Patient Preferences for Weight-Related Terminology
As a researcher studying weight bias and discrimination, this announcement concerned me. The intentions of this recommendation might stem from goals to promote public health, but the potential for stigmatization is high, and the approach could interfere with obesity intervention efforts. To examine this issue more closely, we conducted a study in the United States to assess public perceptions of (and reactions to) language that healthcare providers use when discussing body weight. We asked a nationally representative sample of 1064 adults to rate their perceptions of the following 10 terms to describe excess weight, especially if a provider used these terms to refer to the participant's weight:
• Weight;
• Unhealthy weight;
• Weight problem;
• Overweight;
• High body mass index;
• Heavy;
• Chubby;
• Obese;
• Fat; and
• Morbidly obese.
Participants were asked to what extent they perceived each term to be stigmatizing, blaming a person for their weight, or motivating the individual to lose weight. In addition, we asked participants how they would react if a provider referred to their weight in a way that made them feel stigmatized.
Our findings showed some very consistent perceptions and preferences for weight-related language. Neutral terms, such as "weight" and "unhealthy weight," were the preferred terms for discussing excess weight with patients, whereas such words as "morbidly obese," "fat," and "obese" were rated as the most stigmatizing and blaming. Participants also rated "unhealthy weight" and "overweight" as the terms most likely to encourage weight loss, whereas "fat" and "chubby" were rated among the least motivating. These findings remained very similar across sociodemographic factors, regardless of the participant's own body weight.