Abstract Introduction This article reviews the ethical issues surrounding obesity in public health and clinical contexts. We examine how obesity intersects with medical and social norms that raise questions of liberty, fairness, safety, and effectiveness or consequences. Sources of data PubMed, Cochrane Library, and Google Scholar. Areas of agreement We identify three main areas of agreement that are pertinent to ethical analysis of obesity: stigma is considered harmful, there needs to be a more-than personal responsibility approach, and a general acceptance of a global rise in body weight. Areas of controversy There are many areas of controversy, we limit our focus to four: conflicts of interest in the creation of guidelines and policies, mortality rates, whether weight is a meaningful proxy for health, and how to treat childhood obesity. Areas timely for developing research Post-genomic explanations, such as exposure to endocrine disrupting toxins, and development of epigenomics and microbiomics in the form of personalized nutrition are two developing areas we identify.