Obesity and Language, Part 2

There is still more to say about the subjects broached in yesterday’s gleanings from a paper titled, “What’s in a Word? On Weight Stigma and Terminology,” published back in 2015 when the topic was starting to heat up. There seemed to be some hope that all the larger-bodied people would agree about preferred verbiage. But the authors point out a very troubling obstacle. It is one thing to decide that the target group should be allowed to pick their own label (in which case they would first probably elect to ditch the hostile phrase “target group”).

Here is the fly in that particular ointment:

[T]his population is far from homogeneous, and individuals who do engage with such organizations will be a self-selecting group who are seeking a medical solution…..

[A] coalition of size-acceptance and fat rights groups have challenged the claim that these organizations speak for larger people as a whole, criticizing the top-down setting of the terminology agenda and the absence of grassroots input…

[R]esearch on the preferences of this group has been skewed toward treatment-seeking populations, and therefore the findings of such research cannot be regarded as representing a “consensus.”

Even if the scientific community had been magnanimous about letting all people with obesity vote on what they want to be called, how would they reach the ones who never go to doctors because they don’t want to be body-shamed or have their concerns ignored once again?

Let every voice be heard

Actually, thanks to the Internet, there is a way to find out what the alienated and disaffected members of the public are thinking — through many varieties of social media. That research could be pretty uncomfortable for medical professionals who had not previously given much consideration to their vocabularies. And anyway, the report admitted, “consensus within a socially marginalized group can neither be realistically expected nor made to serve as a prerequisite for moving toward social justice and equality.”

The complications multiplied when studies got underway that attempted to more fairly discover individual preferences. One such attempt asked how each individual would like a doctor to break the news, “You are at least 50 pounds over recommended weight.” This time, two factors made progress difficult:

First, the questionnaire prompts participants a priori to think of weight as a problem. Secondly, the 11 terms used in the Weight Preference Questionnaire were chosen after consultation with patients in treatment-seeking settings. Thus, neither the list of words generated, nor the scenario used in the exercise, is judgment-free.

The least acceptable words were found to be “obesity” and “fat.” Except in Australia, where four out of five adults were fine with both “fat” and “overweight.” Go figure!

Your responses and feedback are welcome!

Source: “What’s in a Word? On Weight Stigma and Terminology,” NIH.gov, 10/05/15
Image by Kilian Evang/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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