How We Talk to Children About Obesity Can Make a Big Difference

Obesity has become one of the most talked-about health issues but, ironically, we still haven’t mastered how to talk about it yet. With all the stigma surrounding the words like fat and obese, discussing weight issues can be tough for both people experiencing it, and physicians trying to address it. Medical experts say stigma can be especially harmful to children struggling with obesity, as it has the potential to leave a lasting negative impact from an early age.

Mass General obesity medicine physician Fatima Cody Stanford, MD, MPH, MPA is a strong a believer that changing the language around obesity is necessary to reduce the stigma and negative health effects that go along with it, and she supports a recent initiative by the American Academy of Pediatrics (AAP) and the Obesity Society to re-frame the conversation in a more positive light to do just that.

 “The language we use in approaching patients with obesity may promote weight bias and stigma. It is important to recognize that nuances such as word choice may influence whether a patient with obesity considers you as supportive of their goals to achieve a healthy weight. In other disease processes, we recognize that a patient is not defined by their disease.

However, in obesity, we often refer to patients as “obese patients” when rather they are, a “patient with obesity.” Also,we use derogatory terms such as “morbid” to define patients with severe obesity. This is absolutely horrible. Do you we do this with any other disease process? No. So, we shouldn’t further stigmatize the patient with severe obesity.”

—Fatima Cody Stanford, MD, MPH,MPA, Mass General Hospital

The AAP recently published findings from a study that evaluated the effect stigma has on the young mind, and it turns out that children as young as three showed signs of being aware of harmful weight-related stigma and stereotypes. Researchers found that weight-related stigma is associated with increased risk of depression, anxiety, substance abuse, low self-esteem and poor body image.

Not only is stigma bad for mental health, but studies show it has a negative impact on physical health as well. Some believe “tough love” is helpful in motivating people struggling with their weight, but scientists say this mentality actually fuels unhealthy habits. Weight-related stigma and teasing has been associated with disordered eating habits and decreased physical activity, to the point where the condition can sometimes worsen.

So what can you do to help? Here are a few guidelines from the American Academy of Pediatrics:

  • Use person-first language
    • Using person-first language assures someone they are not defined by their disease.E.g. “A person with obesity” instead of “obese person”
  • Use neutral words
    • Negative words can lead to feelings of sadness, embarrassment and shame.
    • E.g. “Weight, body mass index” instead of “fat, obese, problem”

Despite differences in opinion, obesity has been classified as a disease and should be treated as such. Part of that includes using appropriate language and remembering that words can heal, but they can also do harm, regardless of the intention.

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