With over a third of Australia’s adult population overweight it is critical that messages regarding lifestyle change, weight maintenance, weight loss and treatment are appropriate. There has been some controversy regarding whether overweight should be considered unhealthy weight, in particular in the elderly and in those with chronic disease. There is also discussion regarding whether weight and body mass index are appropriate measures of adiposity in these groups. Here we analyse the epidemiological evidence behind the controversy to identify the areas of agreement and to provide recommendations on ways to move forward.