Reframing Obesity: Physiological Mechanisms, Clinical Diagnosis, and Implications for Metabolic Bariatric Surgery

Obesity remains one of the most misunderstood and stigmatized chronic diseases, often reduced to a matter of personal responsibility and measured solely by corpulence through body mass index (BMI). This oversimplification has led to inadequate care, persistent stigma, and limited access to evidence-based treatments, including metabolic bariatric surgery (MBS) and pharmacological therapies. Despite growing recognition of its biological and systemic roots, obesity is still commonly framed as a risk factor and a harbinger for other diseases—including type 2 diabetes, cardiovascular disease, and various malignancies—rather than a standalone disease.