Choosing words wisely when talking to patients about their weight

The study, which appears in the advance online publication of the International Journal of Obesity, examined adults’ perceptions of, and reactions to, common terms used to describe excess body weight by doctors. Researchers found that patients prefer that doctors use neutral language such as "unhealthy weight" rather than words that may be perceived as stigmatizing and blaming, such as "fat" or "morbidly obese."

The researchers conducted a national survey of American adults, asking their opinions about 10 common terms used to describe excess body weight. These terms included "weight," "unhealthy weight," "weight problem," "overweight," "high BMI," "heavy," "chubby," "obese," "fat," and "morbidly obese."

The words "weight" and "unhealthy weight" were rated as the most preferable terminology for doctors to use when discussing excess weight, and "morbidly obese," "fat" and "obese" were rated as the most stigmatizing and blaming. Participants also rated "unhealthy weight" and "overweight" to be the most motivating terms for encouraging weight loss, versus "fat" or "chubby" which were rated amongst the least motivating terms. These findings remained generally consistent regardless of sociodemographic factors and the participants’ own body weight.

High percentages of normal-weight, overweight, and obese participants reported that they would feel badly about themselves, embarrassed and upset if stigmatized about their weight by a doctor. Additionally, 19% of adults reported they would avoid future medical appointments, and 21% said they would seek a new health care provider if they felt their doctor had stigmatized them about their weight.

Health care providers play a key role in obesity prevention and treatment, but these findings suggest that the terminology doctors use to describe excess body weight may have important implications for a patient’s emotional and physical health, noted the researchers.

"Although health providers face significant challenges in efforts to prevent and treat obesity, their efforts must begin with a non-stigmatizing conversation with patients about weight and health," said lead author Rebecca Puhl, director of research at the Yale Rudd Center.

The authors assert that using weight-based terminology that is comfortable for patients may help facilitate a positive, productive discussion that communicates support and respect for patients in their efforts to become healthier, rather than instill stigma and blame.

The study can be viewed online.