My choice of words

BMJ 2012; 344 doi: (Published 28 March 2012) Cite this as: BMJ 2012;344:e1370
  1. Ian W Seetho, clinical research fellow, Department of Obesity & Endocrinology, University of Liverpool
  1. iseetho{at}

On our ward round we visited a patient with a raised body mass index. As we stood at the end of the patient’s bed discussing the need for computed tomography (CT), I broached the question of the possible weight restriction of the hospital CT table. On hearing this, the patient’s demeanour immediately changed—for the worse. I had obviously hurt the patient’s feelings when my intentions had only been good. Although I apologised immediately, it took a considerable length of time and explanation to resolve the misunderstanding

Although terms such as obese or bariatric are often used in clinical practice, one’s approach to the topic of body weight with patients may be a sensitive issue. It can be a challenging experience discussing the pertinent health issues whilst remaining aware of the need to conform to acceptable terminology and language. It is possible that use of potentially pejorative adjectives or adverbs when describing individuals may convey to the lay listener that a moral judgment of character is being passed or generalisation to a specific population is being made.

The literature describes studies that have examined the terms that people prefer. Desirable words included “weight,” “body mass index,” and “excess weight.”1 2 In another study, ratings of the terms “weight” and “unhealthy weight” were rated as most desirable; “unhealthy weight” and “weight problem” were rated as the most motivating to lose weight; while “fat,” “obese,” and “extremely obese” were negatively perceived.3

I realised that, whatever I may think I have said, it can easily be interpreted in a different way by the listener. Of course, each patient will be different. Nevertheless, when describing a diagnosis or talking to patients, it is important to be ever so mindful of our choice of words in relation to how they feel about their condition.


Cite this as: BMJ 2012;344:e1370


  • Patient consent not required (patient anonymised, dead, or hypothetical).