It's time we change the way we think and speak about obesity, especially in the doctor's office — and yes, this goes for healthcare providers, too. We spoke with Dr. Alexandra Sowa about how to change the narrative around living with obesity.
How can we move toward a person-first vocabulary when discussing obesity? [puts the person before the disability or disease, and describes what a person has, not who a person is. It does not label someone with their disease.]I think we can move toward a person-first vocabulary when discussing obesity by just remembering that the person in front of us is always a person and not a disease. So I don't talk about a person with hypertension as a hypertensive.
Again, I love to come back to the comparison to hypertension. So, often in medicine, we are very comfortable prescribing someone a medication to help bring their blood pressure down to goal, and we really don't think twice about it. We will also counsel on lifestyle changes, increased physical activity, better diet, decreased salt, but we will always discuss a medication option if it helps them get to goal. And the same should be true of obesity.
One way to help people discuss treatment options for obesity is to be open to learning — and then open to having a discussion. So many healthcare providers and physicians just really didn't learn anything about this field in their education. And the willingness to listen to others, to reframe your beliefs and to engage in continuing medical education is really important.
I do not believe that these two things are mutually exclusive. It's really important to treat people with respect and to realize that, again, this is a disease, not a lack of willpower — something that these patients have or haven't done in their lifetimes. And we should never talk about weight in terms of appearance or being skinny. We should always frame it in terms of being healthy so that we can still love our bodies, but we can be [in] a healthier body with weight loss.
By being open and honest, and by being very gentle when we have conversations about weight. For example, “Can we discuss your weight? I‘ve noticed that during our last visit two years ago prior to the pandemic, you were 20 pounds less. I really understand it. This has been a stressful time. Have you thought about how you would like to manage this?” Just asking open-ended questions, asking for permission.
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