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Health professionals ‘should watch language when discussing body weight’ - UK report

By Tom Pilgrim, PA

Health professionals should steer away from using words such as “fat”, “chubby” and “extra-large” to avoid upsetting patients when discussing their weight, a new survey has suggested.

An online poll of nearly 3,000 mostly female British adults has indicated that people would prefer the use of the terms “weight”, “unhealthy weight” and “overweight”.

Using less-preferred terminology risks provoking negative emotions among adults living with obesity, including “sadness” and “anger”, the study suggested.

Its findings, from researchers at the University of London and University of Leeds, are being presented at the European and International Congress on Obesity, being held online this week.

Researchers surveyed 2,915 adults online who had an average age of 49, 96% of whom were female.

Respondents had an average Body Mass Index (BMI) of 31.5, which is in the obese range.

They were asked their opinions on 22 terms, such as fat, weight problem, higher weight and obesity, that health professionals might use and could indicate their preference for certain terminology through a five-point scale – from strongly agree to strongly disagree.

The survey also asked participants to rate their emotional response to terms using seven emotions: happiness, sadness, anger, contempt, disgust, surprise and fear.

The 856 respondents who were parents were also asked to repeat the questions in relation to descriptions of their children’s weight.

Researchers found that adults saw the terms “super obese”, “chubby”, and “extra-large” as the least favourable for healthcare professionals to use when talking about body weight.

The strongest feelings of disgust, contempt, and anger were associated with the use of the words “super obese”, “chubby”, and “fat” respectively.

Parents preferred the use the terms “weight”, “unhealthy weight”, and “body mass index”, while emotions of contempt, anger, and disgust were most frequently reported in response to use of the words “high BMI”, “fat”, and “super obese” respectively.

Researchers found that overall the most commonly reported emotion associated with all weight-related terminology was sadness.

Dr Stuart William Flint, from the University of Leeds – who led the study, acknowledged that one of the limitations of online research was the high percentage of women in the survey sample.

“It probably tells you more about women’s preferences,” he said, adding that the research had “a good number of male participants”.

He argued that the use of a term like “fat” provoked a similar negative emotional response from both females and males, due to it often reflecting a stigmatising experience, such as bullying in childhood.

Dr Flint added: “The reason that these things are important is because these types of negative emotions we know can translate into becoming a barrier to engaging in health care.”

He continued “We know that negative experiences in a health care setting, which may include the use of inappropriate terminology, can reduce somebody’s likelihood of seeking health care in the future.

“And of course, we don’t want that, we want to support patients as health care professionals and we want to improve the patient practitioner relationship.”

He advised health care professionals to “elicit” a patient’s preferred terms when discussing their weight, because they may differ from person to person.

He suggested people living with obesity were often treated without “empathy and compassion” in society, with “stereotypes” leading to negative experiences in health care settings.

The study, co-authored by Dr Adrian Brown from University College London, will be submitted to a journal in the next couple of weeks, Dr Flint said.

It has been peer reviewed as part of the International Congress on Obesity but not within an academic journal.

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