From Division to Dialogue: Uniting Paradigms to Advance Obesity and Eating Disorder Treatment

Obesity is a complex, multifaceted phenomenon that intersects with biological, psychological, and sociocultural dimensions of health. In recent years, three major frameworks have proposed divergent definitions of obesity: the Health at Every Size (HAES) model, the 2024 European Association for the Study of Obesity (EASO) framework, and the 2025 Lancet Commission classification. HAES promotes a weight-neutral, behavior-centered approach grounded in well-being and the reduction of stigma—principles that have been formally endorsed by leading eating disorder organizations. In contrast, the EASO framework defines obesity as a chronic, relapsing disease requiring personalized, multidisciplinary care, while the Lancet Commission conceptualizes clinical obesity through the lens of adiposity-induced functional impairment, distinguishing between preclinical and clinical states. These models reflect deeper tensions in how obesity and eating disorders are defined, diagnosed, and treated. Yet, rather than treating these paradigms as mutually exclusive, this commentary argues for a synthesis that bridges their strengths. In the context of eating disorder prevention and treatment—where weight stigma, body image disturbance, and medical risk often coexist—integrating these frameworks offers an opportunity to build more person-centered, ethically sound, and clinically effective models of care. Uniting obesity paradigms in dialogue, rather than division, may enhance our capacity to deliver inclusive, evidence-based treatment that addresses the full complexity of weight-related health challenges.