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The American Academy of Pediatrics recommends that clinicians use nonstigmatizing terms to discuss weight issues with adolescents. To determine what terms adolescents prefer to hear from their providers, investigators conducted an online survey among approximately 150 adolescents aged 13 to 18 attending a national weight loss camp. Response rates were 74% of boys and 36% of girls. Respondents rated the acceptability of 16 words providers might use to describe excess weight using a 5-point scale (1=never use this word; 3=not sure; 5=prefer this word).
At least 40% of adolescents disliked the terms extremely obese, obese, curvy, large, fat and heavy (all scale values < 3). At least 44% preferred the terms weight problem, plus size, chubby, BMI (body-mass index), weight, high BMI, and unhealthy weight (mean scale values, 3.2–3.6). Adolescents with BMI between the 85th and 95th percentiles most preferred overweight, higher body weight, weight, and high BMI (mean scale values, 3.5–3.6), and those with BMI >95th percentile most preferred weight problem, unhealthy weight, chubby, and plus size (3.8–4.5). Adolescents with the highest level of weight bias internalization gave highest ratings to weight problem, chubby, plus size, BMI, and high BMI (mean scale values >3.5).
Puhl RM and Himmelstein MS.Adolescent preferences for weight terminology used by health care providers. Pediatr Obes 2018 Mar 24; [e-pub]. (https://doi.org/10.1111/ijpo.12275)
Comment
Despite the methodological limitations of this study, these are the only data currently available and are consistent with findings in adults. I was surprised that “chubby” and “plus size” were acceptable to some teens, but this was mostly among the most obese teens and those with a greater degrees of weight bias internalization; the authors speculate that for these teens, these terms seemed less threatening than obese and extremely obese. Even so, I would recommend avoiding them and use the highly rated terms that are most neutral and can be tied to the concept of health (e.g., BMI, high BMI, weight problem, unhealthy weight).