Words matter when talking about kids' weight

(Edmonton) Doctors who want to develop a strong rapport with parents of overweight children should use terms like “large” or “gaining too much weight” as opposed to the term “obese,” according to findings recently published by medical researchers at the University of Alberta.

Geoff Ball, a researcher in the Faculty of Medicine & Dentistry with the Department of Pediatrics, worked with department colleagues Amanda Newton and Carla Farnesi to review articles about the important relationship between families and health professionals when it comes to addressing concerns about children’s weight. Farnesi has since moved to Montreal where she will soon start her PhD at Concordia University. Their findings were published in the peer-reviewed journal, Pediatric Obesity.

They found that the relationship was a delicate balance affected by what parents preferred in terms of language regarding obesity, how health professionals talked about weight, how care was delivered and what parents expected.

“Health professionals probably shouldn’t use terms like fat, chubby, overweight or obese,” says Ball. “Terms that are more neutral, less judgmental and less stigmatizing should be used. Most of the time, families will want that sensitive type of language. And that’s what clinicians should want, too, because that’s what families want.”

Some parents felt blamed for their children’s weight issues; others found health professionals “rude and judgmental” or inattentive.

When it came to discussing sensitive issues about children’s weight, parents felt it was the role of doctors to spearhead that difficult conversation, especially if there were health concerns. But health professionals were somewhat reluctant to do this because they didn’t want to offend families and negatively affect the physician-patient relationship—especially when it came to raising concerns about weight during an appointment about an unrelated medical issue.

Ultimately, if parents feel ostracized by physicians, the families are less likely to follow doctor recommendations, the researchers concluded.

Ensuring physicians receive guidance on how to address sensitive topics like weight could be a good idea, noted the researchers. It would also be worthwhile to get more feedback from parents about the issue, and to encourage families to work with doctors as a team to find solutions for children. Using more sensitive language about weight is also needed.

“If these changes are made, it could lead to families being more apt to follow the doctor’s advice, families being more apt to return for followup appointments, better interactions between health-care professionals and families, and families being more satisfied with their care,” says Ball, who is also an adjunct professor with the School of Public Health and Faculty of Agricultural, Life & Environmental Sciences. “You want to have a positive rapport with families so they stay engaged. Those are outcomes you would want.”

The research was funded by the Women and Children’s Health Research Institute through the support of the Stollery Children’s Hospital Foundation.