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How should pediatricians talk about obesity?

Pediatricians are often the first source of help for children struggling with their weight. Yet kids' doctors can unintentionally harm weight-control efforts if they use terminology to describe the weight problem that makes children or their parents feel stigmatized or blamed.

That's why a new study in Pediatrics examined parents' feelings about the terms used to describe children's excess weight. As the study's introduction describes, the words really do matter:

In 2010, the British public health minister announced that health providers in Britain should call their patients with obesity “fat” to motivate them to lose weight. Some research results suggest that the term “fat” is perceived to be pejorative or judgmental, and can increase anxiety and depression in those who are labeled this way. Thus, this type of recommendation from a public health official may reinforce weight-based stigma and interfere with quality of care.

The research team found that parents preferred doctors to use the terms "weight" or "unhealthy weight" to describe a child's excess weight. The least-desirable descriptors were "fat," "extremely obese" and "obese" -- these terms were thought by parents to be the most stigmatizing and blaming, and the least likely to motivate weight loss. "Unhealthy weight," "weight problem" and "overweight" were the terms that parents thought would be most likely to motivate weight loss.

The researchers conclude:

In response to weight stigmatization by providers, our findings suggest that parents may react in ways that could have harmful implications for children’s health. Thirty-six percent of parents reported they would put their child on a strict diet in response to weight stigma from a provider. This finding is cause for concern in light of increasing research results that document the health consequences and futility of severe calorie restriction and strict dieting in efforts to achieve longterm, significant weight loss. Given that 35% of parents would seek a new doctor, and 24% would avoid future medical appointments in response to weight stigmatization by providers, it is also possible that health care utilization could be adversely affected by perceived weight stigma from doctors.

Previously: Children and obesity: What can parents do to help? and How to combat childhood obesity? Try everything.

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