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What Label Can You Live With?

For my new book due out in January, Helping Patients Outsmart Overeating: Psychological Strategies for Doctors and Health Care Providers, my co-author, Paige O’Mahoney, MD, and I struggled to find the best ways to describe the patient population we were writing about as well as their concerns. We received input from the Health at Every Size movement (found at HAES) and sought out current research on the subject.
One study, “The impact of weight labels on body image, internalized weight stigma, affect, perceived health, and intended weight loss behaviors in normal-weight and overweight college women” (Essayli, Murakami, Wilson, and Latner, Am J Hlth Prom 1-7, DOI: 10.1177/0890117116661982, ajhp.sagepub.com, 2016) explains that there has been a substantial scientific challenge to use of the BMI-related weight labels of “normal, overweight, and obese” because “it does not reflect differences in muscle mass, age and race.” The study’s “results provide initial support for the hypothesis that a weight label of ‘overweight’ may have negative effects on women’s body image, internalized weight bias, affect, and perceived health, particularly among overweight participants.” Another article, “What's in a word? On weight stigma and Terminology,” (Frontiers in Psychology by Meadows and Daníelsdóttir, doi:10.3389/fpsyg.2016,01527, http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01527/full) questions the whole point of labeling people of high weight at all, noting that doing so creates stigma in itself.
Overweight is often a view of your body compared to: that of others, how it used to be, what weight charts say, or how you wish it to be. To health care providers, overweight means above the narrow range of pounds or kilograms that is considered in excess of “normal.” BMI is an arbitrary standard. According to Wikepedia, it is “a value derived from the mass (weight) and height of an individual” and was “devised by Adolphe Quetelet from 1830 to 1850.” The value of BMI has been challenged by researchers, including Ancel Keys who said that BMI is “appropriate for population studies and inappropriate for individual evaluation.” (Wikepedia, retrieved 2/13/17, https://en.wikipedia.org/wiki/Body_mass_index#History_and_usage_in_obesity_studies)
And therein lies the rub.
How do you feel about the weight label that society or your health care providers give you or the one you openly or secretly give yourself? A reasonable reaction to the word “overweight” might be, “Over what weight?” Both the denotation and connation of the word have come to mean that there is something wrong with you. Many of you are old enough to remember when the word “underweight” was a nice way of saying that a person looked malnourished or unhealthy—again, implying that something was amiss.
For our book, Dr. O’Mahoney and I chose to say “a high-weight or higher-weight person” because what we really wanted to say (in person first language), “a person with a high or higher weight,” was too long to be repeated regularly in the book. Consider what you want to call yourself if you’re at the higher end of the weight spectrum. Then feel free to use the term openly and let others know that this is how you wish to be labeled if you must be labeled at all.
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