Talking about obesity with clients: Preferred terms and communication styles of GBR pre-registration dieticians, doctors, and nurses

Patient Education and Counseling

Volumn 91, Issue 2, 2013, Pages 186-191

  Swift, Judy A ^a   Choi, Edith ^a   Puhl, Rebecca M ^b   Glazebrook, Cris ^a  

^a UNIVERSITY OF NOTTINGHAM   (United Kingdom)

^b YALE UNIVERSITY   (United States)

Author keywords

Communication; Medical terminology; Obesity; Stigma

Indexed keywords

ADULT; ARTICLE; BODY MASS; COMMUNICATION SKILL; CONSULTATION; CONTROLLED STUDY; DIETITIAN ATTITUDE; FEMALE; HEALTH BELIEF; HUMAN; MALE; MEDICAL EDUCATION; MEDICAL INFORMATION; NURSE ATTITUDE; OBESITY; PATIENT EDUCATION; PHYSICIAN ATTITUDE; PRIORITY JOURNAL; PROFESSIONAL COMPETENCE; PROFESSIONAL KNOWLEDGE; SELF REPORT; UNITED KINGDOM; VERBAL COMMUNICATION;

COMMUNICATION; CONSULTANTS; DIETETICS; FEMALE; GREAT BRITAIN; HUMANS; MALE; NURSES; OBESITY; PATIENT SATISFACTION; PHYSICIANS; SOCIAL STIGMA; TERMINOLOGY AS TOPIC;

EID: 84875897308     PISSN: 07383991     EISSN: 18735134     Source Type: Journal    
DOI: 10.1016/j.pec.2012.12.008     Document Type: Article

References (57)

1. The Health and Social Care Information Centre. Statistics on obesity, physical activity and diet: England, 2012. Publication date February 23, 2012. Available from: [cited 12.07.12]. http://www.ic.nhs.GBR/webfiles/publications/003_Health_Lifestyles/OPAD12/Statistics_on_Obesity_Physical_Activity_and_Diet_England_2012.pdf.
2. Wang Y.C., McPherson K., Marsh T., Gortmaker S.L., Brown M. Health and economic burden of the projected obesity trends in the USA and the GBR. Lancet 2011, 378:815-825.
3. Puhl R., Brownell K.D. Bias, discrimination, and obesity. Obes Res 2001, 9:788-905.
4. Puhl R.M., Heuer C.A. The stigma of obesity: a review and update. Obesity 2009, 17:941-964.
5. Maiman L.A., Wang V.L., Becker M.H., Finlay J., Simonson M. Attitudes toward obesity and the obese among professionals. J Am Diet Assoc 1979, 74:331-336.
6. McArthur L.H., Ross J.K. Attitudes of registered dieticians toward personal overweight and overweight clients. J Am Diet Assoc 1997, 97:63-66.
7. Campbell K., Crawford D. Management of obesity: attitudes and practices of Australian dieticians. Int J Obes 2000, 24:701-710.
8. Hebl M.R., Xu J. Weighing the care: physicians' reactions to the size of a patient. Int J Obes 2001, 25:1246-1252.
9. Teachman B.A., Brownell K.D. Implicit anti-fat bias among health professionals: is anyone immune?. Int J Obes 2001, 25:1525-1531.
10. Harvey E.L., Summerbell C.D., Kirk S.F.L., Hill A.J. Dietitians' views of overweight and obese people and reported management practices. J Hum Nutr Diet 2002, 15:331-347.
11. Foster G.D., Wadden T.A., Makris A.P., Davidson D., Sanderson R.S., Allison D.B., Kessler A. Primary care physicians' attitudes about obesity and its treatment. Obes Res 2003, 11:1168-1177.
12. Schwartz M.B., Chambliss H.O., Brownell K.D., Blair S.N., Billingtonm C. Weight bias among healthcare professionals specializing in obesity. Obes Res 2003, 11:1033-1039.
13. Brown I. Nurses' attitudes towards adult patients who are obese: literature review. J Adv Nurs 2006, 53:221-232.
14. Berryman D.E., Dubale G.M., Manchester D.S., Mittelstaedt R. Dietetics students possess negative attitudes toward obesity similar to nondietetic students. J Am Diet Assoc 2006, 106:1678-1682.
15. Puhl R., Wharton C., Heuer C. Weight bias among dietetics students: implications for treatment practices. J Am Diet Assoc 2009, 109:438-444.
16. Poon M.Y., Tarrant M. Obesity: attitudes of undergraduate student nurses and registered nurses. J Clin Nurs 2009, 18:2355-2365.
17. O'Brien K.S., Puhl R., Latner J.D., Mir A.S., Hunter J.A. Reducing anti-fat prejudice in preservice health students: a randomized trial. Obesity 2010, 18:2138-2144.
18. Swift J.A., Hanlon S., El-Redy L., Puhl R.M., Glazebrook C. Weight bias among GBR trainee dietitians, doctors, nurses and nutritionists. J Hum Nutr Diet 2012, [Epub ahead of print]. 10.1111/jhn.12019.
19. National Institute for Health and Clinical Excellence. NICE clinical guidance 43. Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. Issue date December, 2006. Available from: [cited 12.07.12]. http://www.nice.org.GBR/nicemedia/pdf/CG43NICEGuideline.pdf.
20. Martin D. Obese? Just call them fat: plain-speaking doctors will jolt people into losing weight, says minister. The Daily Mail [updated 29.07.10]. Available from: [cited 10.09.11]. http://www.dailymail.co.GBR/news/article-1298394/Call-overweight-peoplefat-instead-obese-says-health-minister.html.
21. Brochu P.M., Esses V.M. What's in a name? The effects of the labels " fat" versus " overweight" on weight bias. J Appl Soc Psychol 2011, 41:1981-2008.
22. Wadden T.A., Didie E. What's in a name? Patients' preferred terms for describing obesity. Obes Res 2003, 11:1140-1146.
23. Dutton G.R., Tan F., Perri M.G., Stine C.C., Dancer-Brown M., Goble M., Van Vessem N. What words should we use when discussing excess weight?. J Am Board Fam Med 2010, 23:606-613.
24. Volger S., Vetter M.L., Dougherty M., Panigrahi E., Egner R., Webb V., Thomas J.G., Sarwer D.B., Wadden T.A. Patients' preferred terms for describing their excess weight: discussing obesity in clinical practice. Obesity 2012, 20:147-150.
25. Gray C.M., Hunt K., Lorimer K., Anderson A.S., Benzeval M., Wyke S. Words matter: a qualitative investigation of which weight status terms are acceptable and motivate weight loss when used by health professionals. BMC Pub Health 2011, 11:513.
26. World Health Organization Obesity: preventing and managing the global epidemic 2000, World Health Organization, Geneva, Switzerland.
27. Thomas S.L., Hyde J., Karunaratne A., Herbert D., Komesaroff P.A. Being 'fat' in today's world: a qualitative study of the lived experiences of people with obesity in Australia. Health Expect 2008, 11:321-330.
28. Ward S.H., Gray A.M., Paranjape A. African Americans' perceptions of physician attempts to address obesity in the primary care setting. J Gen Intern Med 2009, 24:579-584.
29. Lewis S., Thomas S.L., Warwick Blood R., Hyde J., Castle D.J., Komesaroff P.A. Do health beliefs and behaviors differ according to severity of obesity? A qualitative study of Australian Adults. Int J Environ Res Public Health 2010, 7:443-459.
30. Weight Concern. Obese and fat are the most hurtful words a doctor can use. Available from: [cited 10.09.11]. http://www.shape-up.org/weightcon/WCNletterSpring08.pdf.
31. World Health Organization Expert Committee Physical status: the use and interpretation of anthropometry 1995, World Health Organization, Geneva, Switzerland.
32. National Institute for Health and Clinical Excellence. Public health draft guidance. Obesity: working with local communities. Issue date May, 2012. Available from: [cited 12.07.12]. http://www.nice.org.GBR/nicemedia/pdf/CG43NICEGuideline.pdf.
33. Tailor A., Ogden J. Avoiding the term 'obesity': an experimental study of the impact of doctors' language on patients' beliefs. Patient Educ Couns 2009, 76:260-264.
34. Scott J.G., Cohen D., DiCicco-Bloom B., Orzano A.J., Gregory P., Flocke S.A., Maxwell L., Crabtree B. Speaking of weight: how patients and primary care clinicians initiate weight loss counseling. Prev Med 2004, 38:819-827.
35. Tham M., Young D. The role of the General Practitioner in weight management in primary care - a cross sectional study in General Practice. BMC Fam Pract 2008, 9:66.
36. Ma J., Xiao L., Stafford R.S. Adult obesity and office-based quality of care in the U.S. Obesity 2009, 17:1077-1085.
37. Ko J.Y., Brown D.R., Galuska D.A., Zhang J., Blanck H.M., Ainsworth B.E. Weight loss advice US obese patients receive from health care professionals. Prev Med 2008, 47:587-592.
38. Shiffman S., Sweeney C.T., Pillitteri J.L., Sembower M.A., Harkins A.M., Wadden T.A. Weight management advice: what do doctors recommend to their patients?. Prev Med 2008, 49:482-486.
39. Breitkopf C.R., Egginton J.S., Naessens J.M., Montori V.M., Jatoi A. Who is counseled to lose weight? Survey results and anthropometric data from 3,149 lower socioeconomic women. J Community Health 2012, 37:202-207.
40. Miche S. Talking to primary care patients about weight: a study of GPs and practice nurses in the GBR. Psychol Health Med 2007, 12:521-525.
41. Pedersen P.J., Ketcham P.L. Exploring the climate of overweight and obese students in a student health setting. J Am Coll Health 2009, 57:465-469.
42. Hansson L.M., Rasmussen F., Ahlstrom G.I. General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care. BMC Fam Pract 2011, 12:7.
43. Baron R.B. Telling patients they are overweight or obese: an insult or an effective intervention?. Arch Intern Med 2011, 171:321-322.
44. Hoppé R., Ogden J. Practice nurses' beliefs about obesity and weight related interventions in primary care. Int J Obes Relat Metab Disord 1997, 21:141-146.
45. Ottenritter N.W. Service learning, social justice, and campus health. J Am Coll Health 2004, 52:189-191.
46. Wills W., Backett-Milburn K., Gregory S., Lawton J. Young teenagers' perceptions of their own and others' bodies: a qualitative study of obese, overweight and 'normal' weight young people in Scotland. Soc Sci Med 2006, 62:396-406.
47. Tischner I., Malson H. Exploring the politics of women's in/visible 'large' bodies. Fem Psychol 2008, 18:260-267.
48. Eneli I.U., Kalogiros I.D., McDonald K.A., Todem D. Parental preferences on addressing weight-related issues in children. Clin Pediatr (Phila) 2007, 46:612-618.
49. Webb H. 'I've put weight on cos I've bin inactive, cos I've 'ad me knee done': moral work in the obesity clinic. Sociol Health Ill 2009, 31:854-871.
50. Swift J.A., Sheard C., Rutherford M. Trainee healthcare professionals' knowledge of the health risks associated with obesity. J Hum Nutr Diet 2007, 20:599-604.
51. Day S., Fayers P., Harvey D. Double data entry: what value, what price?. Control Clin Trials 1998, 19:15-24.
52. Tabachinck B.G., Fidell L.S. Using multivariate statistics. International Students Edition 2000, Allyn and Bacon, Boston. 4th ed.
53. Cohen J. Statistical power analysis for the behavioral sciences 1988, Erlbaum, Hillsdale, NJ.
54. Berg M. Choose sensitive, accurate terms. Healthy Weight J 1998, 12:12-13.
55. Post R.E., Mainous A.G., Gregorie S.H., Knoll M.E., Diaz V.A., Saxena S.K. The influence of physician acknowledgement of patients' weight status on patient perceptions of overweight and obesity in the United States. Arch Intern Med 2011, 171:316-321.
56. Stange K.C., Flocke S.A., Goodwin M.A. Opportunistic preventive services delivery. Are time limitations and patient satisfaction barriers?. J Fam Pract 1998, 46:419-424.
57. Lyles J.S., Dwamena F.C., Lein C., Smith R.C. Evidence-based patient-centered interviewing. J Clin Outcomes Manage 2001, 8:28-34.