People First, Except Obesity

At ObesityWeek 2014, Andrew Brown presented an elegant analysis of people first language in asthma, autism, diabetes, and obesity. He used Google Books nGram Viewer to examine how frequently people first language has been used over time in various conditions. His analysis shows that when it comes to putting people first, obesity is last.

The preference for people first language in writing about health and disabilities is well established. The American Medical Association, in its Manual of Style, requires that authors to:

Avoid labeling (and thus equating) people with their disabilities or diseases (e.g., the blind, schizophrenics, and epileptics). Instead put the person first. Avoid describing persons as victims or with other emotional terms that suggest helplessness (afflicted with, suffering from, stricken with, maimed). Avoid euphemistic descriptions such as physically challenged or special.

Brown found that this practice has become the norm in published books included in the Google Books database. The use of people first neutral language has increased for asthma, autism, and diabetes over time, while the trend for obesity is in the opposite direction.

To their credit, the major organizations that address obesity — the Academy of Nutrition and Dietetics, the American Society of Bariatric Physicians, the American Society for Metabolic and Bariatric Surgery, the Obesity Action Coalition, and the Obesity Society — have all endorsed and called for consistent use of people first language in writing and presenting on the subject of obesity. That means describing “obesity” as a disease, rather than defining people by their condition — “the obese.”

Implementation is a bit more of a challenge. In policy forums at ObesityWeek 2014, we hear frequent references to the importance of people first language. It goes something like this:

“The use of people first language is very important when talking about obese people.”

We hear this said without a hint of irony. Old habits die hard.

Click here for Brown’s abstract, here for the poster, and here for more on putting people first in obesity.

#1, photograph © Meena Kadri / flickr

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