ESPE Yearbook of Paediatric Endocrinology

Brief summary: This study investigated how frequently negative terminology such as ‘fail’ and ‘morbid obesity’ was used in scientific publications dealing with bariatric surgery in peer reviewed journals. 2.4% of the publications analyzed included the term ‘fail’ and 16.8% contained the term ‘morbid’ in conjunction with obesity. This study showed that negative language, blaming the patient for the lack of weight loss or weight regain, was present within scientific publications.

In the powerful qualitative part of the study, patients’ perspectives on these two terms was obtained. There was a near universal consensus that the expression ‘failure’ to lose weight implies a personal failure rather than a failure of the intervention. In addition, patients felt that the use of the word ‘fail’ by medical practitioners served to reinforce their own firmly held beliefs that a failure to maintain weight loss is the result of their lack of will power, rather than a physiological response. With regard to ‘morbid obesity’, patients who understood this phrase as not directly correlated to a medical definition felt highly stigmatized and that this would mean a scientific assessment of the patient who was likely to soon die as a result of obesity since no effective treatment could be offered.

We all are aware that obesity is a highly stigmatized, chronic disease. Nevertheless, it is deplorable to see that healthcare professionals show the same stigmatizing language and behaviours as the general public. This frequently influences the quality of care provided to the patients (1,2). In many cases the ongoing use of negative language reinforces outdate views that obesity is the result of a personal choice.

It is critical to recognize the importance that language plays in shaping relationships with patients and transmitting stigmatizing beliefs, reinforcing deeply ingrained inherent biases and affecting patient care. Although most journals have developed editorial policies that encourage the use of person-first language, negative language continues to be used, which perpetuates both overt and implied stigma related to obesity. Therefore, editorial policies need to be adopted and widely implemented in order to discourage the use of ambiguous, pejorative words such as ‘fail’ and ‘morbid obesity’.

References: 1. Maroney D, Golub S: Nurses’ attitudes toward obese persons and certain ethnic groups. Percept Mot Skills 1992, 75(2):387–391. 2. 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(6):339–345.