**Abstract**

Most people are aware of how they look and, whether poor or positive, have an opinion about their image. Social media influencers, pressure from societal norms, media images, and even friends and family can impact body image. Body positivity has undoubtedly gone mainstream. Included in this movement are obesity acceptance and its demarginalization. However, the acceptance of overweight and obesity may undermine the decades-long progress made toward reducing risk factors for cardiovascular disease (CVD). Obesity is a global epidemic disease with risk factors that include hypertension, inflammation, heart attack, stroke, and diabetes. Obesity is also associated with obstructive sleep apnea. Positive body image is an important component of overall health. However, also maintaining a proper clinical definition and self-perception of what constitutes "normal" weight, coupled with weight management, regular exercise, and monitoring blood pressure and blood sugar, will continue progress toward reducing the risk of cardiovascular disease.

**Keywords:** obesity, overweight, weight gain, weight reduction, diet, body image, self-image, cardiovascular disease, hypertension, heart disease, stroke, diabetes

### **1. Introduction**

Obesity is a chronic disease with risk factors that include positive energy balance, resulting primarily from "obesogenic" changes that include economic growth, abundance, inexpensive and nutrient-poor food, industrialization, and sedentary lifestyles [1]. Comorbidities and sequelae associated with obesity include hypertension (HTN), inflammation, dyslipidemia, infertility, certain cancers, heart attack, stroke, type 2 diabetes, and obstructive sleep apnea [1, 2]. Weight stigmatization and its associated mental and behavioral consequences, economic burden, and premature death are also associated with obesity.

Historically, obesity went hand in hand with a poor sense of self-perception. Most people are aware of how they look, and whether poor or positive, have an opinion about their body image. Social media influencers, pressure from societal norms, and media images, as well as friends and family, all have an impact on body image. Over the past decade, the body positivity movement has undoubtedly gone mainstream. Often synonymous with this movement is fat acceptance, a movement focused on the demarginalization of the overweight or obese (OW/obese) population. Also mentioned in discussions of fat acceptance and fat rights activism is Health at Every Size® (HAES) as a public health approach to obesity. Yet, the acceptance of overweight and obesity in the absence of prevention or weight reduction threatens to undermine the decades-long progress made toward mitigating risk for cardiovascular disease (CVD).

Positive body image is indeed a necessary component of overall health and an important factor in determining one's ability to reach weight loss goals. An imperative complement to these movements, however, is adequate health literacy, or an ability to read, comprehend, and use information in a manner that promotes and maintains good health [3]. It is only with proper knowledge of what constitutes a clinical definition of "normal" weight versus higher weights associated with increased CVD risk, coupled with mindful weight management, regular exercise, monitoring blood pressure (BP), and maintenance of blood sugar, that will continue progress toward reducing CVD risk.
