Weight bias and people-first language

[Born in Missouri 1,264]

In the 1980s, the concept of “person-first language” developed among disability advocacy groups.

Non-profit organizations, such as the Obesity Action Coalition have expanded advocacy for people-first language to obesity. As of 2017, five U.S. medical societies had pledged for it, and use it in their communications, among them: the American Society for Metabolic and Bariatric Surgery, The Obesity Society, and American Society of Bariatric Physicians.

Labeling individuals as obese creates negative feelings toward individuals with obesity and perpetuates weight-bias.

Quite often, one will see news stories, articles, and journal entries refer to an individual with obesity as “obese.” For example, I found this Wikipedia article on Carol Yager:

Carol Ann Yager was one of the most severely obese people in history, and the heaviest woman ever recorded. In January 1993, Yager was admitted to Hurley Medical Center, weighing-in at 1,128 lb (512 kg). As is common with many severely obese patients, Yager was not able to stand or walk.

https://en.wikipedia.org/wiki/Carol_Yager (Yes, one point of the article on Carol Yager is to focus on how many pounds she weighed, but the article also reveals weight-bias with its wording. Maybe to some, it seems like yet another attempt to be overly-politically correct, but really... how much effort does it take to use people-first language?

https://radicalcopyeditor.com/2017/07/03/person-centered-language/

https://www.obesityaction.org/action-through-advocacy/weight-bias/people-first-language/

https://en.wikipedia.org/wiki/People-first_language

The goal of people-first language is to stop dehumanizing individuals by labeling them with their disease.

Edited July 21, 2018 by Missouri-Lee's Summit

[Creekimp13 5,841]

"Did you see the diabetes person taking up two seats on the plane?"

"She's not attractive. Too much cancer."

"Heart disease people are sloppy and lazy. That's how they got that way."

Obesity is the last safe social prejudice. It's sad. Worse, how self loathing people can be about their own condition.

Never ceases to amaze me to hear people talk about hating themselves for having a metabolic disorder. Feeling shame, personal failure, etc.

For no other medical condition is self hatred so taught.

Obesity is no longer considered a cosmetic issue that is caused by overeating and a lack of self-control. The World Health Organization (W.H.O.), along with National and International medical and scientific societies, now recognize obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.

The disease of obesity is extremely costly not only in terms of economics, but also in terms of individual and societal health, longevity, and psychological well-being. Due to its progressive nature, obesity requires life-long treatment and control.

[nibble 201]

Here's an interesting article...

http://www.weightymatters.ca/2018/07/guest-post-what-happens-to-weight-bias.html

[Born in Missouri 1,264]

Actually, the classification of obesity as a disease by the AMA was not a slam dunk. There was plenty of opposition. There's a 14-page document out there that argues against obesity-as-a-disease, but I couldn't find it.

Here's one journal article that asked the question, "Did the American Medical Association make the correct decision in classifying obesity as a disease?" (Oddly enough, this was written by an Australian medical journal).

"Obesity has reached pandemic proportions, is strongly associated with myriad co-morbid complications, and is leading to a progressive economic and social burden. However, being obese does not necessarily equate to poor health, and evidence suggests individuals may be fat but fit. Perhaps most importantly, labelling obesity a disease may absolve personal responsibility and encourage a hands-off approach to health behaviour. This knowledge raises the question of morality, as individuals must now choose whether they will invest effort into maintaining a healthy lifestyle in order to free society of the healthcare burden associated with obesity. Given the myriad issues surrounding the decision to classify obesity in this way, perhaps a new question should be posed in order for society to continue this discussion: who benefits most from labelling obesity a disease?"

Go to:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259211/

https://www.medscape.com/viewarticle/806566

[Born in Missouri 1,264]

@nibble Thank you for suggesting that article. Powerful words.

"... understanding obesity as a disease has a positive impact on emotions, which then has a positive impact on overall attitudes towards people living with obesity. Findings from this study also support the idea that reducing blame might be an avenue to reduce weight bias attitudes.... Labelling obesity a disease seems to be related to less weight bias for individuals who hold strong beliefs about people getting what they deserve and who are satisfied with their own body weight at least in terms of reducing blame."

Edited July 21, 2018 by Missouri-Lee's Summit

[nibble 201]

Missouri-Lee - I felt compelled to write to the three women who authored the paper. I did not expect a reply but wanted to convey the power of the AMA decision in my life. If you can't access the attachment let me know.

Obesity as a Disease.pages

[Born in Missouri 1,264]

@nibble I am speechless. You wrote to the AMA and they wrote back to you? Wow! That's fantastic.

How did it feel to pour such powerful emotions into a letter and then send it to the very people who had a role in our collective abilities to have life-changing surgery? Without that disease classification, insurance companies would not have included bariatric surgery as a covered benefit.

I COULD NOT OPEN THE DOCUMENT. Boo-hoo.

Thank you so much. Your idea to write that letter profoundly impressed me.

Edited July 23, 2018 by Missouri-Lee's Summit

[nibble 201]

13 minutes ago, Missouri-Lee's Summit said:

@nibble I am speechless. You wrote to the AMA and they wrote back to you? Wow! That's fantastic.

How did it feel to pour such powerful emotions into a letter and then send it to the very people who had a role in our collective abilities to have life-changing surgery? Without that disease classification, insurance companies would not have included bariatric surgery as a covered benefit.

I COULD NOT OPEN THE DOCUMENT. Boo-hoo.

Thank you so much. Your idea to write that letter profoundly impressed me.

Ha, I'm not THAT good! No, I wrote to the three Canadian researchers who were looking at how people dealing with obesity feel now that obesity is classified as a disease, and seeing if it has impact on weight-related bias toward those who are overweight. I will try again to see if I can send it again in a different format. Before reading that article I was not aware of the debate and controversy on the AMA decision. I see I put it in a Pages doc - will try for Word or pdf.

[Frustr8 7,886]

Fire up your Adobe Reader!

[nibble 201]

12 minutes ago, nibble said:

Ha, I'm not THAT good! No, I wrote to the three Canadian researchers who were looking at how people dealing with obesity feel now that obesity is classified as a disease, and seeing if it has impact on weight-related bias toward those who are overweight. I will try again to see if I can send it again in a different format. Before reading that article I was not aware of the debate and controversy on the AMA decision. I see I put it in a Pages doc - will try for Word or pdf.

The website where I found the article is www.weightymatters.ca and you can then get to the whole article. Then there is a partial page of research papers written by Sarah Nutter, who responded to my letter written to the three authors of the study. Well, everything is in png, so hope it works for you!

[Born in Missouri 1,264]

@nibble. Don't argue. You are that good! I appreciate all the time and effort you put into getting this information to me -- and to others here who are interested. Woohoo. I found another (case)study-buddy!! Knowledge is power and sharing is caring.

[nibble 201]

Thanks, Missouri-Lee. I'm glad you could access it this time. As a retired librarian, I try to put my OCD "features" to constructive use in research. I DO LOVE RESEARCH. :-)

[nibble 201]

So, what impact did the AMA decision have on you in your world?

[Born in Missouri 1,264]

@nibble. I had no problem reading the article or the letters. Thank you for sharing your personal story. I have no doubt that those researchers were happy to hear from you. People are often quick to complain, but how many people actually take the time to let someone know that their work touched you in some way. Your letter helped to break the bubble that researchers like Sarah work in. Everyone wants to make a difference and to be recognized.

[Born in Missouri 1,264]

@nibble. Like you, finding out that obesity-is-now-a-disease was the impetus to find out if my insurance covered bariatric surgery. Fortunately, I didn't give up when my first phone call reached someone who mixed up my plan with another plan that did not have bariatric benefits. I became a squeaky wheel after that until I knew my benefits backwards and forwards, and if anyone tried to insert a requirement that wasn't in my plan, I let them know! One of the "requirements" that someone tried to convince me was a part of my plan had to do with not being allowed to gain any weight during the 6-month physician-directed weight-loss attempt. My plan required only that I do those six months. There was nothing in my plan that "punished" me for gaining weight during those six months.

I've noticed several posters on this forum, primarily younger women, who aren't confident in being good self-advocates. Stop apologizing for everything. Stop allowing gatekeepers to keep you from getting the information you need. To make good decisions, you deserve to have all the facts. Read. Ask. Read some more. Keep asking.

A librarian.. .. I considered library science for a while, but ended up getting a B.S. in health information management. Of course, that's not what I do for a living. Who else has a degree or degrees in areas that they don't work in?

Edited July 23, 2018 by Missouri-Lee's Summit