01 August 2012

'Large' more appropriate than obese

'Obese' or 'overweight' are hurtful labels, whereas terms like 'large' considered less offensive.


If doctors want to develop a strong rapport with parents of overweight children, it would be best if physicians used terms like "large" or "gaining too much weight" as opposed to the term "obese." These were findings recently published by medical researchers at the University of Alberta.

Geoff Ball, a researcher in the Faculty of Medicine & Dentistry with the Department of Pediatrics, worked with department colleagues Amanda Newton and Carla Farnesi to review articles about the important relationship between families and health professionals when it comes to addressing concerns about children's weight. Farnesi has since moved to Montreal where she will soon start her PhD at Concordia University. Their findings were recently published in the peer-reviewed journal, Pediatric Obesity.

They found the delicate balance was affected by: parents' preferences about language regarding obesity, how health professionals talked about weight, how care was delivered and parents' expectations.

"Health professionals probably shouldn't use terms like fat, chubby, overweight or obese," says Ball. "Terms that are more neutral, less judgmental and less stigmatising should be used. Most of the time families will want that sensitive type of language. And that's what clinicians should want, too, because that's what families want."

Some parents felt blamed for their children's weight issues, while others found health professionals "rude and judgmental" or inattentive.

Doctors need spearhead better term 

When it came to discussing sensitive issues around children's weight, parents felt it was the role of doctors to spearhead that difficult conversation, especially if there were health concerns. But health professionals were somewhat reluctant to do this because they didn't want to offend families and negatively affect the physician-patient relationship – especially when it came to raising concerns about weight during a medical appointment about an unrelated medical issue.

Ultimately, if parents feel ostracised by physicians, the families are less likely to follow doctor recommendations, the study concluded.

Ensuring physicians receive guidance on how to address sensitive topics like weight could be a good idea, noted the paper. It would also be worthwhile to get more feedback from parents about the issue, and to encourage families to work with doctors as a team to find solutions for children. Using more sensitive language about weight is also needed.

"If these changes are made it could lead to: families being more apt to follow the doctor's advice, families being more apt to return for follow-up appointments, better interactions between health-care professionals and families, and families being more satisfied with their care," says Ball. "You want to have a positive rapport with families so they stay engaged. Those are outcomes you would want."

(EurekAlert, 2012 July)

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