Patients' Preferred Terms for Describing Their Excess Weight: Discussing Obesity in Clinical Practice

Abstract

The increasing prevalence of obesity has become one of the most challenging problems facing healthcare providers. Despite recommendations from the U.S. Preventive Services Task Force many health professionals fail to discuss obesity with their patients. This study sought to identify terms that individuals with obesity and being treated in primary care find the most and least acceptable for describing their excess weight. Three-hundred ninety obese adult primary care patients in the Philadelphia area were administered the Weight Preferences Questionnaire from January 2008 through February 2009. Ratings of 11 terms used to describe excess weight were transformed to a five-point scale, ranging from “very desirable” (+2) to neutral (0) to “very undesirable” (-2). The term “fatness” (mean score -1.1 ± 1.3) was rated as significantly more undesirable than all other descriptors (p < 0.001). The terms “excess fat” (-0.6 ± 1.3), “large size” (-0.6 ± 1.3), “obesity” (-0.5 ± 1.4), and “heaviness” (-0.4 ± 1.2) were rated as significantly more undesirable then the remaining terms, which included weight problem, body mass index (BMI), and excess weight (p<0.001). In contrast, the term “weight” was viewed as the most desirable term for characterizing excess weight. Patients' preferences for terms were not significantly influenced by gender, race/ethnicity, or a BMI ≥ 40 kg/m2. Practitioners who treat obesity are encouraged to avoid undesirable terms when discussing this condition with their patients. Instead practitioners may want to consider broaching the topic using more patient-friendly term such as “weight,” “BMI,” “weight problem,” or excess weight.”

The Use of Language in Diabetes Care and Education

“…People have identified "obesity" as an undesirable (19,20,(42)(43)(44) and highly stigmatizing term (44) that implies a "moral or esthetic failing" (42). People experiencing or fearing healthrelated stigma may avoid treatment or future health care appointments (30,45) and have reported feeling bad about themselves and an increased likelihood of avoiding exercise (45).…”

“…Adults living with diabetes who participated in a focus group study (n 5 68) reported that they experience judgment and blame through the language used by health care professionals, friends, family, and the general public (16). It is preferable in patient and professional education, research, publishing, and health care to use words that are factual, neutral, and nonjudgmental rather than words that impose blame or imply negative attitudes (19)(20)(21). Possibly because of perceived judgment from health care professionals, people with diabetes sometimes alter or underreport blood glucose levels (22) or omit information during health care provider visits (23).…”

Fet, feit eller bare overvektig?

“…Spørsmålene om uttrykkssensitivitet var inspirert av en amerikansk studie (16). Skjemaet ble utviklet for denne studien, og testretest-analyse av 33 personer viste høy korrelasjon.…”

“…Selv om det eksisterer delte oppfatninger blant klinikere om hvordan overvekt bør omtales overfor pasienter (14,15), foreligger det lite empiri på området. I to amerikanske studier er pasienters uttrykkssensitivitet kartlagt (16,17), men forskjeller i språk og kultur gir liten overføringsverdi til norske forhold. Det er ingen norske studier på feltet.…”

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

“…The PCP has the unique advantage of seeing patients for various health concerns, creating many opportunities to address their weight issues [11]. Evidence shows that if health providers diagnose, recommend, and counsel clients about weight loss, patients will be more likely to follow a weight loss program [10,54,55]. Despite its well-established benefits, only 20-40% of primary care providers offer weight loss counseling to obese patients because of time constraints, inadequate knowledge, ill-prepared counseling skills, and difficulty explaining technical language [52].…”