The Language of Body Weight

Sometimes it’s not what is being said, but how it is said that matters. This seems to be the case when looking at how physicians speak to their patients about excess body weight.  A recent study published in the International Journal of Obesity addressed how certain weight-related terms are perceived by a diverse group of Americans, in the context of a healthcare provider referring to a patient’s excess weight. More than 1000 people completed an online survey to assess perceptions and preferences related to 10 common terms to describe body weight.  Researchers found that the terms that are perceived the most favorably were “weight” and “unhealthy weight”.  The terms that were most motivating to patients to lose weight were “unhealthy weight” and “overweight”.  On the other hand, the terms “fat”, “obese”, and “morbidly obese” had the most negative connotations,  with participants rating these terms as the most undesirable, stigmatizing, and blaming, when used by a healthcare provider.

Body weight should be an important point of discussion between healthcare providers and patients, as approximately two-thirds of Americans are now overweight or obese.  Yet, a physician’s choice of wording seems to have a large impact on how a patient will handle the issue. The study found that as much as 19 percent of participants reported they would avoid future medical appointments and 21 percent would seek a new doctor if they felt stigmatized about their weight from their doctor.

Another recent meta-analysis of more than 20 studies found similar results in regard to physicians talking about a child’s weight with parents. Researchers reported in the journal Pediatric Obesity that exchanging terms like “obese” and “overweight” with preferred terms like “large” or “gaining more weight” encourages families of overweight children to follow their doctor’s advice on weight management strategies. The study also found that doctors are often reluctant to talk about a child’s weight because they feel that the parents might get offended; on the other hand, parents usually wait for the doctor to initiate a conversation about the child’s weight. This lack of communication is not in the best interest of the child. How to treat and even address childhood obesity, however, is often a controversial and touchy subject. Last year the state of Georgia ran an anti-childhood obesity ad campaign that prompted quite a debate. Georgia has some of the highest obesity rates in the country, with 40 percent of its youth overweight or obese. Ads told parents to “stop sugarcoating” the issue of childhood obesity.  Overweight children were featured in the ads, with messages such as  “It’s hard to be a little girl when you’re not” and  “Fat prevention begins at home. And the buffet line”. Critics of the ad campaign said that they could stimulate further stigmatizing of overweight children. You can read more about childhood obesity and the Georgia campaign here.

Dr. Mona Misra, expert bariatric surgeon in Los Angeles commented on the new research. She said “these studies illustrate how important it is to understand the psyche of our patients. As experienced high-volume weight-loss surgeons, we understand how imperative it is to be sensitive to the needs of our patients, as we try to guide them through managing this chronic illness.  Our goal is to empower patients to lose weight and improve their overall health. We should make every effort to be aware of our vocabulary when talking to our patients, to encourage them to take action for themselves and their children. We have always known that obesity affects patients’ physical and mental health, so all healthcare providers should try and move them in a positive direction.”

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