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A Patient-and Family-Friendly Language Approach to Discussing Obesity

November 21, 2022

Children and teenagers with overweight or obesity can experience a sense of victimization or negative stigma attached to a higher body mass index (BMI), exacerbated by how it is discussed. What terms do parents use to address their children’s weight? How do children react and what terms do they prefer?

To answer these questions, Puhl et al share with us an analysis (10.1542/peds.2022-058204) of 2 online surveys, 1 of youth ages 10 to 17 years (n=2032) and one of parents of children and teens ages 10 to 17 years (n=1936). Both groups were asked to rate 27 different terms that describe body weight. Parents also identified which of these terms they used at home and youth reported what terms they preferred and how they felt about the terms used by parents.

While there was some consistency in preferred terms (e.g., healthy or normal weight) and non-preferred terms (e.g., obese or extremely obese) by youth, there was variability in terms that were used and the preference for these terms across a wide range of child factors, including weight status, sex, and race and ethnicity.  The authors provide a detailed description of this variation and provide guidance about the terms that we should consider using when providing clinical care. 

What is the best way to have conversations about obesity that is productive and does not exacerbate stigma? We invited a commentary from Drs. Dominique Williams and Eileen Chaves from the Center for Health Weight and Nutrition at Nationwide Children’s Hospital, who point out the unique findings in this study, identify a few limitations (e.g., that gender was not evaluated), and give us specific advice, including learning the terms that patients and families prefer (10.1542/peds.2022-059167). It is well worth it to weigh in and learn from the valuable information contained in this study and commentary. Link to both articles and learn more.

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