With the disease of obesity, most conversations revolve around the perceived cause of the disease (ie, the patients’ lack of willpower, and/or failure to comply with dietary and/ or exercise recommendations). To add insult to injury, if treatment options are discussed or recommended, they are rarely evidence-based, typically consisting of a referral to a commercial weight-loss program. If recommended or available, disease management programs administered by healthcare professionals specially trained in treating obesity are often denied by medical insurance. Most anti-obesity medications are not covered by traditional healthcare plans, despite compelling evidence that they can effectively improve the disease of obesity and obesity-related comorbidities. This reinforces the message that obesity is a character problem and is not worthy of medical attention and treatment.
Telling a patient they have excess weight as though it’s new information is demeaning. Following that statement with a glib prescription to “eat less and move more” is even more demeaning. Patients don’t always want to talk about their weight when they are at a doctor’s office—especially if they are there for another specific reason. Before broaching the subject of a patient’s weight, it’s important to ask permission to address weight and respect the patient’s answer.
As healthcare professionals, we have a responsibility to provide support, rather than judgment, to our patients who suffer from obesity. The language we use when discussing obesity is critical in changing this notion. Here are some tips to consider:
❯ Use people-first language. Words have power. People have obesity, just as they have cancer or diabetes. Saying “obese people” is demeaning. We don’t say “cancerous people.” Instead, we say “people with cancer.”
❯ Acknowledge that patients don’t want to have obesity. Most people with obesity spend a tremendous amount of time, effort, and money attempting to treat their disease. While society tends to label people with obesity as lazy or unmotivated, people who persevere in seeking treatment despite a lack of progress typically have a great deal of tenacity or grit. Acknowledging this and providing recommendations or referrals for evidence-based treatments, such as intensive lifestyle interventions and/or antiobesity medications can be life-changing for
these patients.
