Overcoming the weight stigma with weight-inclusive language 

Weight stigma refers to discrimination and stereotyping based on a person’s body size, shape, or weight. Weight stigma is prevalent in the United States, even in healthcare settings, and is linked to several adverse health consequences. Physiological, psychological, metabolic, and behavioral effects can be observed in children, teens, and adults due to various factors. In healthcare, dietitians can help combat weight stigma by using weight-inclusive language, which can help bring about significant positive changes.  

What is weight-inclusive language?

Weight-inclusive language refers to language that avoids shaming a person for their body weight or size. It also uses people-first language, which lists the person first, followed by the descriptor i.e. person with diabetes vs diabetic person. Instead of using terminology like “obese” or “overweight” when describing a patient, weight-inclusive language opts for a neutral descriptor and people-first language such as “person with a higher weight” or “person in a larger body.” 

Why should dietitians use weight-inclusive language?

1. Support evidence-based practice – Research demonstrates that weight-focused approaches to healthcare are often associated with food & body preoccupation, weight cycling, reduced self-esteem, eating disorders, distraction from other personal health goals, and weight discrimination (1,2). Weight-inclusive language takes a holistic approach to well-being, rather than fixating on weight loss.
2. Reduce body shame and weight stigma – Body shaming refers to the act of criticizing or making fun of someone’s physical appearance, often leading to feelings of shame or embarrassment. It can have negative effects on mental health and self-esteem. Apart from the negative health effects previously discussed, weight stigma is linked to unhealthy eating habits, inadequate physical activity, and avoidance of healthcare (2-4). Using weight-inclusive language can alleviate weight stigma and body shame, which results in a more respectful healthcare encounter for the patient.  
3. Improve patient-provider relationship – As a dietitian, it’s important to use weight-inclusive language to establish a positive and non-judgmental relationship with patients. This approach fosters trust and open communication, which ultimately leads to better quality care, fewer barriers, and increased patient satisfaction (2,4). Furthermore, patients tend to be more motivated to seek healthcare interventions and adhere to treatment when they feel they are being treated with respect and dignity (1,3,5).
4. Focus on behaviors instead of body size – Using weight-inclusive language draws the focus away from body weight and onto health-promoting behaviors. This approach creates more room in the discussion to learn about the patient’s relationship with food, physical activity, mental health, and other components that might be affecting their well-being. 
5. Supportive healthcare environment – When dietitians use weight-inclusive language, it enhances the supportiveness and inclusivity of healthcare settings. This approach creates a more validating environment for patients, reducing perceived weight bias and improving health behaviors and outcomes.
6. Promote body acceptance & diversity – Adopting weight-inclusive language helps to promote body acceptance and normalize body diversity. This language reinforces that a person’s value and respect are not determined by their body shape or size. As a result, weight-inclusive language preserves dignity and can play a part in improving patient mental health and overall well-being.   

Summary

Using weight-inclusive language is a crucial element in ensuring inclusive healthcare. It displays consideration for the patient, irrespective of their physical appearance. Most importantly, this language style fosters a more empathetic, inclusive, and efficient approach to health, nutrition, and wellness. It highlights health-promoting habits and provides evidence-based assistance to patients in attaining their individual health objectives, making it an invaluable tool for dietitians to incorporate.

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References:  

Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(1). https://doi.org/10.1186/1475-2891-10-9 

Dada, J. (n.d.). Weight-Inclusive Care: Evidence and Best Practices [PDF]. Retrieved from https://www.todaysdietitian.com/pdf/courses/DadaWeightInclusive.pdf. 

Tylka, Tracy et al. The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss.  

Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews, 16(4), 319–326. https://doi.org/10.1111/obr.12266 

Tomiyama, A. J., Carr, D., Granberg, E. M., Major, B., Robinson, E., Sutin, A. R., & Brewis, A. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Medicine, 16(1). https://doi.org/10.1186/s12916-018-1116-5     

O’Hara, L., & Taylor, J. (2018). What’s Wrong With the ‘War on Obesity?’ A Narrative Review of the Weight-Centered Health Paradigm and Development of the 3C Framework to Build Critical Competency for a Paradigm Shift. SAGE Open, 8(2). https://doi.org/10.1177/2158244018772888