People-first Language ~ Weight Issues

 

As a gerontologist, I promote maintaining a healthy weight for optimum aging outcomes. This is not my own personal viewpoint, but my stance based on scientific research. Overweight causes a myriad of chronic conditions that not only shorten life, but adversely impact quality of life. While most of my clients strive to maintain healthy habits, I have had some tough discussions with individuals who ignore the facts and tell me despite science, they will defy the odds. It is not possible.

The majority of my clients fear dementia or Alzheimer’s Disease. The first line of defense in cognitive health is healthy living. It is disheartening when clients have the desire to put into practice most the elements of successful aging but insist on maintaining the extra fifty or hundred pounds due to poor lifestyle choices such as excessive alcohol intake, sedentary lifestyle, or excessive snacking. That does not justify stereotyping, scapegoating, or insulting them. While interacting with people, it is imperative to embrace people-first language. More about that later.

Overweight people have two requests. Stop discriminating against them and stop labeling them. Bias against overweight is rampant globally (Sussman, 2021). While laws have been adopted in every developed country to prevent weight discrimination, they are not enforced, and people continue to be discriminated against due to their body weight. Employers, who know it is almost impossible to prove and rarely enforced, have adopted the attitude that overweight applicants can change their bad habits and their condition is self-imposed. Stigmas, bullying, stereotyping, and name calling have been experienced by forty percent of overweight Americans (Susman, 2021).

People in the helping professions are addressing harmful labeling of overweight individuals. I seriously doubt that your primary care physician will discontinue using categories on charts to describe the level of overweight. We are gaining some traction, as the nomenclature “morbidly obese” has been replaced by “Class 3 Obesity” in the medical community.

The medical categories have made their way into the English lexicon, with people using descriptive labeling nomenclature to describe people in everyday conversations. Labeling is harmful, promotes stereotyping, and perpetuates bias and shame. Examples below show how “person-first” language is more respectful, positive, and productive:

Crippled ~ Person with a disability

Retarded ~ Person with a developmental disability

Confined to a wheelchair ~ Person who uses a wheelchair

Elderly ~ Older adult or senior adult

Autistic ~ Person with autism

Diabetic ~ Person with diabetes

Overweight, Fat, Chubby, Plump, or Obese ~ Person with “unhealthy weight,” or “a weight problem”

 

What exactly is “overweight?” anyway? The National Institutes of Health (the NIH) defines “overweight” as a BMI (Body Mass Index) of 30 and above. The World Health Organization [WHO] defines “overweight” as excessive fat accumulation that poses a risk to health, while the OMA defines it as “a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences” (OMA, 2021). While the American Medical Association recognized “overweight” as a disease in 2014, the WHO identified it as such in 1948.

The Centers for Disease Control [CDC] identifies four categories of Body Mass Index including underweight, healthy/normal weight, overweight, obesity, and Class 3 Obesity [formerly “morbid obesity.] Their website provides resources and examples of the five categories.

 

Resources:

Centers for Disease Control and Prevention:  https://www.cdc.gov/obesity/adult/defining.html

 

Sussman, E. (2021, November 3). New policy statement pushes “people-first” language rather than disease-first. Medpage Today. Retrieved from https://www.medpagetoday.com/meetingcoverage/obesityweek/95413

 

Sussman, E. (2021, November 3). Weight management workers urge anti-discrimination policies. Medpage Today. Retrieved from https://www.medpagetoday.com/meetingcoverage/obesityweek/95423

 

The Obesity Medicine Association [OMA]:  https://obesitymedicine.org/what-is-obesity/

 

The Obesity Society [TOS]:   https://www.obesity.org