General chatter - Doctors should use the term "fat" instead of "obese" - do you agree?




tinycities
07-28-2010, 08:47 AM
I came across this article on the BBC News website this morning, and wanted to share it because I thought it would be really interesting to hear what you all think about it (withholding my own thoughts for the moment!).

NHS should use term fat instead of obese, says minister
By Nick Triggle Health reporter, BBC News

GPs and other health professionals should tell people they are fat rather than obese, England's public health minister says.

Anne Milton told the BBC the term fat was more likely to motivate them into losing weight.

She said it was important people took "personal responsibility" for their lifestyles.

But health experts said the word could stigmatise those who are overweight.

Ms Milton, who stressed she was speaking in a personal capacity, said: "If I look in the mirror and think I am obese I think I am less worried [than] if I think I am fat."

She said too many staff working in the NHS were worried about using the term, but suggested it could help encourage "personal responsibility".

"At the end of the day you cannot do it for them. People have to have the information," she added.

The minister spoke to the BBC after setting out the coalition government's vision for public health.

A white paper is expected to be published in the autumn, but she said it would stress the combined role of the individual, state, business and society.

The comments come after Health Secretary Andrew Lansley last month attacked the "lecturing" of recent public health campaigns, such as the drive on school meals that followed on from Jamie Oliver's TV shows.

Professor Steve Field, of the Royal College of GPs, said he agreed with Ms Milton and already tried to use the term fat as much as he could.

"I think the term obese medicalises the state. It makes it a third person issue. I think we need to sometimes be more brutal and honest.

"You can be popular by saying the things people want to hear and in the NHS we too often do that when we should be spelling things out clearly."

But Professor Lindsey Davies, president of the UK Faculty of Public Health, which represents public health professionals, warned against using fat when dealing with patients.

"People don't want to be offensive. There is a lot of stigma to being a fat person."

She said health professionals started using the term obesity to encourage patients to think about the condition in a different way.

"Obesity is something that happens to people rather than something they are. The language you use all depends on the relationship you have with a patient.

"I would probably be more likely to say something like 'can we talk about your weight' rather than obesity, but that is a judgement you make on a patient-by-patient basis."

Source: http://www.bbc.co.uk/news/uk-10789553


SCraver
07-28-2010, 09:23 AM
Fat, obese... same thing. I don't think what word a Dr. uses is going to motivate people to lose weight. People need to lose weight for their own reasons. (Even if that reason is b/c their Dr. told them they were unhealthy.)

It sounds like an article full of excuses. Lot's of people don't want to take responsibility for things. I know that I gained weight b/c I ate a LOT of crap. period. It is not something that "happened to me". I did this to myself. And in a way... that is good - it means I can undo it.

If a person looks at "obese" as something that "happened" to them then I don't think calling that same person "fat" is going to suddenly change their perspective.

Rosinante
07-28-2010, 09:36 AM
I wonder how many lives could have been saved if doctors/healthcare works had felt 'allowed' to be brutally honest? I'm greatly in favour of them being able to tell it as it is - and if I'm upset, tough.

The assumption that "fat" is always a term of abuse is wrong; "fat" is just an adjective, it doesn't make me a bad person. It might, however, have spurred me into losing weight sooner. Or not. But I think doctors should not feel penalized for using the real word for a life-threatening condition.


ThicknPretty
07-28-2010, 09:44 AM
Actually....

Fat is too much of an opinion or an adjective for me (meaning just a descriptive word). I've heard people much smaller than me call themselves fat and other people call them fat, too. So the word, to me, is used very irresponsibly and therefore I do not take it as seriously. What is "fat" to one person can be normal, attractive or desirable to another. It's kind of like the word ugly...

Obese is the word I hate the most. When I realized I was obese, I was heartbroken and ashamed and shocked. That word in itself just really brought it home for me. It's a more clinically used term and therefore I take it more seriously. Also, I just hate the sound of it. The word obese can be given partial credit for making me get off my butt and do something about my weight.

If my doctor just flat out called me fat, I would question their competence, actually. And I would probably shrug it off because hey, not something I haven't heard before, right?

Just my two cents, I'm interested to see how everyone else feels!

knitsforfive
07-28-2010, 10:08 AM
I just read a book called "Fatland" that talked about how much work the government and schools put into avoiding hurting any fat people's feelings during the 90's and 00's and just how detrimental that has been to our sense of responsibility. Medicalizing obesity has made it acceptable, according to the book.

It also talks about how the plus size clothing industry contributed. That particularly hit home because I can remember jogging in high school and college when I realized I was about to have to buy from a catalog or buy adult sizes as a kid. Once the plus sized stores became ubiquitous, though, I didn't worry so much.

souvenirdarling
07-28-2010, 10:42 AM
Wow, to me "fat" is something you feel like. Everyone feels fat sometimes, and it's a word applied to many levels of weight. "Obese" means it could kill you if it gets worse. It's clinical, and defined.

I guess Doctor's can't help it if their patient is ineducated... or in denial, rather. I for the most part support them doing/saying what they need to... Some tact at first would be nice :)

Latchkey Princess
07-28-2010, 11:15 AM
I guess to me I'd rather they use the word obese (or overweight). I prefer that my doctor use the appropriate medical terminology with me. Like some others I think "fat" is more of an opinion, or an insult, than obese.

I guess I say this because I've had a bad experience with a doctor calling me fat. I was only 16 years old, and wasn't even there for anything except getting the pill. I was maybe 15 lbs overweight and not at all unfit, I could run 2 miles nonstop and swim laps for an hour. My doctor took a look at my chart and called me fat (not kidding, she looked at me and said, "You're fat. You need to lose weight.") and told me I needed to go on a diet and start exercising. At 16, all I can say is that was devastating.

Thighs Be Gone
07-28-2010, 11:23 AM
The word OBESE is actually what nudged me off the cliff. I got on a Wii at a friend's house--can you imagine the way I felt there in front of everyone with the word OBESE written across the screen.

ShihtzuX2
07-28-2010, 11:42 AM
I guess to me I'd rather they use the word obese (or overweight). I prefer that my doctor use the appropriate medical terminology with me. Like some others I think "fat" is more of an opinion, or an insult, than obese.

My doctor took a look at my chart and called me fat (not kidding, she looked at me and said, "You're fat. You need to lose weight.") and told me I needed to go on a diet and start exercising. At 16, all I can say is that was devastating.

:mad: That was SO wrong! What a rotten thing to do to a kid. Wonder how many girls and women had their self-esteem damaged by that doc's attitude and were nudged toward disordered eating, skewed body image and other unhealthy behaviors.

caryesings
07-28-2010, 11:53 AM
I guess to me I'd rather they use the word obese (or overweight). I prefer that my doctor use the appropriate medical terminology with me. Like some others I think "fat" is more of an opinion, or an insult, than obese.



This is pretty much what I feel. I would rather have the doctor use the medical terminology to get my attention. If a doctor had called me fat, I don't think that would have even gotten my attention, as by the time I was 13 and medically normal I was already calling myself fat.

kaplods
07-28-2010, 04:30 PM
I think words and how they're used can make a difference, but I don't think there's any word that is "magically" effective with everyone. Some people find some words offensive, but they're often different onces. Some people prefer "fat," and some people prefer "obese." Some people would be motivated and others demotivated by the same word.

I don't think there's any way a doctor can say "you're fat," that is truly helpful. It's not the diagnosis that helps people, it's practical strategical advice. "What do I do about it?"

I think we think the answer is obvious "lose weight," but many of us have learned that wanting to lose weight, trying to lose weight, and succeeding at losing weight are very different things.

I've known I was fat since I was 5 years old, and I tried more often than not to lose weight. So doctors telling me (with words or attitude) that I was fat, obese, humongous, disgusting, pitiful...... none of it helped. I knew my condition, I didn't know how to successfully address it.

And doctors apparently don't either. For as long as I can remember, anytime I saw a new doctor, I brought up the issue first (and was hoping that some doctor would really have some answers). I'd tell the doctor that I've been trying to lose weight since I was 5 years old, I'd tell them what I was currently doing, where I was succeeding and failing, and then would ask them if they had any other suggestions or recommendations (almost always they said "no," some of them in creative ways - like the obese doctor who told me "No, but if you find anything, could you please let me know").

The only treatments I found effective were amphetemine diet pills (in the short-term. I was only 14, so I probably shouldn't have been on them at all, but I was desperate and so was my doctor), and low-carb (which until my present doctor, every doctor I'd ever seen advised against). Even when my doctor suggested it, I was skeptical and reluctant to try it until I had a consult with the weight loss clinic doctor who had lost almost 100 lbs on low-carb dieting herself, and her husband had lost over 100 lbs.

Doctors should be discussing patient's weights, but it's not the terminology they use that's important. Compassion and knowledge are what is lacking, and until doctors have and can use both, they won't be helping patients as much as they could.

You can call someone a horrible, horrible word and if it's done with compassion, they often will not take offense. You can use the kindest words, and yet communicate contempt. If doctors have contempt for their patients, they will not be able to help them, because it's nearly impossible to respect the opinion of someone who has shown you no respect. And you know when someone is looking down their nose at you.

Doctors generally have had very little nutritional training, and yet they don't refer patients to dietitians. The reason is obvious - most medical insurances do not cover consultations or visits with dietitians or diabetic counselors except under very specific circumstances. Even if your insurance does, your doctor isn't likely to make the referral, because most don't.

Everyone knows how to lose weight - at least that's what we assume, but the truth is very different. I'm not an idiot. I sailed through school, college, and graduate school because I read and retain information very quickly and easily. I didn't have to "study" in the way most of my classmates did. I studied weight loss more than I did any other subject, and put a lot more time and effort into studying weight loss than I did psychology for my B.A. and M.A. degrees.

Finally, after nearly 40 years of study, I think I've got the solution for my weight problems (and it's still difficult to put it into practice). A good part of the reason I didn't succeed earlier is that I had to unlearn some misconceptions about low-carb dieting (and a few other components as well).

While "eating less and moving more" is at the heart of most weight loss, putting that into practice is a lot more compicated. Sending folks home with that advice isn't enough.

Participation in weight loss groups, whether it be Weight Watcher's, OA, TOPS, a small club in someone's home, or online like here ate 3FC, have been shown to improve people's odds of success, and yet doctors are reluctant to recommend them. Why is complicated, but I think it includes fear of endorsing a plan they know little about, but I think there are other social and cultural reasons. There is still stigma attached to being overweight, and there's some pressure for fat people to do weight loss behind closed doors.

I'ver rarely if ever had a doctor advise me to do join a weight loss group or a gym. When I've told them I have, I've usually gotten praise (and sometimes astonishment, which felt a little weird, to be honest, as if I were doing something radical or shocking, and maybe just a little wrong).

Though some input has helped and some has hindered, I've never felt that my weight loss depended upon my doctor's input. I can't blame or credit any doctor for my weight gain or weight loss, but I think doctors can be part of the solution, but only if they're more knowledgeable on the subject than they currently (as a whole) are.

Wysteria
07-30-2010, 03:01 PM
I wonder how many lives could have been saved if doctors/healthcare works had felt 'allowed' to be brutally honest? I'm greatly in favour of them being able to tell it as it is - and if I'm upset, tough.

The assumption that "fat" is always a term of abuse is wrong; "fat" is just an adjective, it doesn't make me a bad person. It might, however, have spurred me into losing weight sooner. Or not. But I think doctors should not feel penalized for using the real word for a life-threatening condition.

This. I agree one million percent. It's just an adjective. I think it's only hurtful if you're REALLY sensitive or people use it in a hurtful way. Obese is just a polite way of telling someone they're overly fat, after all. I'd never heard it used until the mid-90's when all this political correctness crap came into being because of people with no backbone complaining all the time.

If you're fat, you're fat. And doctors should definitely tell it as it is. My doctor plain and simple told me that if I kept 'getting fatter' I'd get diabetes. She didn't say 'if you keep gaining weight'. And I think I love her for that. It really kickstarted me into weight loss.

kaplods
07-30-2010, 04:22 PM
I consider fat a more neutral term than obese. To me, obese sounds ominous, and morbidly obese even more so. Although they struck fear in my heart, they didn't help me lose weight. Only knowledge and a supportive environment did that.

I don't think people are so stupid that they don't know that fat and obese mean the same thing. Or that "gaining weight" is the same as "getting fatter."

I think there are very few fat/obese people who are unaware of their situation. The health risks may be unclear, and that's where doctors need to clarify. "You need to lose weight," no matter how diplomatically or cruelly it's said isn't the information people need to hear.

Patients need to know the health risks (so doctors need to tell them) and they need to know how to lose weight healthfully. I think a doctor does patients a disservice if they tell them to lose weight, and don't care how they do it. There are health risks associated with some forms of weight loss and the patients need to know that too. They need to know why "just not eating at all, until you lose all the weight" is a very bad idea (you're losing a lot more muscle than you would if your diet includes adequate protein).

Most doctors I've had did not care about the "how," (in fact, they probably didn't even know about the how), and the how is incredibly important. I've only begun to realize exactly how important.

I had one doctor tell me that I needed to eat 1000 calories a day, and that I could eat that 1000 calories in snicker bars if I wanted (that was 30 years ago, when I was 14. I sure hope no doctor today would give that advice, though I've received some pretty stupid advice even recently with a doctor trying to push me into weight loss surgery, even though I have health issues that increase my risks from the surgery exponentially).

Diabetic educators are perhaps the best "specialist" in the medical field. Although my husband was diagnosed diabetic in Illinois about 8 years ago, none of the doctors referred him to a diabetic educator. The only advice he got was a four page pamphet and warned not to eat bananas (they're higher in sugar than most fruit, but avoiding them completely isn't necessary. All I can think is that the doctor has a banana prejudice).

Our current doctor is fantastic. He referred hubby and I both to a diabetic educator. At the time, I was pre-diabetic so my insurance only covered one consultation with the educator. As an actual diabetic, my husband was able to take a full course of classes (and can take refresher courses every year). Our doctor even complained to us that more classes weren't covered for pre-diabetes. Or for people who were at risk, but still had normal blood sugars. The people education could help the most. He told us how lucky we were, because I could go with hubby to the classes, and told me that I should consider myself diabetic for all practical purposes (that is I should be following a diabetic diet too, even though I wasn't "technically" diabetic).

It's ironic that the most sensitive, caring doctor I've ever had, also has pased on some of the best, most useful weight loss advice I've ever gotten. The brutal honesty isn't as important as plain ol' honesty - and information, information, information.

I didn't know our area had a warm water therapy pool, until my doctor gave me a referral (I had mentioned that I loved swimming, but I couldn't tolerate the cold water anymore). I didn't even know such things existed (even though when I lived in Illinois I was unknowingly within 10 minutes drive of similar programs). I lived in IL for 38 years, and was never informed by any of my doctors that such programs existed.

Maybe I was too young for doctors to consider me for the program, but my mom wasn't, and she was never told of their existence either, even though she'd benefit from them greatly. I haven't been able to persuade her to get over her fear of being seen in a bathing suit, but maybe her doctor's opinion would sway her (she never listens to my advice. I can't tell you how many times she's excited about something her doctor has told her to do, that I've been trying to persuade her into for years).

Support systems are really important to weight loss. Research stats have found that groups like WW and TOPS (and dozens of others) tend to be more successful than patients doing it on their own, though I only have ever had one doctor suggest such a group. More recently, online groups have been shown to provide many of the same benefits, again no doctor has ever suggested those.

I'm not blaming my doctor for not passing on this info. I've been "studying" weight loss for years, and I don't feel my doctor's input has been vitally important (it would have been nice to have some information sooner, but mostly I found it on my own), at least not past adulthood (some of my childhood experiences with doctors regarding weight loss was pretty counterproductive. I could have done without the amphetemine diet pills at 14 and the advice about the candy bar diet).

Being that weight issues are so extremely common, and such a medical issue, it's ridiculous that general practice doctors don't get much training in weight management. They really need training in nutrition, diet therapies, and exercise physiology. They can't pass on information they don't have.

JenMusic
07-30-2010, 04:31 PM
I lived overseas (China) for 4 years. In Chinese, there's one common word for fat/obese/overweight/chubby - all of it (I don't speak medical Chinese, so I'm sure there's something more precise).

The "F word" lost almost all of its stigma while I was in China. Everyone calls everyone else fat. :) It's a greeting: "Hey, you're looking fatter today!" and it's really commonplace to have friends/strangers ask you how much you weigh. I became really comfortable with the word "fat" while in China, but I do NOT feel that way here in the States.

In the US, I feel like "fat" is not a statement about weight - it's a statement about worth. When people use "fat" (usually as an insult) it's often shorthand for saying that the fat person is lazy, ugly, stupid, and a waste of space and resources. I know that sounds extreme, but just look at how often a fat person is the butt of jokes on TV and in movies.

I know I've read it somewhere, but can't remember where - the obese actually seek medical treatment less than their normal weight counterparts, and one theory is that this is because they feel their doctors will be mean to them.

So no, I don't think fat shaming is an effective method of motivation. I've been overweight my whole life, since childhood, and I've known it. But when I was ready, I took the necessary steps to deal with it. If a doctor wants to discuss my weight with me in a professional, clinical manner, great. But if he/she calls me fat and insults me, I'm done.

kaplods
07-30-2010, 04:48 PM
For most of my life, I felt like a freak trying to find a way to become normal (and never understanding why I never could quite make it).

Oddly enough, I think feeling "normal" helped me lose a lot more weight than feeling like a freak.

Understanding the whys behind the difficulty in losing weight has really helped me overcome it. Feeling lazy, crazy, or stupid didn't work. Feeling like a normal person with a normal (or at least understandable) challenge, changed my mindset. Instead of looking at each slip as a failure, seeing it as a perfectly understandable challenge gave me more motivation to change it.

Seeing my behavior as logical gave me more strength than seeing it as self-destructive for no apparent reason.

Aclai4067
07-31-2010, 11:05 AM
Personally, I think the term obese sounds way worse than fat. Plus it's the clinical term; I'd be weirded out by a doctor saying fat instead just because it sounds unprofessional and (from a doctor) under-educated

JulieJ08
07-31-2010, 01:58 PM
I don't know why it doesn't occur to people that ... People. Are. Different.

Just because the author feels motivated when someone calls her fat, doesn't mean other people don't just crave ice cream like **** when made to feel bad.

Seriously? She's totally unaware not everyone reacts like she does? Really?

Ciao
07-31-2010, 02:15 PM
I lived overseas (China) for 4 years. In Chinese, there's one common word for fat/obese/overweight/chubby - all of it (I don't speak medical Chinese, so I'm sure there's something more precise).

The "F word" lost almost all of its stigma while I was in China. Everyone calls everyone else fat. :) It's a greeting: "Hey, you're looking fatter today!" and it's really commonplace to have friends/strangers ask you how much you weigh.
I'm living in the wrong country then! :lol:

I really don't like the word fat. Never have I, or
will I use the word fat to describe myself or someone
else. I cringe at the word and I think that overall
it's just a really negative word. I also don't like the
word skinny. Something about that word makes me
cringe also. I prefer terms like big or tiny.

joyra
07-31-2010, 04:31 PM
I think fat is an insult word. Obese is a disease word. Calling me obese makes me feel like I better lose weight or I'll die. Calling me fat makes me think I am not as good as you are. Or rather YOU think I am not as good as you are.

Think about it--would you call someone smaller than you fat? Probably not. Most people only call someone who is larger than themselves "fat."

Doctors, stick with the medical terminology.

EZMONEY
07-31-2010, 07:57 PM
I have a friend that is 6' 2" and weighs 330 pounds....

he will say things like "my ex-wife got fat and blah...blah...blah" always bashing her for their divorce/lives

Someone else with us at work will say "dude! You are fat!" He always comes back with "No, I'm big...I'm just a big guy"

or he'll say to me "Wow your brother eats a lot!"....and seriously this guys eats at least as much or more than my 6' 2" 245 pound brother.

We have been friends for over 40 years so we just ignore this stuff for the most part....heard it too many times.

I swear he still sees himself still as an 18 yr. old maybe just a little overweight.

He will also describe people as obese...we tell him that he is obese and it's always.."Well, not really...I'm just a big guy"....

People have always been described as fat ~ chubby ~ skinny ~ thin ~ tall ~ short ~ stocky ~ lanky

these ARE the words we use to describe people....

When I was younger I was described as skinny...sometimes I felt embarrassed about it...

but the fact is...I WAS skinny!!!

call it what you want...thin...skinny....lanky....it's all the same!