乌鸦传媒

Three-quarters of patients seeking bariatric surgery preferred the term "person with obesity" to "obese person," a small study found.

Among a selection of terms used for patients with a body mass index (BMI) ≥30, study participants favored people-first language, rating "person with elevated BMI" highest (5.3 out of 7), followed by "person with obesity" and "person with excess weight" (4.9 and 4.7, respectively), reported Rebecca Pearl, PhD, and colleagues from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

And while only one-third of patients (37%) reported discussing weight stigma with their healthcare providers, half said doing so would help them feel better about themselves (49%) and feel more understood by their provider (50%), the authors wrote in .

"The idea behind [people-first language] is, we don't want to define our patients by their disease. They are a person first, and we know from prior research that the words we use, especially in healthcare settings, can really affect how patients feel," Pearl told 乌鸦传媒. "Patients do report feeling stigmatized by certain words that are used. For example, the phrase 'the obese' lumps people together in this homogeneous group instead of talking about people as individuals who also have this condition of obesity."

Previous studies have found that the use of specific language by healthcare providers -- such as "" or "" -- may for patients who are overweight or obese. Using people-first language for individuals or groups with a high BMI, as opposed to an "obese person" or "the obese," may reduce these stigmas, according to Pearl's group.

Pearl and her team also asked participants to rate a selection of terms used to describe people with a BMI ≥40. "Morbid obesity" and "extreme obesity" were rated the lowest (2.6 and 3.3 out of 7, respectively), compared to the most-preferred terms, "class III obesity" and "severe BMI" (4.4 and 3.9, respectively).

"That's important because patients seeking bariatric surgery tend to have BMIs of 40 or above or 35 or above with an obesity-related comorbidity," Pearl said. "These are terms that are coming out in a patient's medical chart printout and are being used in a healthcare setting. The terms all mean the same thing, so we can still be medically accurate while also being respectful and thoughtful about the words we use, making sure we're not inadvertently leading patients to feel stigmatized."

Researchers distributed three questionnaires, the Weight Bias Internalization Scale (WBIS), the Everyday Discrimination Scale, and the Stigma Preferences Questionnaire (developed for the study), to 84 women and 13 men with BMIs ≥30 at a university-based hospital.

Respondents had an average age of 46.3, and were more likely to be white (OR 2.1, 95% CI 1.3-3.2, P=0.001), older (η_p²=0.02, 95% CI 0.01-0.04, P<0.001), and have lower BMIs (η_p²=0.01, 95% CI 0.00-0.02, P=0.02) than those who did not choose to answer the survey.

The Everyday Discrimination Scale revealed that 55 of the 97 respondents reported having experienced discrimination on the basis of their weight at least a few times in the past year.

And patients with higher WBIS scores (more instances of discrimination based on their weight) were more likely to report that discussing weight stigmas as part of their weight management was important, helpful, or necessary compared with those with lower WBIS scores (β=0.31, P=0.003). In total, 42 of the 97 patients surveyed believed discussing weight stigmas would improve their chance of losing weight.

"This has really important implications for weight management and bariatric surgery clinical care. Stigma is something that is very pervasive and patients seeking bariatric surgery are particularly vulnerable to internalizing weight biases," Pearl said. "It's not incorporated into standard weight management protocols at this time to talk about weight stigma or to validate this experience and help patients cope with it, so what these data suggest is that patients would be receptive to incorporating discussion of weight stigma into weight management settings."

The women in the study demonstrated a higher predilection toward people-first language than the men, with 69 of 84 women reporting a preference toward phrases like "people with obesity" as opposed to "obese people." Just 5 of the 13 men surveyed reported the same preference (OR 6.9, 95% CI 1.7-28.2, P=0.007).

Pearl stated that potential selection bias, due to the fact that the data were collected from a larger subset and participation in the study was optional, as limiting the findings' generalizability. She also called for a more diverse sample of participants for future studies, as, like much of the research in this field, the study primarily sampled women.

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