o in O

The O-Word Versus the W-Word

The o-word has long been a problem. “Obesity” is a medical term that is more than just off-putting. It’s a stigmatizing diagnosis. Even worse is labeling people as “obese.” That’s not OK. Most people with obesity will tell you that they might have some excess weight, but obesity has nothing to do with them. Thus the w-word has long found much wider use when people are seeking to do something about the o-word.

But now, the w-word is itself polarizing. Shall we retreat to talking more vaguely about health and avoid that word too? This is a puzzle with no obvious solution that will satisfy all parties.

Preferences for Weight versus Obesity

A whole series of studies point to the importance of word choices when healthcare professionals discuss obesity. In 2013, Rebecca Puhl and colleagues found that people view weight-related terminology as the most desirable and motivating. On the other hand, they found precisely the opposite for language about being fat or obese.

Likewise in another study, Puhl found that the most favorable responses to public health campaigns came when the o-word wasn’t part of the message. Focusing on healthy behaviors – like healthy foods and physical activity – seems preferable. And in yet another study, these researchers found that stigmatizing campaigns do nothing to motivate people to adopt healthier behaviors.

Consumer Movement Toward Health Versus Weight

On top of all of this, it’s now becoming apparent that consumers have very mixed feelings about weight. Dieting to lose weight is decidedly out of fashion. Yes, people still do it, and they gobble up magical thinking about diets. But in our hearts, we know that short-term solutions to a chronic problem simply don’t work.

So the preferred approach is sustainable, healthy patterns for life. That’s why Weight Watchers became WW. It doesn’t have to be all about weight. It can be “Wellness that Works.” Likewise, a contingent of dietitians are resisting weight management and promoting the tenets of  Health At Every Size.®

Avoiding the Issue?

Dancing around the semantics of obesity and weight has its own risks. WW has encountered a few bumps with its rebranding. And it’s worth noting that one study found patients with obesity can find euphemisms for obesity to be distressing.

At the end of the day, obesity is a medical condition. Catastrophizing it doesn’t help – either in public campaigns or in individual dialogues. It will remain an uncomfortable subject for as long as we are lacking uniformly effective solutions that meet individual needs.

But getting rid of the o-word won’t solve the problem. Nor will an excessive focus on weight – the w-word. Focusing on health is good, but ignoring the impact of obesity on health outcomes is not. These are intensely personal concerns. Health and wellness providers must put the client first and use language with empathy and sensitivity.

Cookie cutter solutions simply don’t work here because one size does not fit all.

Click here for further perspective on the tension in how we approach obesity, weight management, and health.

o in O, photograph © Jerzy Durczak / flickr

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August 13, 2019

2 Responses to “The O-Word Versus the W-Word”

  1. August 13, 2019 at 10:38 am, Allen Browne said:

    Yup ! Focusing on health is good, but ignoring the impact of obesity on health outcomes is not.



  2. August 13, 2019 at 7:15 pm, Ang said:

    Although I understand from a patient perspective – if we as healthcare providers do not call the disease what it is we will never get this to be seen by the health and public system as a whole able to acknowledge the disease of obesity. Just my two cents. Thanks as always for making us think