fitness · health · Weekends with Womack

Language matters: how words in health contexts can hurt

CW: talk of fat-shaming and weight connected to health (for purposes of describing my presentation). The past two weeks have been conference-intensive. I was in Guelph, Ontario a couple of weeks ago, listening to talks about Feminism and food and also hanging out with our blog founders and friends Sam and Tracy. I mini-blogged about some of the talks here.

This past week, I was giving a talk at the American Public Health Association Meetings in Philadelphia. It was about health-concern trolling of fat people in the doctor’s office and other healthcare contexts. Spoiler alert: I’m against it.

What do I mean by health-concern trolling? Think of it as fat-shaming speech justified by health concerns on the part of the speaker. Here are some common examples:

  • I’m just concerned about your health.
  • You’d find that life was a lot easier if you weighed less.
  • (insert any disease or condition here) would be less severe/go away/never have appeared if you lost weight.
  • Before treating (insert any disease or condition here), you need to lose weight.

But of course images speak volumes. You’ve seen it before, but it’s a classic:

Comic of a woman impaled on a stake, and a doctor telling her she’d do better if she lost weight.

Apart from the big problem the woman in the comic has, how does health concern-trolling harm us? I think (as do others working in feminist bioethics– there’s strength in numbers…) that it’s a form of microagression, which wears us down with the repeated message that we don’t matter as patients, as persons who deserve respect and care.

What do I mean by microagression? This: A microaggression is a relatively minor insulting event made disproportionately harmful by taking part in an oppressive pattern of similar insults. The pattern of insults tends to be linked to stable traits such as gender, ethnicity, disability status, or (in this case) weight. Philosopher Regina Rini explained the harms of microaggressions well here:

What makes microaggression distinctively harmful is victims’ awareness that each instance is not an isolated accident. It will happen again and again and again. Further, these minor insults are linked to vast social harms…”

There’s a lot written about microagressions, and I’m just getting started thinking and writing about them. Next year I’m applying for funding to do some focus groups of fatter people to ask about their experiences with health-concern trolling in healthcare contexts. The goal is to find out what they think good health care looks like from their perspective. Stay tuned for more updates on the health concern trolling front.

Readers, what does good health care look like to you? What would you want to change in your encounters with health workers? I’d love to hear from you.

6 thoughts on “Language matters: how words in health contexts can hurt

  1. The last time I went for my physical, the nurse said ok I just need to get your weight and height. I said is that really necessary? She said it’s just for your BMI. I said I know but I don’t think it’s necessary. I said I work out regularly etc. She said ok. I hate that they still ask for that and wish they didn’t.

    1. I agree with you. I also don’t want to be weighed until it’s for a medical reason. I tell them (like you do), but it’s unpleasant.

  2. I know I’ve said it here before, but I changed doctors a couple years ago because the last one felt the need to discuss my BMI, which was/is “barely in the normal range.” I cannot understand how any physician thinks that is a good starting point for a discussion of someone’s health. And such conversations, I am sure, keep people from going back to the doctor to address potentially serious concerns. Avoiding the micro-aggression can be a powerful motivator!

    1. That’s awful– “barely in the normal range”! I don’t have enough time to write all that’s wrong in that statement. Grrrrr. Thanks for sharing this with us.

      1. Yeah, I was furious. I called him on it, but I’m sure I didn’t change any minds that day.

  3. They should weight you only after you take your clothes off and weigh yourself in a private room because your shoes and clothes add 10 to 15 pounds on your body.

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