Weight...What Should We Call This? ABCD vs Obesity
By Dr. Ryan Oughtred, ND, CBE.
Weight Loss/ Weight Management Doctor in Vancouver
As a weight management doctor practicing in Vancouver, I've spent years helping patients navigate their weight loss journey. Over time, I've noticed a significant barrier that often hinders progress: the stigma attached to the word "obesity."
The Weight of a Word
While recognizing obesity as a chronic disease has been crucial in providing access to effective weight loss programs and obesity medications, the term itself carries a heavy burden. Many patients experience negative emotion when they hear it, which can impede their willingness to seek help or stick with a treatment plan.
A Compassionate Approach to Weight Management
In my Vancouver practice, I've seen firsthand how simply saying the word “obesity" can create distance between myself and the person I am trying to help. Despite explaining that weight issues are largely driven by biological and environmental factors—not a lack of motivation or willpower—patients often experience shame and self-blame related to their condition. I suspect this is because societal misconceptions about body weight are deeply ingrained and hard to undo. Given that fact, I suspect I might likely feel the same way if I were in their shoes.
Introducing ABCD: Adiposity-Based Chronic Disease
To foster a more supportive environment, the US endocrine association has been trying for years to change the name to Adiposity-Based Chronic Disease (ABCD). This shift aims to reduce stigma by focusing on the medical aspects of excess body fat without the negative connotations associated with obesity.
Why Language Matters
Language can be both therapeutic and detrimental. By changing the way we talk about weight, we can alleviate some of the emotional burdens our patients carry. Instead of using potentially triggering terms, I often ask, "I wonder how much your weight or BMI is related to your health right now?" This opens up a dialogue without assigning labels that might cause harm.
The Impact on Patient Care
Using less stigmatizing language encourages more people to seek professional help. Patients are more likely to engage in weight loss programs and consider obesity medications when they don't feel judged. This is especially important in a diverse city like Vancouver, where cultural perceptions of weight can vary greatly.
Understanding Obesity Bias
Weight bias and stigma are not just social issues; they have real implications for health outcomes. Bias can lead to psychological distress, decreased quality of life, and can even affect the severity of the disease itself. It's important for both healthcare providers and patients to recognize and address these biases.
Choosing your Weight Loss Doctor
If you select a weight loss doctor or weight management program that has an understanding of obesity bias and is mindful of the language they use, you might be increasing your chances of success. We know that when people feel shame they are less motivated, they are more stressed, and they are less likely to engage with health behaviours (which is how all treatments work!). Watching for the simple avoidance of the word Obese, or subtle efforts to use person first language like “living with weight” or “this condition you have” are subtle cues you can watch for. Also the use of language that posits behaviour change as challenging, not easy, or is rooted in genetics and is not anyone’s “fault”.
Learn More About ABCD and Obesity Bias
To delve deeper into this topic, I recommend reading the American Association of Clinical Endocrinology's consensus statement titled:
Summary of the AACE Consensus Statement
The consensus statement highlights several key points:
Understanding Obesity as ABCD: Obesity is reframed as Adiposity-Based Chronic Disease, putting the focus on unhealthy body fat, similar to any other organ that might become unhealthy.
Impact of Weight Stigma and Bias: Weight stigma and internalized weight bias (IWB) negatively impact patients' mental and physical health, contributing to psychological distress and decreased quality of life.
Biopsychosocial Model: The statement advocates for a holistic approach that considers biological, psychological, and social factors in the diagnosis and management of ABCD.
Revised Staging System: Incorporating weight stigma, IWB, and social determinants of health into the staging of ABCD to better assess disease severity and personalize treatment plans.
Clinical Recommendations:
Screen patients for weight stigma and IWB using validated tools.
Use patient-first language to reduce stigma.
Focus on improving health outcomes rather than solely on weight loss.
Provide education and resources to healthcare professionals to address bias.
By embracing terms like ABCD and being mindful of our language, we can create a more compassionate and effective approach to weight management. This not only helps reduce stigma but also empowers patients to take proactive steps toward better health.
If you're looking for a supportive and evidence-based weight loss program in Vancouver, I'm here to guide you on your journey. Together, we can find the best approach for your unique needs.