Seek First to Understand

Disordered Eating and Eating Disorders in Pediatric Obesity: Assessment and Next Steps

“…Additionally, using the language children and adolescents use when describing their weight can help youth feel heard and understood during these conversations. Recent research has shown that this is particularly relevant when talking with Black and Latine youth, who report a preference for words such as "thick" and "curvy" to describe their weight [51,52]. Table 3 provides specific and practical language that can be used to both begin the conversation related to eating behaviors and begin treatment of challenging and changing DEBs.…”

Weight stigma and bias: A guide for pediatric clinicians

“…Pediatric clinicians and support staff may be one of the few groups providing tangible support to an individual child vulnerable to weight stigmatization. Words matter: In addition to asking permission to talk about weight, take an additional step and ask patients about their preferred terms [ 35 ]. Children and adolescents dislike terms like “’[morbidly or extremely] obese,” “fat,” or “large” as they trigger feelings of guilt and shame [ 3 , 19 , 36 ].…”

“…Among all groups, “healthy weight” and “normal weight” are generally the most preferred terms. These nuanced differences in preferred terms demonstrates the importance of communicating with patients to identify their desired terms [ 35 , 37 ]. Table 1 provides additional guidance Provide a welcoming clinic environment : An organization that has appropriate resources for patients with obesity validates the level of concern for a patient's safety, comfort, and physical and psychosocial needs [ 38 ].…”

Pivot from Pain to Productive: Conversations about Weight Management in Youth with Obesity

“…Considering that obesity is a complex, chronic disease that affects the emotional, medical, and physical health of affected youth, a nuanced approach is needed in order to develop effective treatment plans to encourage or maintain physical activity (3,23). This article introduces ways to pivot the conversation from musculoskeletal pain to a productive, well-received conversation about a holistic approach to weight management that further promotes physical activity and overall wellness in youth with obesity.…”

“…Training sports medicine clinicians in the use of people-first language and the application of different communication techniques adds to their skillsets. Patient-centered communication also considers the weight-related words and phrases preferred by youth with obesity, as well as acknowledgment that the meaning and significance may vary depending on factors like race/ethnicity, gender identity and expression, weight, and body habitus (23,37,38). Such a nuanced approach to communication is not a panacea to barriers to treatment but represents another method to help pivot the conversation (4,23,39) (Table 1).…”