

We are saying this is one medical condition they may be living with.

That distinction matters.

2. A Medical Word Can Still Carry Shame

At the same time, we have to be honest.

For many people, the word obesity does not feel neutral.

It may sound like judgment.

It may sound like blame.

It may bring up years of being criticized, watched, measured, shamed, or misunderstood.

The same is true with anorexia.

For many individuals with anorexia, the word itself may be connected to years of fear, secrecy, control, treatment, misunderstanding, and shame.

So even when professionals use clinical language correctly, the person hearing it may not experience it as neutral.

That does not mean the professional meant harm.

It means we need to understand that words have histories.

And people carry those histories in their bodies.

This may also help explain why public health language in places like Japan shifted much of its focus toward metabolic syndrome, sometimes called “metabo,” rather than centering the word obesity alone. It is not that the medical word obesity fully disappeared. It is that the language moved more toward metabolic health, risk, and prevention. That shift matters because language can change what people focus on and how safe or stigmatized they may feel.

3. Labels Can Become Identity

One of the clearest findings from my research is that language can become part of identity.

When someone is repeatedly called anorexic, the illness can begin to feel like the only part of them that others see.

When someone is repeatedly called obese, their body can begin to feel like the main thing others notice.

The label becomes bigger than the person.

And over time, that can affect how someone speaks to themselves.

This is why the power of words is not a small issue.

Words can shape the inner voice.

Words can shape shame.

Words can shape silence.

Words can shape whether someone feels safe enough to ask for help.

In my research, participants often described how invalidating, blaming, or reducing language made it harder to speak honestly.

When words felt unsafe, silence became protection.

That finding matters deeply.

Because healing requires safety.

And safety requires language that does not reduce a person to a diagnosis.

4. Professionals Must Pay Attention to the Words They Use

Professionals have power.

Doctors, therapists, dietitians, teachers, parents, and caregivers all use words that can stay with someone for years.

Sometimes forever.

This does not mean professionals need to be perfect.

It means they need to be aware.

Before we use a label, we can ask ourselves:

Am I describing a condition, or am I defining a person?

Will this word help the person feel safe enough to engage?

Could this word create shame, even if I do not mean it that way?

Is there a more human way to say this?

That is the heart of language informed care.

It is not only about what we say.

It is about how the person experiences what we say.

5. The Goal Is Not Perfect Language. The Goal Is Safer Language.

I do not believe the answer is to make everyone afraid to speak.

That creates more silence.

The goal is not perfect language.

The goal is safer language.

The goal is to speak in a way that protects dignity.

The goal is to remember that every person is more than one word.

A better way to begin may be:

“Can we talk about your health in a way that feels respectful to you?”

“What language feels safe when we talk about weight?”

“What language feels safe when we talk about your eating disorder?”

“I want to discuss this medically, but I also want to make sure you do not feel judged.”

“You are not the diagnosis. You are a person, and this is one part of what we are trying to understand.”

That small shift can change the entire conversation.

Where Language Changes Everything

When someone hears:

“You are obese”

they may feel labeled.

When someone hears:

“You have obesity”

they may feel slightly more separated from the diagnosis.

When someone hears:

“She is anorexic”

they may feel reduced to the illness.

When someone hears:

“She has anorexia”

they may feel there is still a person beyond the diagnosis.

But when someone hears:

“I want to understand your experience without reducing you to a word,”

they may feel human again.

And that is the real goal.

Not just better terminology.

Better connection.

Better care.

Better safety.

A Different Way to Think About This

Through The Bespoke KARMA Method™:

K = Knowledge and Awareness

Before we use a word, we must understand its impact.

Before we label someone, we must ask what the label may do to their sense of self.

Before we talk about weight, food, or illness, we must remember that the body carries stories.

And before we assume someone feels safe, we must listen.

Because sometimes the issue is not only the word itself.

It is the history attached to the word.

It is the tone.

It is the relationship.

It is the silence that follows.

What This Conversation Taught Me

My conversation with Dr. Russell Gura helped me see both sides more clearly.

He is right.

There is a meaningful difference between saying “someone is obese” and saying “someone has obesity.”

One sounds like an identity.

The other describes a medical condition.

But I also believe we have to go one step further.

Even when we use person-first language, we still need to recognize that certain words may carry pain, stigma, and shame because of how they have been used socially and personally.

This is especially true for people who have spent years feeling judged by their body, their food, their symptoms, or their diagnosis.

A Final Thought

Words are not just words.

Words can become mirrors.

Words can become wounds.

Words can become identities.

But words can also become bridges.

They can help someone feel seen.

They can help someone feel safe.

They can help someone remember that they are more than a diagnosis, more than a body, more than a symptom, and more than a label.

As I often say:

Words do not only describe our reality. They can shape the way we experience ourselves, our relationships, and our healing.

So yes, there is a difference between saying:

“You are obese”

and saying:

“You have obesity.”

And there is a difference between saying:

“She is anorexic”

and saying:

“She has anorexia.”

But the bigger question is:

Can we speak in a way that helps people feel human, safe, and understood?

That is where healing begins.

Ask Your Question

If you are a teen, parent, or professional navigating questions about body image, food, weight, shame, eating disorders, relationships, communication, or mental health, you can write anonymously to The Sunday Compass.

Submit here:

https://www.bespokewellnesspartners.com/about-1-1

“The words we choose are never neutral. They either close a door or open one. And sometimes, the difference between shame and healing begins with a single sentence.” — Dr. Limor Weinstein

About Dr. Limor Weinstein

Dr. Limor Weinstein is a Licensed Mental Health Counselor, relationship and communication expert, and the founder of The Bespoke KARMA Method™. Transactional analysis and polyvagal theory are the foundation of the method, along with practical DBT-based skills and the science of self-love. Dr. Weinstein’s long research with individuals with (long term "anorexia nervosa") investigates how language and communication, including what is spoken and what remains unspoken, can contribute to a lack of psychological safety in relationships and influence how individuals experience the illness.

If you are ready to strengthen your communication, set clear boundaries without escalating, and build healthier relationships, you can join one of Dr. Weinstein’s relationship and communication groups. These groups are designed to help you practice these skills in real time in a supportive, guided setting.

Click here to learn more about upcoming groups and reserve your spot:

Accepted insurance plans: United HealthCare, Aetna, and David Shield.

Thank you for reading!

Your words. your power.

Love

Limor