Control and pathologization of fat bodies: conceptual bases of so-called “Obesity” in Brazilian protocols

Abstract

Protocols are recommendations systematically developed based on scientific evidence to healthcare professionals in their decision-making. "Obesity" has been classified as a disease since 1948; however, studies indicate that this classification was not based on scientific, epidemiological, or laboratory evidence. This article aimed to identify the main protocols regarding "obesity" currently in use in Brazil and to analyze how they conceptualize “obesity”. A document analysis of five Brazilian protocols was conducted, revealing that the majority (four) use Body Mass Index (BMI) as a diagnostic criterion, even though the protocols themselves acknowledge the instrument's flaws. While there is a commitment to evidence-based science, quantitative studies are often overvalued, once they are not always sufficient to address questions regarding anomalies within the current scientific paradigm. The continued pathologization and medicalization of fat bodies, grounded in a fragile and biased conceptualization, reinforces the biopolitics of "obesity," wherein the control of body mass serves as a means of controlling bodies deemed deviant; this perpetuates fatphobia and anti-fat hatred, denying fat people access to human rights. Keywords: Obesity, Medicalization, Pathologization, Fatphobia.