"It isn't the word. It's the intention behind it."
--Judy Sullivan, Size Wise

Terminology can be a hot-button point for many issues. Writers have to walk a fine line between being too  "politically correct," yet recognizing the negative connotations of many common terms.

It can especially difficult to decide what words to use when writing about weight. This page is to discuss what terms I use on this site and why.

Why Use "Fat"

In the size-acceptance and Health At Every Size® movements*, there has been a trend to reclaim the word "fat." We feel it is part of empowering yourself to see that word simply as a physical description instead of a character assassination.

Unfortunately, many people have had the word "fat" used only negatively against them. They cannot hear it without all the judgment and venom attached to it ─ the voices of the past echo too strongly in their ears. And some people would literally rather die than have the word "fat" used about them.

However, "fat" is just an adjective, not a moral judgment ─ or it should be. If more of us reclaimed the word "fat," it would lose much of its negative power to hurt others, especially our vulnerable children as they grow up.

If "fat" makes you uncomfortable, feel free to use whatever term you prefer, but remember that when I use "fat" I mean it in a neutral way. Perhaps it's time to experiment with using it as part of your empowerment journey.

The Odious "O" Words

But why not use commonly-accepted terms like "overweight" and "obese"? Aren't we being too sensitive if we avoid these?  Aren't they just physical descriptors too?

The problem is the underlying assumptions behind these terms.  For example, the standards for determining what is normal change over time.  And "overweight" judges your weight by standards which may or may not be realistic for your body; some people cannot attain a "normal" BMI no matter how well they eat, or even after mutilating weight loss surgery. We feel that "overweight" is too arbitrary; if you are eating reasonably and getting reasonable exercise, then you are at the normal weight for your body.

As for the term "obese," the latin roots reveal the underlying medical bias about it:
from obesus "that has eaten itself fat," past participle of obedere "to eat all over, devour," from ob + edere
"Obese" just furthers the misperception that we are heavy because of overeating.  Yes, some people are fat because they eat too much, but this is not true for all heavy people.  By the medical definition, all heavy people are assumed to be eating too much.  As one blog notes:
Obese defines someone as a glutton, essentially, and that is a negative connotation if ever there was one. Obese isn't simply a word made hostile by doctors attaching modifiers such as "morbid" or "malignant" to "obesity". The word is very much judgmental to its core and we need to look past it to define ourselves.
In addition, "obese" implies pathology in modern medicine. If you are "obese," then something is wrong with you. It doesn't matter if you have normal eating and exercise habits and this is just how your body is; your normal state is pathological and abnormal and dangerous. In other words, you are seen as diseased.

Although some would argue that "obese" is simply a physical descriptor too, its usual medical use implies disease, pathology and abnormality. It is an ugly word, often one used to demonize people of size, and one often accompanied in medical research by judgmental adjectives like "massive" or "grotesque."

Therefore, most people of size strongly prefer any term other than "obese."  This is why the size acceptance community has adopted the word "fat" instead of "overweight" or "obese." Ironically, we find it more neutral.

Other Possible Terms

Of course, some people have so much negative experience around the word "fat" that they send me hate mail for using it here. So I have also looked hard for a term that is more universally-accepted.  This has not been an easy task.

"Plus-sized" is a fairly neutral term that seems to be well-accepted among most women. Because of the relative neutrality of the term to a wide spectrum of people and the catchy alliteration it presented, I chose this as the title of my main website, www.plus-size-pregnancy.org.  But I'm not crazy about the term.

At first, "women of size" felt overly politically-correct and stilted, but the more I used it, the more I liked it. It's physically descriptive without the emotional baggage, so I often use it when speaking to mixed audiences who may not be comfortable with "fat."

One term I have used at times is "BBW," which stands for Big Beautiful Woman.  This was a term popularized by various magazines in the past. I used this for its alliterative qualities in the section of my website called "BBW Birth Stories."  However, some women are uncomfortable with this term because it's often used by the subgroup of Fat Admirers who exploit fat women.  So I've veered away from using it, except in previously-named parts of my site.

There are many euphemisms for women of size.  "Zaftig" literally means "juicy" and "Rubenesque" refers to the bountiful physique memorialized by the painter Ruben. It is good to remember that the curvy physique of times past was considered much sexier than the stick-figure you see in Hollywood today. But unfortunately, many people are not familiar with these terms.

Other euphemisms can include words like "large," "chubby," "ample," "portly," "hefty," "big," "stout," "plump," "heavy," "pudgy," "voluptuous," "big-boned," "curvaceous," "bountiful," "fluffy," etc. Some people love these, but many people find them condescending and patronizing.  I use "large" and "big" and "heavy" at times for the sake of variety, but I tend to avoid the cutesy euphemisms.

Of course, context is everything. How the word is spoken and meant by the speaker ─ and the inherent judgments behind its use ─ become more important than the actual word. As Judy Sullivan notes, "It isn't the word. It's the intention behind it."


Another situation that can cause bad feelings is when we try to delineate differing degrees of fatness. "Morbid obesity," "severe obesity," "extreme obesity," "massive obesity," "grossly obese" or "grotesque obesity" are terms that have been coined by the medical community in the last 30 years or so to describe different levels of fatness.

Yet these terms are used inconsistently.  For example, "morbid obesity" in the research sometimes means BMI ≥ 35, and sometimes BMI ≥ 40.  Furthermore, words like "morbid," "severe," "extreme," "gross" or "grotesque" carry an inherent bias about fatness.  And after a while, authors start running out of superlatives to describe just how fat "fat" is, as demonstrated by these statements from the research literature:
  • "If only those women with morbid, gross, debilitating obesity (≥150% ideal body weight) are studied, the prevalence of obesity during pregnancy is 6-10%." (written by an endocrinologist)
  • "We will discuss those women with massive, morbid, gross debilitating obesity (i.e., those greater than 90 kg or 200 lbs.) before or during pregnancy."  (written by an OB)
Nearly every person of size loathes these over-the-top terms ─ yet there really does need to be a way to delineate different degrees of fatness when discussing the medical research.

So the size acceptance community came up with the term "supersized" (long before junkfood restaurants used it to describe extreme portions of food). Exact definitions differ, but it is most often used to mean people above 300 lbs., or above a size 26/28 or so.

The size acceptance community felt supersized was empowering because they came up with the term themselves, and it was descriptive without being truly demeaning. However, sometimes it engenders ill feelings, especially now that society uses it to describe extreme portions of junk food.

Thankfully, there has been a small move towards less emotionally-loaded terms in the medical literature recently.  Some researchers now refer to different classes of obesity:
  • Class I Obesity   = BMI 30-35
  • Class II Obesity  = BMI 35-40
  • Class III Obesity = BMI 40 and over
This is a step in the right direction, but has its limitations too.  Chief among these limitations is that it tops out at a BMI of 40+, when there are many degrees of fatness above that.  So a new category called "Super Obese" has come into use, and usually refers to people with a BMI over 50.

It can be useful to have categories that delineate degrees of fatness, but far too often these top categories imply that THIS size is the Armageddon of Fatness, the Fatpocalypse if you will.....yet many "Morbidly Obese" and "Super Obese" people are very healthy and active.

So, in summary, there does not seem to be any universally accepted method of describing degrees of fatness. Supersized is our best informal term for it, and the term best accepted by the size acceptance movement, but it is certainly less than completely ideal.

For the purposes of medical research, various "classes" of obesity (Class I, II, III etc.) can be used for uniformity of definition. Generally I prefer to avoid "morbidly obese" and terms like it, but when discussing medical research that uses such terms, sometimes I have to hold my nose and use the language of the study.

My Choice of Terminology

You may call yourself whatever term you prefer, but I use a wide variety of terms on the blog to reflect common usage by other people and for search engine optimization purposes.

I personally prefer "fat," but often also use "woman of size," "heavy," "large," or "plus-sized," as most people tend to find these fairly neutral.  A new term that has recently come into use is "high BMI," which, while not perfect, I also use sometimes.

Unfortunately, the odious "O" terms ("obesity" and "overweight") are the search terms most most used to find my blog. Using them helps with search engine optimization.

I also use "obese" and all its Fatpocalypse Variations when discussing research studies because that's the official medical terminology used in the studies. Using their lingo helps me reach care providers looking for information about pregnancy and obesity online, and helps them take my point of view more seriously.

So while I've had many approaches to the terminology issue over the years, in the end I've decided that getting the message out to those who need it most takes priority over people's personal terminology preferences.

As a result, I use a mix of terms, from the "o" words to "fat" to euphemisms. This makes my blog more likely to be found by a variety of people, and helps me preach not just to the choir but to folks new to the message and the care providers who need to hear an alternative perspective.

You can agree or disagree with my choice of terms, but it's the compromise that works best for me.

Other Women Write About "Fat" Terminology

One mom wrote:
I'd much rather be called "fat" or "super-sized" or "woman of size" than "morbidly obese". That makes it sound like I already have one foot in the grave and the other on a banana peel.
Another mom wrote:
A crash course in fat acceptance...in my mind, Step #1 is accepting that you are fat and that being fat does NOT equal being bad, ugly, dumb, stupid, lazy, dirty, irresponsible, or one-foot-in-the-grave. This is why people object to being called "fat", you do understand? "Fat" has been used as an epithet so much, people forget that it's just a word to describe a person, no different from "tall" or "brunette."

A lot of people in the fat acceptance community feel strongly about reclaiming the word "fat." Part of that is because it's unfair to use it as a word that means "bad" in some way. Part of it (at least for me) is just to stop tip-toeing around the issue and confront it head-on, like, I'd rather someone call me "fat" than "big-boned" or "plump" or "heavy-set" or anything like that. 
Various writers wrote about terminology at http://www.bigfatblog.com/discussions/archives/001289.php
I ...really hate "overweight" because it does assume that there is a magical weight we can be "over" and "obese", because it is a made-up name for a made-up disease, used as an excuse to prescribe a cure which does not work.

I think it is important to use the word "fat" as a rule---that is the only way to take the taint and the stigma from the word (which reminds me of something Lenny Bruce said about using certain words over and over again to divest them of power).

I looove the word 'fat'. It scares people. It's in-your-face. Imagine! A simple, descriptive word. People think when I describe myself as fat that I'm being self-deprecating. I have to tell them, no, I'm simply being descriptive.
Judy Sullivan says it so well in her book, Size Wise, www.sizewise.com:
Overwhelmingly the descriptive word of choice among individuals who have come to terms with being a larger-than-"normal" person is the word fat. It is time to decriminalize this word. I have chosen to use it on occasion throughout the book and on this web site and mean no offense to anyone. Those of you who just don't care for the term should feel free to mentally change each occurrence of fat to whatever word you prefer. I won't be offended...[But] it isn't the word. It's the intention behind it.

*Health At Every Size is a registered trademark of the Association for Size Diversity and Health (ASDAH) and used with permission.