Doctors have been urged to avoid using ‘judgemental’, ‘threatening’ or non-medical terms such as ‘chunky’ when treating obese patients.
A new language guide from the charity Obesity UK says the way clinicians talk to obese or overweight patients can have a profound impact, leading to stigma and discrimination.
In the report, one patient describes their humiliating experience of a doctor grabbing their belly fat and ‘jiggling’ it during an appointment.
A new language guide from the charity Obesity UK has urged doctors to avoid using ‘judgemental’ or non-medical terms such as ‘chunky’ when treating obese or overweight patients
The patient, who was at the doctor’s to discuss suspected endometriosis, was being examined on the table and was stripped naked from the waist down.
They recalled how, ‘the doctor grabbed a handful of my belly fat, jiggled it about and announced to the nurse, “she needs to get rid of THIS first”.’
Another patient who went to the doctor with chest pains was told to ‘go home and look in the mirror as that was what was wrong with [them]’ – instead of being treated.
Later that night, they were rushed to hospital as they couldn’t breathe and were diagnosed with bronchitis.
The charity, Obesity UK, says they hear on a daily basis how badly people living with obesity are spoken to and treated.
Their guide, Language Matters: Obesity, is aimed at doctors to help them use more appropriate and helpful language when interacting with patients with obesity.
It outlines examples to doctors of what to avoid saying, and what to try instead.
The guidance says doctors should avoid using ‘threatening’ phrases such as telling patients: ‘If you don’t lose weight you will end up with your leg chopped off, or just plain dead.’
One patient in the report described their humiliating experience of a doctor grabbing their belly fat and ‘jiggling’ it during an appointment
It urges doctors to avoid ‘using non-clinical terms, which can be disrespectful, judgemental and inappropriate’ such as: ‘You’re a bit on the chunky side, shall we say.’
Instead it suggests that doctors say: ‘Some people with your symptoms, find that losing a bit of weight and a little exercise can be helpful.’
The guide says that talking about ‘some people’, rather than ‘you’ avoids attributing blame on the patient and also says doctors should try ‘asking permission to discuss weight’.
Other recommendations include that saying ‘you just need to eat less’ is unhelpful.
The guidance explains the reason why this choice of language is wrong, saying: ‘People living with obesity have lower levels of and/or are insensitive to the hormones that give pleasure from food and cause satiety afterwards.
‘As a result, the main symptom of obesity is hunger, even after eating.
‘Telling a person living with obesity to eat less is like telling a person with asthma to breathe less.’
David Strain, of the University of Exeter medical school, who co-led the project to produce the guidance, speaking to The Times said: ‘There is general agreement that living with obesity is associated with a stigma.
‘Words can burn, and contribute to the problems, meaning people may be far less willing to seek support.
‘As healthcare professionals, we have the opportunity to address this stigma, in leading by example with our words and actions, to promote the best health outcomes.’
According to the NHS website, a person with a BMI of over 30 is considered to be obese.
In England, 29% of adults are living with obesity, which is a risk factor for a range of secondary conditions such as type two diabetes, heart disease and certain types of cancer.
Figures published earlier this year show that there record numbers of patients being taken to hospital because of obesity.
Hospitals in England are being flooded with 2,400 obese patients a day – up almost a quarter in a year.
Health officials have warned the obesity crisis is likely to have worsened during the pandemic, with millions of children stuck at home and doing less exercise.
Boris Johnson launched an anti-obesity strategy this week, with plans for restaurant and takeaway chains to be forced to publish the calories in every meal they serve.
Proposals also include a watershed for adverts for certain foods, and the end of promotional deals on unhealthy foods.
Boris Johnson launched an anti-obesity strategy this week which includes plans for restaurant and takeaway chains to be forced to publish the calories in every meal they serve