Monday, November 17, 2014

People-First Language

At the most recent meeting of the Obesity Society, the use of people first language was widely encouraged. "People first" means using obesity language in such a way that it is not part of the person's identity, rather that it's indicated as a condition. So, saying "people with obesity" rather than "obese people".

People first language stems from the perception that obesity is a disease, something I regularly debate with myself. As an obesity researcher, I'm a huge proponent of people-first language. But the reaction of others has been, well, mostly confused.

When trying to explain the concept--to highly educated PhDs, no less--most seem very confused. "People with obesity" works okay, but "people with overweight" just sounds strange, and that is apparent on the faces of those I try to explain this to. Some people also think the distinction is silly, that "obese people" is not offensive, that it's simply a descriptor.

But I think there is an important difference. "Obese person" makes obesity part of the identity of the person, makes it an attribute. "Person with obesity" makes obesity something that happens to a person. Using "obese person" perpetuates the concept of blame and responsibility. We haven't reached a point in the public perception that people with obesity are not blamed and held responsible, but I hope we have in the research arena. Our use of people-first language is most important in how it influences perceptions of a wider audience.

But we don't. A quick survey of the most recent issue of Obesity, fewer than 15% of articles demonstrated use of people-first language in their titles and abstracts. How do we encourage this use without seeming to either obsess over small details or scold those not using it? I don't have a brilliant answer. I think the most important thing we can do is model the behavior. I try to always use people-first language, and I bring up the concept with students, fellows, and colleagues when opportunities arise.

People first language has become the norm for most other health conditions and disabilities. However, there is plenty of reasonable criticism. One argument is that by forcing people-first language, especially in awkward ways (like "people with overweight") actually has the opposite effect of the goal to focus on the person first. Others argue that taking on the identity of a disease or disability is not inherently bad, as the condition is inseparable from the person.

Personally, I believe we should continue to promote people-first language with obesity. Individuals have the right to take on the identity of obese, or fat, or anything else for themselves. But the language we use shapes the perceptions of the world around us. People with obesity already feel like obesity is their defining characteristic, and most do not want it to be. Most just want to be seen as people. We can use other conditions (diabetes, for example) when explaining the purpose of people first language. But the most effective thing we can do is just use it. All the time.

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