Inquisitive.me

We normalized something dangerous.

There’s something strange happening right now.

The more often we see something, the more normal it starts to feel — even when it slowly destroys us.

Stress became normal.
Sleeping five hours became normal.
Being constantly busy became normal.
Living with pain became normal.

And obesity quietly became normal, too.

Not because it’s harmless.
But because we see it everywhere.

The human brain is fascinating like that. Repeated exposure changes perception. The more often we encounter something, the less alarming it feels. Eventually, we stop questioning it altogether.

I once had a patient who became stressed because he wasn’t stressed.

His coworkers constantly complained about how overwhelmed and exhausted they were.
Meanwhile, he felt relatively calm. Until he started wondering if something was wrong with him because he didn’t feel permanently overwhelmed like everyone else around him.

That’s how powerful normalization is.

And I think something similar happened with obesity.

Not because people are stupid.
Not because they’re lazy.
And definitely not because they deserve shame.

But because we slowly drifted into a culture where we became uncomfortable telling the difference between compassion and denial.

And those are not the same thing.

This Is Not a Post About Shaming People 🔔

Before we continue, I want to make something very clear.

This is not:

• a “just lose weight” article
• a body shaming post
• a “skinny = healthy” argument
• an attack on overweight people

I work with these people every single day. And if there’s one thing I learned, it’s this:

Most people with obesity already know they have a problem.

Within the first few minutes of treatment, many of them say something like:

“Yeah, I know… I should lose weight.”

They already carry the guilt.
They already carry the shame.
What they often don’t carry is understanding.

Because medicine is surprisingly bad at this sometimes.

“Lose weight” gets thrown around constantly, but many people never receive:

• practical help
• realistic guidance
• behavioral support
• understanding of why change feels so difficult

And that matters.

Because obesity is not just a willpower problem.
It’s biological.
Behavioral.
Psychological.
Environmental.
Social.

Food is not just calories.

Sometimes food is comfort.
Sometimes food is routine.
Sometimes food is identity.
Sometimes food is connection.

I once had a patient who genuinely wanted to become healthier. But his wife cooked every meal and became upset whenever he tried changing his eating habits. So he kept eating the same way because maintaining peace in the relationship felt emotionally safer than changing his health behaviors.

Humans are complicated.

That’s why simplistic advice fails so often.

The Original Idea of Body Positivity Wasn’t Wrong 💛

Honestly, I understand why the body positivity movement started.

Nobody deserves to hate themselves.

Nobody deserves humiliation because of their body.

And as a physiotherapist, body positivity means something important to me:

• feeling safe enough to move
• not being afraid of exercise
• not seeing your body as the enemy
• understanding that pain and worth are not the same thing

That part matters.

But somewhere along the way, something shifted.

Acceptance slowly turned into avoidance.

And in some spaces, “don’t shame people” became:

“pretend obesity has no serious consequences.”

That’s where I disagree.

Because compassion should reduce shame.
Not remove reality.

Obesity Is Not Just “Extra Weight” 🧬

One of the biggest misunderstandings around obesity is thinking it’s only a mechanical problem.

People imagine:

“More weight = more pressure on joints.”

And yes, partly.

But the story is much bigger than that.

Fat tissue is not inactive storage. It’s biologically active tissue.

Especially visceral fat — the fat surrounding the organs — can become metabolically problematic. There’s even a term for this dysfunctional fat tissue: adiposopathy or “sick fat.”

And I think this concept is crucial to understand.

At first, the body handles excess energy surprisingly well. It stores it in fat cells. New fat cells get recruited and expanded. Up to a point, this is actually an adaptive mechanism.

But eventually, the system gets overwhelmed.

The fat cells continue expanding, blood supply can no longer keep up properly and the tissue becomes stressed. Some cells become deprived of oxygen, start malfunctioning and eventually rupture. The immune system reacts to this by sending inflammatory cells into the tissue to clean up the damage.

The result?

A state of chronic low-grade inflammation.

The fat tissue itself begins releasing inflammatory signaling molecules — adipokines — into the body.

And this is where obesity stops being “just extra weight.”

Because this chronic inflammatory environment influences:

• insulin resistance
• cardiovascular disease
• recovery capacity
• hormone balance
• fatty liver disease
• blood pressure
• pain sensitivity
• healing processes

This is why obesity is associated with:

• type 2 diabetes
• cardiovascular disease
• hypertension
• certain cancers
• increased all-cause mortality

And this is also why obesity is recognized as a disease.

And to be clear: this doesn’t suddenly mean that being “only overweight” is harmless.

Overweight is often the stage before obesity. The physiological stress can already begin long before someone officially crosses the BMI threshold into obesity.

Not every overweight person is metabolically unhealthy, of course. Biology is more nuanced than that. But statistically, risk factors already begin increasing with rising body fat levels — especially when visceral fat, inactivity, poor sleep and low muscle mass enter the equation.

So this isn’t a binary distinction between:

“healthy” and “diseased.”

It’s more of a spectrum.

And many people slowly slide along that spectrum for years without realizing it.

The difficult part is that many of these consequences remain invisible for years.

That’s what makes obesity or being overweight so deceptive.

You can feel relatively okay while the internal stress slowly accumulates in the background.

The Problem Is Bigger Than Weight 🌍

But here’s where I think many discussions completely miss the point.

We don’t just have an obesity problem.

And to be precise: obesity itself is not simply a lifestyle problem.

Obesity is an actual illness.

But it can be the result of a lifestyle problem.

And even that explanation is incomplete because obesity, just like chronic pain, is multifactorial.

Genetics matter. Environment matters. Sleep matters. Stress matters. Trauma matters. Food environment matters. Social dynamics matter. Mental health matters.

Human biology is messy.

But lifestyle still plays a massive role in how this entire system evolves over time.

And that’s where I think we have a societal problem.

We have a culture problem.

We built environments that quietly push humans toward:

• chronic stress
• sleep deprivation
• hyperpalatable food
• convenience
• inactivity
• isolation
• constant mental overload

And then we act surprised when health falls apart.

Our culture glorifies burnout.

People proudly talk about:

• never stopping
• never resting
• never sleeping
• constantly hustling

Meanwhile:

• movement disappears
• muscle disappears
• recovery disappears
• health becomes optional

And eventually the body sends the invoice.

Not immediately.
But slowly.

That’s why I find it dangerous when obesity discussions become purely aesthetic.

Because this isn’t about beach bodies.

It’s about:

• energy
• independence
• resilience
• mobility
• survivability
• quality of life

The Missing Conversation Might Be Muscle 💪🏻

Ironically, I think we focus too much on fat and not enough on muscle.

Because muscle changes everything.

Muscle is protective tissue.

When skeletal muscle contracts during exercise, it releases substances called myokines. These influence:

• inflammation
• metabolism
• mood
• brain health
• insulin sensitivity

In many ways, myokines act like the physiological opponent of the inflammatory adipokines released from excessive dysfunctional fat tissue.

Movement literally changes the chemical environment inside the body.

And one of the strongest predictors of aging well is not simply “being thin.”

It’s maintaining muscle mass and movement capacity.

I recently saw a fascinating image comparing the thighs of:

• a 40-year-old athlete
• a sedentary 74-year-old
• a trained 74-year-old athlete

The sedentary older adult had dramatically less muscle and significantly more fat infiltration.

But the trained 74-year-old looked shockingly similar to the younger athlete.

That image honestly says more than a thousand motivational quotes ever could.

Because the goal isn’t becoming shredded.

The goal is keeping your freedom.

But I didn’t only see this in studies.

I met it in real life.

My grandmother fractured her femur at 88 years old. The surgeon told us he had rarely seen someone her age with that much muscle mass.

She wasn’t some fitness influencer.

She simply:

• walked daily
• moved throughout the day
• did small morning exercises
• used an ergometer while watching the news
• stayed physically engaged with life

Movement was normal to her.

And I truly believe that saved her for many years.

Right now, she’s probably in the last days, weeks or months of her life. We honestly don’t know.

But I will probably talk about her until the day I die because she became living proof of something I deeply believe in:
Movement matters.

Not because it makes you look better.

Because it keeps you alive longer.
Capable longer.
Independent longer.

No joke, I recently had a patient who got my grandmother stuck in her head after I told her her story.

And honestly?

Good.

Because I think we need more examples like that.

Why Quick Fixes Usually Fail 💉

Now we arrive at Ozempic.

And honestly? I don’t think these medications are evil at all.

GLP-1 drugs work remarkably well for many people.

They reduce appetite — which is exactly where many people struggle and why simplistic advice like “just listen to your body” or intuitive eating often doesn’t work properly for people with obesity or disordered eating patterns. Their hunger and satiety signals are often already dysregulated.

They help create an energy deficit.

They also lower inflammation and improve insulin resistance.

They can dramatically improve health outcomes.

That’s not controversial.

And I think it’s important to say this clearly because some people talk about these medications as if using them is somehow morally wrong.

It isn’t.

The obesity crisis became severe enough that we developed pharmaceutical tools to help people fight the biological side of the problem.

And unlike many restrictive crash diets, GLP-1 medications usually don’t force weight loss through pure willpower and suffering.

They lower the biological resistance to weight loss.

That’s exactly why many people suddenly succeed with these medications after failing countless diets before.

Their physiology changes.

And honestly, I think Ozempic can sometimes function like a gate.

Just like very basic movement can become the gate toward exercise for someone in pain.

A person with severe pain often cannot jump directly into intense training. First, they need enough symptom reduction, enough confidence and enough physical capacity to even enter the next stage.

I think GLP-1 medication can work similarly for some people with obesity.

Not as the final solution.

But as an entry point.

A tool that lowers the physiological resistance enough that sustainable habits, movement and behavioral change suddenly become more realistic and accessible.

The constant hunger quiets down. The food noise becomes less aggressive. The body stops fighting every calorie deficit as hard.

That matters.

But this is also where I think people misunderstand the situation.

Because changing physiology is not automatically the same thing as changing behavior.

If someone:

• loses muscle
• never learns new habits
• never changes routines
• never improves sleep
• never improves movement
• never changes their environment

then stopping the medication often leads right back to the starting point — just like many restrictive diets people tried before.

Not because they failed morally.

But because biology usually wins against temporary motivation.

I Think Many People Feel Trapped 🪤

One reason I care about this topic is because I see the suffering daily.

People whose bodies slowly became prisons.

People who:

• can’t get off the floor easily
• avoid stairs
• struggle tying their shoes
• become breathless from simple tasks
• live with constant pain and exhaustion

And many of them genuinely feel misunderstood.

Some doctors tell them:

“You just need to lose weight.”

And technically that’s true.

But it doesn’t work like that.

Humans are not purely rational creatures.

If we were, nobody would smoke anymore. Nobody would drink too much alcohol. Nobody would doomscroll until 2 a.m. despite knowing they have to wake up early.

Knowledge alone rarely changes behavior.

Telling someone with obesity:

“You just need to lose weight.”

is often about as helpful as telling a depressed person to:

“Just smile a little.”

It ignores how complex human behavior actually is.

Truth without support often just creates shame.

I think people need both:

• honesty
• and compassion

Because pretending obesity is harmless doesn’t help people.

But neither does humiliating them.

Maybe Health Starts Smaller Than We Think 🚶

One thing I learned from rehabilitation is this:

Small changes matter far more than dramatic intentions.

A short walk after meals can improve glucose regulation.

Better sleep can improve hunger regulation.

More protein can protect muscle mass.

Ten minutes of movement is infinitely better than none.

Health doesn’t suddenly appear after one perfect transformation.

It’s usually built through hundreds of tiny negotiations with yourself.

And no, it’s not easy.

Especially when:

• stress is high
• sleep is poor
• habits are deeply wired
• food became emotional support
• the environment constantly pushes convenience

That’s exactly why compassion matters.

But compassion should help people move forward.

Not convince them there’s no fire.

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📝 Key takeaways

• Compassion and honesty can exist together.
• Obesity is not just an aesthetic issue, but a metabolic and inflammatory condition.
• The normalization of obesity does not make it harmless.
• Most people with obesity already know they struggle — shame is rarely the missing ingredient.
• Sustainable lifestyle change matters more than temporary motivation.
• Muscle, movement, sleep, and daily habits may matter more long-term than chasing perfection.
• The goal isn’t becoming flawless. The goal is keeping your freedom for as long as possible.