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Yale study: Words matter when talking about obesity, binge eating disorder

October 25, 2016

Patients with obesity don’t want to be told they are “fat” or “large sized” by their healthcare providers, according to a Yale study that assessed words used to stigmatize excess weight.

Discussions of weight between provider and patient are sensitive, and talking about them can leave the patient feeling stereotyped or discriminated against, according to researchers with the Yale Program for Obesity Weight and Eating Research (POWER), directed by Carlos M. Grilo, PhD, professor of psychiatry and of psychology at Yale.

In the study, published in the journals Psychiatry Research and the International Journal of Clinical Practice, researchers asked people how they would like their providers to talk to them about their weight and eating behaviors.

A questionnaire was developed, and patients responded that their preferred terms for obesity were “weight,” “BMI,” and “unhealthy body weight.” The least preferred was “fatness,” followed by “obesity,” “excess fat,” and “large size.”

Researchers also asked patients with binge eating disorder to rank terms and phrases used to discuss the problematic eating behavior. Binge eating involves overeating and feeling a sense of lost control while overeating.

Preferred terms were “loss of control,” “you ate until you were uncomfortably full,” and “kept eating even though you were not physically hungry.” Among the most negatively viewed terms were “you knew you were going to eat a large amount of food, so you didn’t’ even consider stopping,” “addicted to the food you were eating,” and “like you lost your willpower.”

“It is important to remember that talking about eating and weight is a sensitive topic for many people, but a critical one for providers to raise,” the authors wrote. “Concerns with eating and weight should be discussed, but care should be taken not to make patients feel negatively judged or powerless to change.”

Preferred and non-preferred terms were generally consistent across socio-demographic characteristics, although women rated non-preferred obesity-related terms as even less desirable than men rated them, according to researchers.

The researchers said that if healthcare providers use language that makes people feel comfortable, they will feel more confident talking with their patients about obesity and eating behaviors like binge eating, and patients will have a better experience, as well.

The studies were funded, in part, by the National Institutes of Health. Contributing to the studies from Yale were Katharine Galbraith, ‘16; Janet A. Lydecker; Valentina Ivezaj; Rachel D. Barnes; Marney A. White; and Carlos M. Grilo.

Galbraith, a former student in the program, will present the results of the research at the Association for Behavioral and Cognitive Therapies annual convention in New York on October 27-30.

Submitted by Christopher Gardner on October 25, 2016