More than a Word­—Putting Patients First

| February 1, 2018

A Message from Dr. Christopher Still

Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania.

This editorial message was co-written by James Zervios, Vice President of Marketing and Communications at the Obesity Action Coalition.

Dear Readers,

“Hello, thank you for coming back for your follow-up. I have your results and unfortunately, you are cancerous.”

As a healthcare provider, how often have you heard that statement? My guess is probably never! Obesity is one of the last acceptable forms of discrimination in today’s society. One of the most prevalent areas of weight bias is in healthcare. This is very unfortunate, as this is the one place where a person in need of medical care should be allowed to feel vulnerable and get the care they need.

In obesity medicine, providers are often guilty of perpetuating weight bias, and, many times, they’re not even aware they are doing it. One of the biggest culprits of weight bias in the healthcare setting is the use of the word “obese.” Typically, when we discuss weight with patients, we’ll say “You’re in the obese range” or “You’re obese.” These statements can be extremely harmful because they dehumanize the person with obesity, and they essentially make them their disease.

Changing the lexicon when talking about obesity is quite simple, yet it seems to be met with much resistance, which is likely rooted in weight bias and the oversimplification of the disease. When talking about obesity, simple changes such as “patients with obesity” or “patients affected by obesity” allow the patient to be distinguished from their weight issues, whereas “obese” encapsulates the patient and his or her weight all in one. People are not their disease, and we must remember that when discussing obesity. Other words are also perceived negatively when talking to patients, such as “fat,” “morbidly obese” and “chubby.” The following questions are all constructive ways you can discuss weight with your patients:

“Could we talk about your weight today?”

“How do you feel about your weight?”

“What words would you like us to use when we talk about weight?”

Weight bias is a serious priority for society to address, especially in the realm of healthcare. The cycle of weight bias traps patients with obesity in the cyclical journey where they continue to experience bias, delay important medical issues, and cope with the impact of weight bias by engaging in unhealthy behaviors. Fortunately, there is hope for us to diminish, and ultimately eradicate, weight bias through a variety of ways, such as using people-first language for obesity, especially when verbally conversing with our patients. You might also want to ask yourself some important questions, such as:

“How do I feel when I work with people of different body sizes?”

“Do I make assumptions regarding a person’s character, intelligence, abilities, health status, or behaviors based only on their weight?”

“What stereotypes do I have about people with obesity?”

“How do my patients with obesity feel when they leave my office?”

As a healthcare provider, it’s also important to create a welcoming environment for patients with obesity. Physicians can do this by ensuring their offices have proper seating, obesity-friendly medical equipment (i.e., scales, blood pressure cuffs, gowns, exam tables), and staff that is trained on the use of people-first language for obesity.

As we nationally recognize obesity as an epidemic and a disease, we need to start advocating for changes in the way in which we talk about obesity. By doing this, we can help combat a significant area of weight bias and create a more positive environment for people with obesity, especially in the healthcare setting. To learn more about people-first language for obesity, please visit www.obesityaction.org/weight-bias-and-stigma/people-first-language-for-obesity.

Sincerely,

Christopher Still, DO, FACN, FACP

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Category: Current Issue, Editorial Message

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