Doctors seek best way to talk about kids’ weight

There are no magic words for pediatricians when it comes to discussing weight with young patients and their parents, said Dr. Joanna Zolkowski-Wynne, an adolescent medicine specialist at Yale New Haven Health at Bridgeport Hospital.

“In my experience, no matter what words you pick, there’s always someone who has hurt feelings, because their impressions and experiences can have meaning that you’re not aware of,” she said. “Information is dependent upon the people receiving it.”

If the role of a doctor is to offer guidance and care in seeking healthy outcomes, using stigmatizing language is a setback for both the patient and the provider. Citing scarcity in the body of research on the language preferences of youth to discuss body weight, researchers with the University of Connecticut’s Rudd Center for Food Policy and Obesity authored a study meant to find the appropriate language for providers to use; it was published this year in the peer-reviewed medical journal Pediatric Obesity.

Researchers Rebecca Puhl, deputy director of the Rudd Center, and Mary Himmelstein, Rudd Center Postdoctoral Fellow, provided a link to an online survey that was completed by 148 people between the ages of 13 and 18 enrolled at a commercial weight loss summer camp in 2017 — split evenly between boys and girls — and rating 16 different words and terms for body weight on a scale from unpreferable to preferable.

Overall, only “weight problem,” “plus size” and “chubby” were rated preferable by more than half of respondents, while about half of respondents disliked “curvy,” “obese” and “extremely obese.”

The researchers said the study is a “first step” to addressing a gap in research by soliciting youth perspectives on stigmatized terms and weight discussion.

“Although more work is needed to obtain a comprehensive understanding of youth reactions to weight based terminology, providers can be proactive in their use of appropriate weight-based language, recognizing that language preferences vary in their patients, and asking youth what words they feel most comfortable using to talk about their weight,” the researchers wrote in their conclusion.

Tamiko Jackson-McArthur, a New Haven-based pediatrician and member of the city’s Board of Education, said it’s best practice to “always use words that are kind.”

“You don’t want to make a child feel less than. You talk to them about how to live healthily, like drinking water and eating healthy,” she said. “Approach children holistically.”

Zolkowski-Wynne said she speaks with young patients and parents to find solutions.

“They see their bodies every day, so it’s not new information,” she said. “I try to emphasize that everyone’s body is different and my job as the doctor is to teach them about ways to be healthy. You don’t want to hurt children’s feelings or put them on the defensive. It’s always better to feel you have a solution than a problem.”

Jackson-McArthur said those solutions often must be made at the household level, so parents are crucial in that collaboration.

“It’s not just a change for the child,” she said. “Kids might get teased a lot, so you don’t want to make that problem worse.”