Thursday, June 29, 2006

Polite 'Obese' vs. Politically Incorrect 'Fat'

Is this man "fat" or is he "obese" -- which term do YOU prefer?

This NewsBlaze story written by bariatric doctor Caroline J. Cederquist, MD (you might remember her from this blog post last year when she described the Atkins diet as "extreme" and "dangerously unhealthy") stirs up a very provocative topic of discussion about what we should call people who are carrying around a few extra pounds -- "fat" or "obese"...or something else?

Dr. Cederquist cites new research from the University of Pennsylvania that studied the exact words used by doctors when they talk to their patients about their weight problem. It zeroed in on how the decision about the terminology used to describe the condition of weighing too much can make or break a patient's receptivity to the message that they desperately need to hear the message loud and clear.

Did I ever get into trouble when I wrote a blog post entitled "Get Over It Lady, You're Fat!" about that woman last August who sued her doctor for defamation of character because he told her she needed to lose weight.

"I told a fat woman she was obese," exclaimed Dr. Terry Bennett from Rochester, New Hampshire doctor at the time. "I tried to get her attention. I told her, 'You need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you."

I defended what Dr. Bennett said as her physician because it is my contention that people sometimes need to be jolted into reality about their weight by their doctors, especially if they are in denial about it. Sure, I care about people's feelings, but those won't do you any good if you're not around to have them hurt anymore!

But Dr. Cederquist admits it is such a "sensitive issue" in this day and age of political correctness. You can't call somebody "fat" because that is tantamount to calling a black person the "n" word or a gay person the "f" word. "Fat" has become taboo and is avoided like the plague.

The new word du jour for the modern "fat" person is "obese," which Dr. Cederquist says is actually "just a medical term" that any doctor would use to describe a plump patient of theirs.

"Obesity is a medical problem, a public health problem," Cederquist wrote. "It does have behavioral aspects, but as more attention and resources are devoted to considering all its aspects, we learn every day how multifaceted and complex it really is."

One of those complexities is the stereotype that overweight people are "lazy, sloppy or undisciplined."

When I weighed 410 pounds, I was NOT lazy, somewhat sloppy, but definitely disciplined in most areas of my life, except my weight. The labels that are thrown around about people who are "big" are mostly unfair, but people are going to be people, aren't they?

The good thing about this is you don't have to stay stuck in your misery about your weight if you decide that you are ready to take it on and defeat it once and for all. That's when somebody telling you how "fat" you are might just be motivation enough to help you overcome it. I understand everyone won't respond positively to that, but it will motivate some.

Getting back to the medical term "obese," people are even getting antsy about THAT word now, Cederquist notes.

"The negative connotations [obese] carries are so entrenched in the public psyche that the simple medical meaning is lost," Cederquist pointed out. "Body size is so often regarded--even by them--as a reflection of their character."

Man, I must have been one BIG GIANT character a couple of years ago then! :D

Seriously, I never even thought about or even worried about what people called me because I knew I was big and didn't care at the time. When I finally did decide to do something about my weight, that is when I started caring about how people saw me. You can call it my "fat sensitivity scale" now. It's funny how NOBODY ever calls me "fat" or "obese" now. :D That's a GREAT feeling!

Remember that study? The researchers looked at all sorts of euphemisms and phrases that run the gamut and came up with the most desireable ways patients like to be described when they have a "fat" issue.

Here they are in order of patient preference:

1. "weight"
2. "excess weight"
3. "BMI"

Sheeez, that's lame! Oh, you have a "weight" issue to take care of. Dear Johnny, your "excess weight" is holding you back. That BMI of yours has me concerned. Oh brother, give me a break!

The study found the term "obesity" was the absolute WORST way to describe someone who is "fat" because it is most undesirable.

Well, you know what? That's just too bad because the truth can and should hurt sometimes when it comes to a doctor talking to his patient. I OH SO WISH my doctor would have been frank with me about my obesity a long time ago. Instead, he just danced around the issue and urged me to eat low-fat, exercise, yadda yadda yadda which meant NOTHING to me. It still doesn't.

But we may hurt their wittle feelings, Dr. Cederquist contends. Oh the horrors of a doctors being "offensive" in ANY way so their advice doesn't get missed by the patient. Well, boo freakin' hoo.

If you don't like it, then there is one thing you can do to make those labels go away. There will be no more lessons in semantics if you lose the weight. I know, I know, that's easier said than done, but I did it and so can you. It IS possible with the right plan and following through on that plan. Obesity is the most preventable condition in America today and yet two-thirds of Americans are dealing with their weight. Ugh!

Dr. Cederquist also noted at the end of her column that despite groups that celebrate their obesity (like this woman who didn't like my "Get Over It Lady, You're Fat" post), the vast majority of overweight people are buying it. That's why she recommends doctors come up with "non-offensive, non-confrontational terminology" to get their point across.

Sure, keep on doing that, doctors, and see how well that works for you as your patient keeps getting bigger and bigger until one day he or she ends up having a massive heart attack.

WAKE UP PEOPLE! We don't need our doctors to present a sugar-coated, politically correct way to tell people they are big. Just tell 'em already and share with them various ways they can overcome it. Low-fat has monopolized medical advice for far too long and it's time livin' la vida low-carb gets a leg in the door, too.

If you are "fat," then you know what you need to do. NO MORE EXCUSES! Whether you are "fat," "obese" or otherwise.

7-1-06 UPDATE: This blog post from the "Keep It Off" blog of Dr. John Hernried segueways rather nicely on this topic about how people are in denial about their obesity.


Blogger Lowcarb_dave said...

What we need is for Doctors to care about their patients. To actually sit and 'listen' to their patients and dialogue with them. To believe what they say.

Most of the time it's some sort of cold scornful judgement.

As a kid I didn't need Doctors taunting me and calling me fat, because everyone else was.

In fact being labelled harshly, and bullied and taunted constantly as a child, as caused massive self esteem issues within myself that will most likely be there for life.

What I needed was someone to present a workable solution and educate me on how to achieve these aims.

I needed someone there to support me through it! A child can't do it on their own! All parents want to do is bring down harsh discipline!

So people can use all the words in the world to hurt the most vulnerable in this world, but what it will do, is actually the opposite, it will dis-empower that very people who you want to empower!

It's totally illogical to me, to destroy the self esteem of someone who you want to empower themselves!

6/30/2006 12:01 AM  
Blogger Newbirth said...

As an adult you have more choices. Kids can't decide to join a group and decide what will be served to them. As an adult we usually have a lot more control over what goes in our mouths. I do my own grocery shopping so I just don't buy crap anymore. I could count point or fat grams or whatever I wanted. Kids can't do that unless they have really supportive parents (rare).

6/30/2006 1:00 AM  
Blogger Lowcarb_dave said...

Newbirth (Vctoria)

Awesome! You said it just right!

6/30/2006 2:07 AM  
Blogger Jimmy Moore said...

But Dave, ignoring the severity of obesity doesn't do any good either. There has to be SOMETHING doctors have the kahunas to do to help their patients regardless. This is TOO serious an issue to play around with.

6/30/2006 8:01 AM  
Blogger Mark said...

My thoughts on the subject. Ms. Cederquist basically says that if you offend the person they won't listen which seems reasonable. However, I can think of situations where I took offense at something I was told about myself. However, the embarassment and shame of that thing made me change my behavior and therefore habits. Sorry, but I won't say what it was except to say it had to do with personal hygiene. The point is that Ms. Cederquist's is more concerned with the process (i.e. communication) than the results. I frankly can't imagine how a doctor is going to tell a patient he or she needs to lose 50 pounds or more with just the term 'weight '.

"Mr. Jones your weight is over, no strike that. You might prevent diabetes if your weight was 50 lbs less."

"Sorry, but I'm not overweight! How dare you imply I'm overweight!"

It's like tying both hands behind your back. Sensitivity is one thing, self censure is another.

6/30/2006 1:27 PM  
Blogger Jeff Hamlin said...


You can tell someone your concerns with tact by not going to either extreme. You don't need to sugarcoat nor is it wise to say, "Lady, you're fat!"

6/30/2006 11:07 PM  
Blogger Jimmy Moore said...

I agree, Jeff. But we're not talking about average everyday people here, but rather doctors. They have a RESPONSIBLITY to be frank with their patients to help keep them healthy. Dr. Cederquist believes they need to keep dancing around the issue with the "nice" card. My point is that hasn't been effective to date and perhaps a new stategy should be considered. As for your average Joe or Jane on the street talking about people who are "big," ABSOLUTELY they should have tact about it. THANKS for your comments!

7/01/2006 8:38 AM  
Blogger . said...


7/02/2006 3:41 PM  

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