Saturday, March 24, 2012

Weight Based Terminology

Puhl RM, Peterson JL, Luedicke J. Parental perceptions of weight terminology that providers use with youth. Pediatrics. 2011;128:e786-e793

I came across an article from Medscape that had to do with doctors addressing obesity or overweight with their young(child) patients.  I had just posted my comments about kids and calories when the Medscape Week In Review landed in my inbox, so I saved it.

I took a break from my studies today, just to give it a quick read for the purpose of summarizing it here.  Well, of course, the advice to physicians comes from the results of a research study.  A survey based one at that (my favorite).  So you know I had to track it down and read about the sample, methods and data analysis.  I am a nerd that way.

These tangents were fine when I was in Florida, but are an indulgence with a price these days.  

So bottom line:
  • docs need to address the issue because overweight/obesity lead to adverse  psychological and physical outcomes (teasing, alienation, disease)
  • parents respond differently to the language doctors use
  • the least stigmatizing or blaming terminology should be used - suggestions are based on the survey responses of nearly 500 parents  (70% of the sample was white and the majority had more than a HS education) 
  • the words used (along with some personal traits of the parents) has an impact on the parents response to the physician's assessment
  • even when the doctors used the words that the parents found the most blaming or stigmatizing the majority (71%) still said that they would encourage their children to lose weight
  • the researcher is concerned that other parents will either find another doctor, not follow up with health care, or worse - put their child on an extreme diet
The survey results found that the terms the parents found most motivating (for weight loss) and least blaming were "weight problem", "unhealthy weight" or just "weight."
The words that were most stigmatizing and least helpful were "obese", "fat" and "extremely obese."
My favorite way to say it is "unhealthy weight."  I think that parents need to hear the connection between weight and health.  

The responses or answers were compared by some demographics and other traits (called psychographics).  For example, did the choice of most helpful response (unhealthy weight) change based on a persons race, gender, income, education level, own weight status, history of personal victimization or child's victimization, or the parents score on the fat phobic scale.  Yeah, thought that last one might get you.  I looked it up and it is attached below.  
The answers were pretty consistent by all traits with only subtle differences noted.

Here is a link to the Fat Phobia Scale (I would call it the fat negativity scale myself)

Here is the summary for the research article by Dr. Puhl.

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