A bioethical and comprehensive approach to obesity towards human dignity and happiness
Abstract
Obesity is a complex and multifactorial public health problem that requires immediate attention through the redress of the social and structural determinants and social injustices that contribute to its development. The objective of this research is to propose a comprehensive bioethical approach to obesity that fosters human dignity and happiness, based on the experiences of people with excess body fat. This qualitative, descriptive study explored the experiences of people living with obesity who successfully completed the SIN MEDIDA program. Responses were categorized using the principles of thematic analysis. A total of 12 people from different socioeconomic levels recognized that programs aimed at this population group should promote learning and enjoyment, as well as provide psychological, physical, and social benefits with professional support. It is imperative that programs pursue a bioethical approach that initiates strong informed consent and is oriented toward human dignity. More importantly, it is imperative that treatments, interventions, and recommendations for people living with obesity guarantee their long-term happiness.
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Alfaro-Molina, J. G. (2022). El concepto de vida (βίος) para Aristóteles y su importancia en la ética eudaimonista. Apuntes de Bioética, 5(2), 5–18. https://doi.org/10.35383/apuntes.v5i2.779
Arrieta, F. & Pedro-Botet, J. (2021). Reconocer la obesidad como enfermedad: todo un reto. Revista Clínica Española, 221(9), 544–546. https://doi.org/10.1016/j.rce.2020.08.003
Asociación Mexicana de Agencias de Inteligencia de Mercado y Opinión (AMAI). (2022). Niveles socioeconómicos. https://www.amai.org/descargas/CUESTIONARIO_AMAI_2022.pdf
Barquera, S., Hernández-Barrera, L., Oviedo-Solís, C., Rodríguez-Ramírez, S., Monterrubio-Flores, E., Trejo-Valdivia B., Martínez-Tapia B., Galván-Valencia, O., Aguilar-Salinas, C., Chávez-Manzanera, E., Rivera-Dommarco J. & Campos-Nonato, I. (2024). Obesidad en adultos. Salud Publica Mex, 66, 414–424. https://doi.org/10.21149/15863
Barrera-Carranza, Y. Z. (2021). Ideal de cuerpo femenino y cultura de la dieta. Apuntes de Bioética, 4(2), 56–72. https://doi.org/10.35383/apuntes.v4i2.682
Bastos, M., Kovaleski, D. F. & Lima, B. (2024). Compreendendo o termo gordofobia médica a partir da perspectiva de pessoas gordas. Saúde e Sociedade, 33(1), e220842pt. https://doi.org/10.1590/S0104-12902024220842PT
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Cámara de Diputados del H. Congreso de la Unión. (2024). Ley General de Salud. https://www.diputados.gob.mx/LeyesBiblio/pdf/LGS.pdf
Capoccia, D., Milani, I., Colangeli, L., Parrotta, M. E., Leonetti, F. & Guglielmi, V. (2025). Social, cultural and ethnic determinants of obesity: From pathogenesis to treatment. Nutrition, Metabolism and Cardiovascular Diseases, 35(6). https://doi.org/10.1016/J.NUMECD.2025.103901
d’Empaire, G. (2010). Calidad de atención médica y principios éticos. Acta Bioethica, 16(2), 124–132. https://doi.org/10.4067/S1726-569X2010000200004
Eïd, J. & Desgrées du Loû, A. (2022). Empowerment-based support program for vulnerable populations living with diabetes, obesity or high blood pressure: a scoping review. BMC Public Health, 22(1), 2051. https://doi.org/10.1186/S12889-022-14480-3
Elío-Calvo, D. (2023). Los modelos biomédico y biopsicosocial en medicina. Revista Médica La Paz, 29(2), 112–117. http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1726-89582023000200112&lng=es&nrm=iso&tlng=es
Fung, T. T., Long, M. W., Hung, P. & Cheung, L. W. Y. (2016). An Expanded Model for Mindful Eating for Health Promotion and Sustainability: Issues and Challenges for Dietetics Practice. Journal of the Academy of Nutrition and Dietetics, 116(7), 1081–1086. https://doi.org/10.1016/j.jand.2016.03.013
García, E. A. G., Patiño, D. C. & Torres, A. R. (2024). Representaciones sociales de productos milagro en pacientes con obesidad y sobrepeso. International Journal of Professional Business Review, 9(11), e04989. https://doi.org/10.26668/businessreview/2024.v9i11.4989
García, M. Á. (2006). Los principios de la bioética y la inserción social de la práctica médica. Revista de Administración Sanitaria Siglo XXI, 4(2), 341–356.
Gobierno de México. (2022). Alertas sanitarias de publicidad engañosa. https://www.gob.mx/cofepris/documentos/alertas-sanitarias-de-publicidad-enganosa?state=published
Goodman, S., Armendariz, G. C., Corkum, A., Arellano, L., Jáuregui, A., Keeble, M., Marshall, J., Sacks, G., Thrasher, J. F., Vanderlee, L., White, C. M. & Hammond, D. (2021). Recall of government healthy eating campaigns by consumers in five countries. Public Health Nutrition, 24(13), 3986–4000. https://doi.org/10.1017/S1368980021001415
Guiza, M. del R. (2018). Desarrollo moral, vergüenza y obesidad. Psic-Obesidad, 8(31). https://doi.org/10.22201/FESZ.20075502E.2018.8.31.80707
Gunsalus, K. T. W., Mixon, J. K. & House, E. M. (2024). Medical Nutrition Education for Health, Not Harm: BMI, Weight Stigma, Eating Disorders, and Social Determinants of Health. Medical Science Educator, 34(3), 679–690. https://doi.org/10.1007/s40670-024-02025-9
Haros-Becerra, L. C. (2023). El concepto de felicidad en el transhumanismo y en la bioética realista. Apuntes de Bioética, 6(2), 30–43. https://doi.org/10.35383/apuntes.v6i2.997
Hassapidou, M., Vlassopoulos, A., Kalliostra, M., Govers, E., Mulrooney, H., Ells, L., Salas, X. R., Muscogiuri, G., Darleska, T. H., Busetto, L., Yumuk, V. D., Dicker, D., Halford, J., Woodward, E., Douglas, P., Brown, J. & Brown, T. (2023). European Association for the Study of Obesity Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Adults Developed in Collaboration with the European Federation of the Associations of Dietitians. Obesity Facts, 16(1), 11–28. https://doi.org/10.1159/000528083
Hernández, C. A. B. (2018). Análisis de la estrategia nacional para la prevención y control del sobrepeso, la obesidad y la diabetes en méxico 2013-2016. Encrucijada Revista Electrónica Del Centro de Estudios En Administración Pública, 30, 1–24. https://doi.org/10.22201/FCPYS.20071949E.2018.30.65672
Hernández-Leonardo, F. & Román-Rivera, D. I. (2025). Más allá de la balanza: Repensando la salud en un contexto de pesocentrismo. Journal of Behavior and Feeding, 4(8), 44–50. https://doi.org/10.32870/JBF.V4I8.62
Hudson, A., Batalha, L. & Ciarrochi, J. (2025). Higher-weight social identity as a risk and protective factor in the negative health consequences of weight stigma: a systematic review. International Journal of Obesity, 49, 1209–1228. https://doi.org/10.1038/s41366-025-01755-z
Laguna-Camacho, A. & Serrano-Plata, M. (2021). Efecto en el peso de una dieta casera en mujeres con sobrepeso u obesidad: un ensayo controlado aleatorizado. Behavioral Psychology/Psicología Conductual, 29(3), 743–762. https://doi.org/10.51668/bp.8321313s
Martínez, A. (2017). La consolidación del ambiente obesogénico en México. Estudios Sociales. Revista de Alimentación Contemporánea y Desarrollo Regional, 27(50). https://doi.org/10.24836/es.v27i50.454
Medina, F., Aguilar, A. & Solé-Sedeño, J. (2014). Aspectos sociales y culturales sobre la obesidad: reflexiones necesarias desde la salud pública. Nutrición Clínica y Dietética Hospitalaria, 34, 67–71. https://doi.org/10.12873/341medina
Medina‐Aedo, M., Beltran, J., Valli, C., Canelo‐Aybar, C., Song, Y., Ballester, M., Bowman‐Busato, J., Christogiannis, C., Grammatikopoulou, M. G., Groene, O., Heijmans, M., Hoogendorn, M., Killeen, S. L., Kontouli, K., Mavridis, D., Miñambres, I., Mueller, B. S., Niño de Guzman, E., Noordman, J., … Alonso‐Coello, P. (2024). Recommendations on self‐management interventions for adults living with obesity: COMPAR-EU project. Clinical Obesity, 14(4). https://doi.org/10.1111/cob.12667
Modesto, B. T., Bartholomeu, T., Basso, L., Riani Costa, L. A., Tinucci, T. & de Moraes Forjaz, C. L. (2021). Effects of a Real-Life Park-Based Physical Activity Interventional Program on Cardiovascular Risk and Physical Fitness. Preventing Chronic Disease, 18, E18. https://doi.org/10.5888/PCD18.200115
Moroshko, I., Brennan, L. & O’Brien, P. (2011). Predictors of dropout in weight loss interventions: a systematic review of the literature. Obesity Reviews, 12(11), 912–934. https://doi.org/10.1111/j.1467-789X.2011.00915.x
Muñoz, V., Jiménez, J. M., Vanegas, J. M. & Torres, C. A. (2024). Efectividad de un programa multidisciplinario para el manejo de la obesidad: cambio en la calidad de vida y en los parámetros clínicos, fisiológicos y antropométricos. Medicina Clínica Práctica, 7(1), 100404. https://doi.org/10.1016/j.mcpsp.2023.100404
Murillo-Godínez, G. (2019). Panaceas, medicinas alternativas y similares: el auge y triunfo de la pseudociencia médica. Medicina Interna de México, 35(1), 113–143. https://doi.org/10.24245/MIM.V35I1.2233
Neri, L. de C. L., Mariotti, F., Guglielmetti, M., Fiorini, S., Tagliabue, A. & Ferraris, C. (2024). Dropout in cognitive behavioral treatment in adults living with overweight and obesity: a systematic review. Frontiers in Nutrition, 11. https://doi.org/10.3389/fnut.2024.1250683
Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura. (2008). Derechos humanos y dignidad del individuo. https://unesdoc.unesco.org/ark:/48223/pf0000183348_spa
Payne, M. E., Porter Starr, K. N., Orenduff, M., Mulder, H. S., McDonald, S. R., Spira, A. P., Pieper, C. F. & Bales, C. W. (2018). Quality of Life and Mental Health in Older Adults with Obesity and Frailty: Associations with a Weight Loss Intervention. The Journal of Nutrition, Health and Aging, 22(10), 1259–1265. https://doi.org/10.1007/s12603-018-1127-0
Pérez, J. (2024). La Ética Aristotélica y su Devenir en la Modernidad. Ciencia Latina Revista Científica Multidisciplinar, 8(1), 5757–5775. https://doi.org/10.37811/cl_rcm.v8i1.9926
Pérez, J. G. (2024). Felicidad después del COVID-19: Estudio Cualitativo en Profesionales de Medicina y Enfermería en Yucatán. LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, 5(4). https://doi.org/10.56712/latam.v5i4.2292
Prats-Arimon, M., Puig-Llobet, M., Barceló-Peiró, O., Ribot-Domènech, I., Vilalta-Sererols, C., Fontecha-Valero, B., Heras-Ojeda, M., Agüera, Z., Lluch-Canut, T., Moreno-Poyato, A. & Moreno-Arroyo, M. C. (2024). An Interdisciplinary Intervention Based on Prescription of Physical Activity, Diet, and Positive Mental Health to Promote Healthy Lifestyle in Patients with Obesity: A Randomized Control Trial. Nutrients, 16(16), 2776. https://doi.org/10.3390/nu16162776
Rockström, J., Thilsted, S. H., Willett, W. C., Gordon, L. J., Herrero, M., Hicks, C. C., Mason-D’Croz, D., Rao, N., Springmann, M., Wright, E. C., Agustina, R., Bajaj, S., Bunge, A. C., Carducci, B., Conti, C., Covic, N., Fanzo, J., Forouhi, N., Gibson, M.,… DeClerck, F. (2025). The EAT–Lancet Commission on Healthy, Sustainable, and Just Food Systems. The Lancet, 406(10512), 1625–1700. https://doi.org/10.1016/S0140-6736(25)01201-2
Rotter, G., Ortiz, M., Binting, S., Tomzik, J., Reese, F., Roll, S., Brinkhaus, B. & Teut, M. (2022). Mindful Walking in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. Journal of Integrative and Complementary Medicine, 28(6), 474–483. https://doi.org/10.1089/jicm.2021.0361
Rubino, F., Cummings, D. E., Eckel, R. H., Cohen, R. V, Wilding, J. P. H., Brown, W. A., Stanford, F. C., Batterham, R. L., Farooqi, I. S., Farpour-Lambert, N. J., Roux, C. W. le, Sattar, N., Baur, L. A., Morrison, K. M., Misra, A., Kadowaki, T., Tham, K. W., Sumithran, P., Garvey, W. T., … Mingrone, G. (2025). Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology, 13(3), 221–262. https://doi.org/10.1016/S2213-8587(24)00316-4
Ruiz-Canizales, R. (2020). Obesidad, la otra pandemia. Un enfoque desde la bioética y el derecho a la no discriminación en México. Revista Colombiana de Bioética, 15(2), 1–17. https://doi.org/10.18270/rcb.v15i2.3203
Velazquez, A. (2025). Weight Stigma. Endocrinology and Metabolism Clinics of North America, 54(1), 9–16. https://doi.org/10.1016/j.ecl.2024.10.001
Villeda-Sánchez, M. A., Escoto, M. del C., Camacho, E. J. & Zalce, A. (2025). Efectos de intervención mindfulness sobre estrés, regulación emocional y alimentación intuitiva en adolescentes: estudio piloto. Ciencia Latina Revista Científica Multidisciplinar, 9(1), 4382–4398. https://doi.org/10.37811/cl_rcm.v9i1.16154
Williams, M. S., McKinney, S. J. & Cheskin, L. J. (2024). Social and Structural Determinants of Health and Social Injustices Contributing to Obesity Disparities. Current Obesity Reports, 13(3), 617. https://doi.org/10.1007/S13679-024-00578-9
Xu, J., Gu, X., Gu, J., Zhao, L., Li, M. & Hong, C. (2025). Motivational interviewing intervention for the management of hypertension: a meta-analysis. Frontiers in Cardiovascular Medicine, 11. https://doi.org/10.3389/fcvm.2024.1457039
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