Words can have a very powerful emotional impact.  Words break hearts and it is harder to mend a broken heart than a broken bone. Many hurtful words that have found their way into our vocabularies are derived from the diet industry.

For best bariatric practices: LOSE THESE WORDS

FAILURE
If patients are given a prescription for a medication for high blood pressure, or diabetes and their pressure or glucose is not reduced, we would not use the words fail of failure for the patient, but rather the medication failed or was ineffective.
However when an obese patient is prescribed a diet or has weight loss surgery and their weight is not reduced they become the failure. We can be successful or unsuccessful in our endeavors to change… not failures
Failure has a sense of permanence and is “stuck” in the belief systems of many…we want to “unstuck it”.

CHEATING
Whether referring to infidelity, or cheating on an exam or taxes,cheating has profound moral and ethical connotations and is easily internalized. Cheaters are dishonest, deceptive or unfaithful. Certainly adults have the right to deviate from their diet plans. That is choice…. not cheating.

GOOD FOOD /BAD FOOD— AKA—HEALTHY/ UNHEALTHY FOOD
Food is not our moral compass and is neither good nor bad. All food contains nutrients and provides energy and cannot be labeled as healthy or unhealthy or good or bad. These words feed into the diet mentality and fuel the perfectionist, all or nothing forbidden food behaviors. Certainly some foods could be of advantage or disadvantage to specific medical conditions but this does not moralize them nor make them inherently good, bad, healthy or unhealthy.

FATTENING
All food contains nutrients and calories. Calories in excess of one’s individual needs results in the storage of adipose tissues….fat. Therefore, there are no specific foods that make you fat or can be considered fattening. All nutrition in excess of need results in weight gain…not any specific food choice.

We are part of the problem when we continue to label food with emotionally charged words like, fattening, good and bad, healthy or unhealthy. Then when patients deviate from diet plans we imply they are cheaters and failures.  Most of the patients we see have lived lives riddled with fat shaming. By continually using these words we provoke additional feelings of guilt and shame and then wonder why patients resist keeping honest food records for us to review.

Fat shaming (Fat Shaming in the Doctor’s Office Can Be Mentally and Physically Harmful) is as old as medicine and has never cured obesity. Best practices in genuine bariatric care requires sensitive awareness of the profound psychological burden associated with obesity, a burden that we can counteract by personally ridding ourselves of words that break hearts.

(APA)  Fat Shaming in the Doctor’s Office Can Be Mentally and Physically Harmful
http://www.apa.org/news/press/releases/2017/08/fat-shaming.aspx