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Motivating or stigmatizing? Public perceptions of weight-related language used by health providers
Abstract
Background Research demonstrates that health providers express negative attitudes toward overweight and obese patients that can be conveyed through weight-related language, yet little is known about people's perceptions of weight-related language used by providers. The current study examined public preferences and perceptions of weight-based terminology used by health-care providers to describe excess weight. Method A national sample of American adults (N=1064) completed an online survey to assess perceptions and preferences associated with 10 common terms to describe body weight. Participants rated how much they perceived each term to be desirable, stigmatizing, blaming or motivating to lose weight (using five-point Likert scales), and how they would react if stigmatized by their doctor's reference to their weight. Results The terms 'weight' (3.43, 95% confidence interval (CI) 3.35-3.50) and 'unhealthy weight' (3.24, 95% CI 3.15-3.33) were rated most desirable, and the terms 'unhealthy weight' (3.77, 95% CI 3.69-3.84) and 'overweight' (3.51, 95% CI 3.43-3.58) were rated most motivating to lose weight. The terms 'morbidly obese', 'fat' and 'obese' were rated as the most undesirable (95% CI 1.61-2.06), stigmatizing (95% CI 3.66-4.05) and blaming (95% CI 3.62-3.94) language used by health providers. Notably, participant ratings were consistent across socio-demographic variables and body weight categories. A total of 19% of participants reported they would avoid future medical a…
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Patients who report having experienced weight bias in the healthcare setting have poor treatment outcomes and might be more likely to avoid future care.
“patients who report having experienced weight bias in the healthcare setting have poor treatment outcomes40 and might be more likely to avoid future care41.”
From Joint international consensus statement for ending stigma of obesity (2020) · cites this paper as [41]
Citations
Cites
Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. Adults
Calle, E. E., Rodriguez, C., Walker-Thurmond, K., & Thun, M. J. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021423 · Cited by 7,696
Handbook of the Sociology of Mental Health
(2013) · Handbooks of Sociology and Social Research · doi:10.1007/978-94-007-4276-5 · Cited by 922
Internalized Societal Attitudes Moderate the Impact of Weight Stigma on Avoidance of Exercise
Vartanian, L. R., & Novak, S. A. (2011) · Obesity · doi:10.1038/oby.2010.234 · Cited by 381
Screening for Obesity in Adults: Recommendations and Rationale
U.S. Preventive Services Task Force* (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-11-200312020-00012 · Cited by 347
Does dieting make you fat? A twin study
Pietiläinen, K. H., Saarni, S. E., Kaprio, J., & Rissanen, A. (2012) · International Journal of Obesity · doi:10.1038/ijo.2011.160 · Cited by 173
Flagged first, then by citations
Research works printed but not linked: 41
- Wadden TA, Didie E . What’s in a name? Patients’ preferred terms for describing obesity. Obes Res 2003; 11: 1140–1146. · DOI
- Volger S, Vetter ML, Dougherty M, Panigrahi E, Egner R, Webb V et al. Patients’ preferred terms for describing their excess weight: discussing obesity in clinical practice. Obesity (Silver Spring) 2012; 20: 147–150. · DOI
- Dutton GR, Tan F, Perri MG, Stine CC, Dancer-Brown M, Goble M et al. What words should we use when discussing excess weight? J Am Board Fam Med 2010; 23: 606–613. · DOI
- Flegal KM, Carroll MD, Kit BK, Ogden CL . Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 2012; 307: E1–E7. · DOI
- Andreyeva T, Puhl RM, Brownell KD . Changes in perceived weight discrimination among Americans: 1995–1996 through 2004–2006. Obesity (Silver Spring) 2008; 16: 1129–1134. · DOI · Paper page
- Puhl RM, Heuer CA . Obesity stigma: important considerations for public health. Am J Public Health 2010; 100: 1019–1028. · DOI
- Puhl RM, Brownell KD . Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring) 2006; 14: 1802–1815. · DOI · Paper page
- Price JH, Desmond SM, Krol RA, Snyder FF, O’Connell JK . Family practice physicians’ beliefs, attitudes, and practices regarding obesity. Am J Prev Med 1987; 3: 339–345. · DOI
- Schwartz MB, Chambliss HO, Brownell KD, Blair SN, Billington C . Weight bias among health professionals specializing in obesity. Obes Res 2003; 11: 1033–1039. · DOI · Paper page
- Brown I . Nurses’ attitudes towards adult patients who are obese: literature review. J Adv Nurs 2006; 53: 221–232. · DOI
- Huizinga MM, Bleich SN, Beach MC, Clark JM, Cooper LA . Disparity in physician perception of patients’ adherence to medications by obesity status. Obesity (Silver Spring) 2010; 18: 1932–1937. · DOI · Paper page
- Puhl RM, Wharton C, Heuer CA . Weight bias among dietetics students: implications for treatment practices. J Am Diet Assoc 2009; 109: 438–444. · DOI
- Amy NK, Aalborg A, Lyons P, Keranen L . Barriers to routine gynecological cancer screening for White and African-American obese women. Int J Obes 2006; 30: 147–155. · DOI
- Friedman KE, Ashmore JA, Applegate KL . Recent experiences of weight-based stigmatization in a weight loss surgery population: psychological and behavioral correlates. Obesity (Silver Spring) 2008; 16: S69–S74. · DOI
- Annis NM, Cash TF, Hrabosky JI . Body image and psychosocial differences among stable average weight, currently overweight, and formerly overweight women: the role of stigmatizing experiences. Body Image 2004; 1: 155–167. · DOI
- Carels RA, Young KM, Coit CB, Harper J, Gumble A, Hobbs MW et al. Internalized weight stigma and weight loss treatment outcomes in treatment-seeking adults. Ann Behav Med 2009; 37: 350–355. · DOI
- Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289: 76–79. · DOI · Paper page
- Thomas SL, Hyde J, Karunaratne A, Herbert D, Komesaroff PA . Being ‘fat’ in today’s world: a qualitative study of the lived experiences of people with obesity in Australia. Health Expect 2008; 11: 321–330. · DOI
- Lewis S, Thomas SL, Blood RW, Hyde J, Castle DJ, Komesaroff PA . Do health beliefs and behaviors differ according to severity of obesity? A qualitative study of Australian adults. Int J Environ Res Public Health 2010; 7: 443–459. · DOI
- 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. · DOI
- Ward SH, Gray AM, Paranjape A . African American’s perceptions of physician attempts to address obesity in the primary care setting. J Gen Intern Med 2009; 24: 579–584. · DOI
- Tailor A, Ogden J . Avoiding the term ‘obesity’: an experimental study of the impact of doctors’ language on patients’ beliefs. Patient Educ Couns 2009; 76: 260–264. · DOI
- Brochu PM, Esses VM . What’s in a name? The effects of the labels ‘fat’ versus ‘overweight’ on weight bias. J Appl Soc Psychol 2011; 41: 1981–2008. · DOI
- Berg M . Choose sensitive, accurate terms. Healthy Weight J 1998; 12: 12–13.
- Vartanian LR . ‘Obese people’ vs ‘fat people’: impact of group label on weight bias. Eat Weight Disord 2010; 15: e195–e198. · DOI
- Markman EM . Categorization and Naming in Children. MIT Press: Cambridge, MA, USA, 1989.
- Degher D, Hughes G . The adoption and management of a ‘fat’ identity. In: Sobal J, Maurer D, (eds). Interpreting Weight: The Social Management of Fatness and Thinness. Aldine De Gruyter, Inc.: Hawthorne, NY, USA, 1999; pp 11–28.
- Puhl RM, Andreyeva T, Brownell KD . Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes 2008; 32: 992–1000. · DOI · Paper page
- Schafer MH, Ferraro KF . The stigma of obesity: does perceived weight discrimination affect identity and physical health? Soc Psychol Q 2011; 74: 76–97. · DOI
- Muenning P, Haomiao J, Lee R, Lubetkin E . I think therefore I am: perceived ideal weight as a determinant of health. Am J Public Health 2008; 98: 501–506. · DOI
- Puhl RM, Peterson JL, Luedicke J . Parental perceptions of weight terminology that providers use with youth. Pediatrics 2011; 128: e786–e793. · DOI
- Puhl RM, Heuer CA . Public opinion about laws to prohibit weight discrimination in the United States. Obesity (Silver Spring) 2011; 19: 74–82. · DOI
- Kelly JF, Westerhoff CM . Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. Int J Drug Policy 2010; 21: 202–207. · DOI
- Bacon JG, Scheltema KE, Robinson BE . Fat Phobia scale revisited: the short form. Int J Obes 2001; 25: 252–257. · DOI
- Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimus 1-year follow-up. J Am Diet Assoc 2007; 107: 1755–1767. · DOI · Paper page
- Post RE, Mainous AG, Gregorie SH, Knoll ME, Diaz VA, Saxena SK . The influence of physician acknowledgment of patients’ weight status on patient perceptions of overweight and obesity in the United States. Arch Intern Med 2011; 171: 316–321. · DOI
- Loureiro ML, Nayga RM . Obesity, weight loss, and physician’s advice. Soc Sci Med 2006; 62: 2458–2468. · DOI · Paper page
- Bleich SN, Pickett-Blakely O, Cooper LA . Physician practice patterns of obesity diagnosis and weight-related counseling. Patient Educ Couns 2011; 82: 123–129. · DOI
- Pedersen PJ, Ketcham PL . Exploring the climate for overweight and obese students in a student health setting. J Am Coll Health 2009; 57: 465–480. · DOI
- Finset A . One size does not fit all: how to talk to patients about obesity. Patient Educ Couns 2009; 76: 147–148. · DOI
- Stommel M, Osier N . Temporal changes in bias of body mass index scores based on self-reported height and weight. Int J Obesity 2012; e-pub ahead of print 1 May 2012; doi:10.1038/ijo.2012.67. · DOI
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Sorted by citations
Joint international consensus statement for ending stigma of obesity
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How and why weight stigma drives the obesity ‘epidemic’ and harms health
Tomiyama, A. J., Carr, D., Granberg, E. M., Major, B., Robinson, E., Sutin, A. R., & Brewis, A. (2018) · BMC Medicine · doi:10.1186/s12916-018-1116-5 · Cited by 712
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Alberga, A. S., Edache, I. Y., Forhan, M., & Russell-Mayhew, S. (2019) · Primary Health Care Research & Development · doi:10.1017/s1463423619000227 · Cited by 348
Obesity Stigma: Causes, Consequences, and Potential Solutions
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The use of language in diabetes care and education
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Puhl, R. M., Lessard, L. M., Himmelstein, M. S., & Foster, G. D. (2021) · PLOS ONE · doi:10.1371/journal.pone.0251566 · Cited by 233
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Metadata
- Authors
- Puhl, R., Peterson, J. L., & Luedicke, J.
- Affiliations
- Yale University (US)
- Corresponding author
- Puhl, R
- ORCID
- Puhl, R
- Venue
- International Journal of Obesity
- Published
- 2012-07-10
- Volume
- 37
- Issue
- 4
- Pages
- 612-619
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2068389121
- Cited by
- 304
- References
- 5
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 28 · 2023: 26 · 2022: 22 · 2021: 23 · 2020: 38 · 2019: 28 · 2018: 24 · 2017: 19 · 2016: 17 · 2015: 12 · 2014: 14 · 2013: 16 · 2012: 2
- FWCI
- 13.73
- Type
- journal article
- Language
- en
- Update notices
- erratum (2013-04-09)
- Open access
- closed
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- weight stigma, public perception, overweight, patient preferences, weight loss motivation, physician-patient communication
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Body Weight, Communication, Female, Health Personnel, Humans, Male, Middle Aged, Motivation, Terminology as Topic, Obesity, Physician-Patient Relations, Self Concept, Social Class, Social Perception, Stereotyping, United States
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