What Words Should We Use When Discussing Excess Weight?

Abstract

Background: There is limited research on how patients prefer physicians to communicate about the topic of obesity, and there is even less understanding of which terms physicians most commonly use.Methods: In this cross-sectional, nonrandom sampling study, patients who were seeking treatment for weight loss rated the desirability of 12 terms to describe excess weight, and physicians rated the likelihood with which they would use those terms during clinical encounters. Participants rated terms on a 5-point scale, with ؊2 representing "very undesirable" or "definitely would not use" and ؉2 representing "very desirable" or "definitely would use."Results: Patients (n ‫؍‬ 143; mean age, 46.8 years; mean body mass index, 36.9 kg/m 2 ) rated "weight" (mean ؎ SD) as the most desirable term (1.13 ؎ 1.10), although it did not significantly differ from 5 other terms provided. They rated "fatness" (؊1.30 ؎ 1.22) as the most undesirable term, although this rating did not differ significantly from 4 other terms. Physicians affiliated with a community-based medical school (n ‫؍‬ 108; mean age, 48.8 years; 79.6% primary care specialty) were most likely to use "weight" (1.42 ؎ 0.89), which was significantly different from ratings for all other terms. They were least likely to use "fatness" (؊1.74 ؎ 0.59), although this rating did not differ significantly from 3 other terms.Conclusion: Physicians generally reported that they use terminology that patients had rated more favorably, and they tend to avoid terms that patients may find undesirable. Understanding the preferences and terminology used by patients and physicians is an important initial step to ensure that communications related to obesity and weight loss are efficient and effective. The provision of weight loss counseling by physicians in primary care settings offers a potentially effective approach to combating the problem of overweight and obesity.1-4 However, physicians often neglect broaching the topics of obesity and weight loss during primary care encounters. 3,[5][6][7][8] Barriers that may hinder physicians' provision of weight-loss counseling include time constraints, lack of reimbursement, and perceptions that treatment will be ineffective. In addition, physicians may feel ill-equipped to address these issues. 5,9 -12 Despite these barriers, overweight and obese patients may desire greater involvement of their primary care physician in weight-loss counseling and treatment efforts. 6,7 Until recently, however, few studies have examined how patients would prefer their physicians to discuss the topic of obesity. In one study, obese patients rated the term "weight" as significantly more desirable than a variety of terms physicians could use to describe excess weight; they rated "obesity," "excess fat," and "fatness" as the most undesirable terms physicians could use. 13 The parents of pediatric patients overwhelmingly preferred that physicians use the phrase "gaining too much weight" as compared with other options, including "overweight," when discussing their chi...

Parental Perceptions of Weight Terminology That Providers Use With Youth

“…These findings were similar to preferences documented among treatment-seeking adults with overweight and obesity. 32,33 Our findings remained consistent across sociodemographic variables, including gender, race, income, education, and parent and child's body weight. The age effects observed indicate the need for additional research to clarify whether preferences of weight-based language shift as parents (and their children) become older.…”

“…Two studies of adults seeking treatment for overweight and obesity revealed that "obese" and "fat" were rated as undesirable terms, and "weight" and "BMI" were preferred. 32,33 Others studies have revealed that "obese" may be perceived as a negative term, 34,35 perhaps because of implications of more serious medical consequences and a sense of confusion it may invoke. 30 Among parents, in 1 qualitative study parents were found to prefer that physicians call their children "overweight" and "obese" instead of more colloquial terms (eg, "chubby" or "plump"), 36 and another reported study "obese" and "fat" were found to be parents' least preferred terms.…”

Entrevista motivacional: una herramienta en el manejo de la obesidad infantil

“…La EM es un enfoque centrado en el paciente y la familia, que pretende la toma de decisiones de forma colaborativa, proporciona feed-back sin enjuiciar, acepta la resistencia al cambio por parte del paciente y les anima a desarrollar sus propios motivos para el cambio de conducta de salud 9,10 .…”

“…Esto no quiere decir escuchar en silencio reflexionando o haciendo hipótesis para uno mismo, sino que tras cada respuesta del paciente se le devuelve una reflexión o un resumen, para comprobar si es eso lo que quiere decir 9,11,12 . Buscando el significado detrás de las palabras del paciente.…”

Fat Type Level: A Simpler Way for Men to Understand Body Shape and Health Risks

“…Obesity and diabetes prevention and intervention can occur at key opportunities, such as in the primary care office during a routine office visit or an annual physical [53]. The PCP has the unique advantage of seeing patients for various health concerns, creating many opportunities to address their weight issues [11].…”