If you are reading this and you live in a larger body, it is likely you have already tried almost everything. Changed what you eat. Moved more. Moved differently. Restarted plans with hope, only to meet disappointment. 

But what if obesity is not proof of failure, but evidence of a complex biological signal acting over time? 

Obesity is now recognized by the National Institutes of Health and global medical organizations as a chronic, relapsing, multifactorial disease. Genetics, neuroendocrine signaling, gut hormones, sleep disruption, stress physiology, medications, trauma, and environment all influence appetite regulation and fat storage. Research over the last year continues to confirm that the body actively defends its highest sustained weight through increased hunger signals and reduced energy expenditure after weight loss. 

Culture is not neutral. Traditional foodways across many societies supported health through shared meals, whole foods, and natural movement. Modern environments normalize ultra-processed foods, oversized portions, sedentary defaults and chronic stress. Personal responsibility still matters, but culture determines how difficult healthy choices are to sustain over time. 

Diet quality and movement remain essential pillars of health. A diverse, adequate, satisfying diet supports satiety, metabolic function and consistency. Physical activity improves insulin sensitivity, cardiovascular health, strength and mood, even when weight loss is modest. These practices are not moral tests; they are tools of care. 

In the past year, GLP-1 receptor agonists and related medications have reshaped obesity treatment. These therapies do not create discipline; they restore disrupted hunger and satiety signaling for many people. Their effectiveness reveals an important truth: When biology is supported, behavior often follows. Medications work best when paired with nutrition, movement and medical supervision, yet insurance coverage remains inconsistent. 

Responsibility still exists, but it is not synonymous with blame. Responsibility means seeking accurate information; addressing sleep, stress, trauma and medications; exploring nutrition, movement, therapy, pharmacologic or surgical options when appropriate; and advocating for care rather than accepting dismissal. 

And if you’re older and concerned about your weight? 

As a rule of thumb, keep an extra 10 to 15 pounds. Move often. Eat what you cook. Sleep. Get your body into fresh air daily if possible. Done.

Dear reader, once all reasonable avenues to manage obesity have been thoughtfully investigated and acted upon as your biology, access and life allow, may you honor and celebrate yourself—not as a problem to be fixed, but as a human being worthy of dignity, respect and a full life, exactly as you are.

Hedy Schneller is the founder of illumia Skincare, which features products crafted with local, fresh and healthy ingredients. In her previous professional life, Schneller was an occupational therapist and rehabilitation director. In addition to her work with illumia, she writes an opinion column for the River Reporter. Visit www.illumiaproducts.com.