My choice of words

BMJ 2012; 344 doi: (Published 28 March 2012) Cite this as: BMJ 2012;344:e1370

Re: My choice of words

Words are powerful, and so is the context in which they are delivered. When selecting words to use to describe a patient’s weight status, it is important to take this into account. If the objective is to encourage a patient to take action to address his/her obesity, then using words that the patient would find most acceptable in a non-clinical situation may be least effective. Using qualitative interviews with people who were obese or approaching obesity and had been given feedback about their objectively-measured weight, we found that most considered “overweight” to be an acceptable description of their weight status, but few felt it would motivate them to lose weight (1). In contrast, terms that were viewed as less acceptable, including “obese”, were often considered to be more likely to make them want do something about their weight.

Framing excess weight as a medical problem by telling someone that they are “clinically obese” or making explicit links between a patient’s weight and their health may be an unwelcome message, but may be more effective in motivating weight loss, particularly if support or advice is offered. However, it is important that sensitivity is used, as discussion of a person’s weight is often taken to be a comment on their moral status or worth rather than a simple description of their physical shape. To achieve a more useful patient response in the situation described by Seetho, using the word “overweight” may be less offensive but the fact that this state can present as a problem (not just to patient but also to the doctor for diagnostic purposes) also needs to be communicated.

(1) Gray CM, Hunt K, Lorimer K, Anderson AS, Benzeval M, Wyke S. Words matter: a qualitative investigation of which weight status terms are acceptable and motivate weight loss when used by health professionals. BMC Public Health 2011; 11(513):1-9.

Competing interests: No competing interests

02 April 2012
Cindy M Gray
Research Fellow
Kate Hunt, Karen Lorimer, Annie S Anderson, Michaela Benzeval, Sally Wyke
University of Glasgow
Institute of Health and Wellbeing