A Sneaky Artifact of Weight Bias That Should Fade Away

Bias makes us human. It can even help us thrive by recognizing patterns in our lives. But of course, bias is sneaky, reinforcing patterns that keep people down for no good reason. So it is with weight bias – which some people believe causes more harm than obesity itself. One of the ways that weight bias sneaks into the lives of people living with obesity is through words – words that convey more than their technical meaning.

The example of the day is recidivism.

A Technical Term of Art

In a letter to the editors of Obesity, Lou Aronne and colleagues correctly point out that recidivism is a term of art for describing a relapse to a former condition. Bariatric surgeons have used this term to describe the weight regain that quite normally occurs after bariatric surgery. Though surgery is a very effective treatment for obesity, some degree of weight regain is normal. It is distressing to patients who fear that they might be doing something wrong or be seeing yet another failure – despite their best efforts – to bring obesity under control.

Emotionally Powerful

Recidivism is both technically correct and emotionally powerful. The emotional power comes from the common meaning of the word:

“The act or habit of continuing to commit crimes, and seeming unable to stop, even after being punished.”

In this context, someone with weight recidivism is committing something of a crime. We hear this attitude toward people with obesity all the time. For example, a surgeon recently told us on twitter that people with obesity who died from COVID had been “as irresponsible as smoking a pack a day.”

An Artifact Ready to Recede into History

Also in Obesity, Ted Kyle, Joe Nadglowski, and Patty Nece write that it’s time for this artifact to fade into history. They say that social norms have begun to reject explicit fat shaming, but offer caution:

“Implicit weight bias persists and may even increase when public health campaigns employ unfortunate approaches to promote obesity awareness. As this journal notes in its guidelines for authors, pejorative language has no place in a scientific journal.”

In their letter, Aronne et al agree that it’s important to consider the words we use in talking and writing about obesity.

Bias is sneaky because it embeds itself in our language. Words like imbecile, moron, and retarded were once just fine in scientific writing about intellectual disabilities. But such language is obviously degrading today.

Do we use recidivism to describe a relapse of breast cancer? Of course not. Nor should we make the implicit comparisons between weight regain after bariatric surgery and committing yet another criminal offense. So let’s erase recidivism from the vocabulary of obesity care.

Click here for the letter from Kyle et al and here for the letter from Aronne. For perspective on the history of language used for mental disabilities, click here. For more on the emotional content of words attached to obesity, click here.

Sneaky, illustration by Kazimir Malevich / WikiArt

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June 15, 2021