The Best and Worst Words to Use When Discussing Kids' Weights

Parents have weighed in: it's better to describe a child as being an "unhealthy weight" than as being "heavy" or "obese."

A new study says that the words doctors might use when discussing a child's weight have varying effects on a parent's attitude.

Researchers asked 445 parents how they felt about 10 words or phrases doctors might use when speaking to them about their children's weight. They found that some terms, such as "obese" and "fat," were not only undesirable but stigmatizing, according to the parents, while terms such as "unhealthy weight" were preferred, as they seemed to assign less blame.

"Pediatricians and doctors really play an important role when it comes to obesity prevention and treatment, but their efforts to provide quality care can really be [limited] if they use stigmatizing language," said study author Rebecca Puhl, director of research and weight stigma initiatives at the Rudd Center for Food Policy & Obesity at Yale University.

The study is published online today (Sept. 26) and in the October issue of the journal Pediatrics.

Bad words and better words

"With the high rates that we have of childhood obesity, it is certainly important for [doctors] to be talking about body weight, but how we approach it is just as important," Puhl said.

In the end, the researchers found that "weight" was the preferred term, with "unhealthy weight," "high BMI," "weight problem" and "overweight" also being better regarded than other options.

On the other hand, the parents did not prefer "heavy," but said it was less offensive than other terms, such as "chubby" and "obese." Referring to a child as "extremely obese" or "fat" was regarded as most stigmatizing by more than 60 percent of parents surveyed.

One lesson to take from the study is that anyone speaking to a parent about a child's weight should ask what words they would prefer, Puhl said.

"There are going to be individual differences in people's preferences. What we need to recognize as providers is you can't make assumptions about people's preferences," Puhl said.

Another concern in dealing with weight, the researchers noted, was that many parents with overweight children have struggled with weight themselves. As a result, they may be more sensitive to the language used, either having a negative reaction to meetings with the doctor or avoiding future appointments entirely.

The issue of word usage has received more attention recently, as obesity, particularly among children, becomes a growing concern.

"I thought it was a really innovative study addressing a really important topic that people are not talking about now," said Dianne Neumark-Sztainer, a professor of epidemiology and community health at the University of Minnesota.

Stigmatizing words and health

While the study did not look at whether children's health was affected by the language used, Neumark-Sztainer said there is some evidence to suggest that the stigma of language would not be helpful for a child.

"In our society, we have a lot of weight stigmatization. These terms are not taken lightly," she said.

Neumark-Sztainer said parents who felt stigmatized might simply put their child on a restrictive diet, which would likely backfire.

"When parents encourage their children to go on a diet, they actually end up gaining weight over time," she said. "Suggestions, even with the best of intentions, can have unintended consequences."

Strategies for weight loss require greater lifestyle changes than simply a diet, she said, and discussions could be more limited if parents feel uncomfortable.

"I think [we need to be] really sensitive to the fact that for many parents and children who are overweight, they have experienced weight stigma, they are sensitive to the language used," Neumark-Sztainer said. "We really want them to feel comfortable in the heath care provider's office so they will return and they will be open to getting advice."

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