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  #1   ^
Old Tue, Jul-25-17, 11:25
JLx's Avatar
JLx JLx is offline
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Default The problem with ‘morbid obesity’

The problem with ‘morbid obesity’

Quote:
The term morbid doesn’t help us out medically when it comes to weight. As a doctor I know what a BMI of 16, 26, 36 and 46 all mean health-wise. I know which one is associated with osteoporosis and which is associated with diabetes. If I don’t then I don’t need an adjective – I need to go back to medical school. I can diagnose, discuss, manage and bill for endometriosis, diabetes and kidney disease just fine without using the term morbid, so why do I need it for obesity?

It is true that patients often ask if their condition is worrisome or serious, but if we can manage with mild, moderate and severe stages of disease (typically one through four) with essentially every other medical condition from prematurity to cancer, then I am quite confident we do not need any special word for obesity.

It’s time to erase the term morbid obesity from our medical lexicon and probably just do away with the term morbid in medicine altogether. http://www.mercurynews.com/2017/07/...morbid-obesity/


I first encountered this term working in medical records and coding diagnoses long before I ever became it, and I remember it standing out to me. She's right, that there really is nothing comparable that I can think of in medical terminology. It definitely seems punitive. And these days, when medical records are much more accessible to patients than they used to be, it can't be said that patients won't see the term.

I know when I was morbidly obese, I didn't need to see my records to know that my doctor would be referring to me that way. Yes, it can be a wake up call for some people I suppose, but it felt to me that it just fueled my self hatred, which is never an impetus to positive self change for me.

Last edited by JLx : Tue, Jul-25-17 at 13:33. Reason: typo
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  #2   ^
Old Tue, Jul-25-17, 14:39
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barb712 barb712 is offline
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I transcribed medical records for 24 years, and the word "morbidity" came up a lot when referring to a state of physical injury or ill health. A mildly or even moderately obese person is in a different place than a morbidly obese person. I don't think using a descriptive ls meant to humiliate or stigmatize a patient but rather to treat him/her more effectively. But what do I know...

Last edited by barb712 : Tue, Jul-25-17 at 15:01.
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  #3   ^
Old Tue, Jul-25-17, 17:53
Zei Zei is offline
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Quote:
I don't think using a descriptive ls meant to humiliate or stigmatize a patient but rather to treat him/her more effectively.

I hope so because my own thought when I saw this article was that it had been a word intended to frighten very heavy people that they might soon die of their condition, which is questionable at best. I've heard of people getting those extreme gut-rearranging bariatic surgeries because of doctors saying they'd soon be dead from extreme overweight if they didn't, and of one lady dying from the surgery whereas she might have lived a very long time just staying fat.
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  #4   ^
Old Tue, Jul-25-17, 19:12
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deirdra deirdra is offline
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In the 1980s, pregnant woman over 35 were recorded as having "senile pregnancies"
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  #5   ^
Old Tue, Jul-25-17, 19:33
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bluesinger bluesinger is offline
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I still remember the day I was left alone in the doctor's office and looked at my chart. I was my usual 20 lbs. heavier than I wanted to be, but seeing the words "menopausal obese female" came as a shock to me. I had never before thought of myself as obese.

Words matter.
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  #6   ^
Old Tue, Jul-25-17, 21:21
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honeypie honeypie is offline
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Quote:
In the 1980s, pregnant woman over 35 were recorded as having "senile pregnancies"
Is that true? I know they're just called geriatric pregnancies, but senile is always in reference to the loss of mental faculties, no?

Either way, geriatric pregnancy is already pretty plenty depressing.

Morbid obesity doesn't bother me as a medical term at all however. There are some consequences due to being off-the-charts fat, and the fact that morbid obesity is a term in common usage, and that there is a formula used to standardize results of larger populations and to indicate something on a chart that specifically correlates to that category, is frankly the least upsetting thing about being overweight to me. I certainly never would have attributed the word 'punitive' to to describe the phrase.

Why would "morbid obesity" be more standout, or more punitive, than "terminal cancer"? Neither are attributing blame or punishment. They're just descriptors. I have no doubt that in all cases, they are descriptors that we don't like. But they're still just descriptors.
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  #7   ^
Old Tue, Jul-25-17, 21:36
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barb712 barb712 is offline
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Very well said, honeypie. I feel the same.
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  #8   ^
Old Wed, Jul-26-17, 04:06
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teaser teaser is offline
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I see the term co-morbidity used a lot, as in schizophrenia being often comorbid with bipolar, heart disease often co-morbid with diabetes, etc. In this context, morbid seems to mean a disease state--morbid obesity might be looked at as obesity that has progressed to the point where it constitutes a disease state, where it's a threat to health. Which is really just repeating what some others have said here. That said--language is for communication, and if the message received is too often not the message intended, I think there is an onus on the person speaking to make themself more clear to their audience.
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  #9   ^
Old Wed, Jul-26-17, 08:41
Bonnie OFS Bonnie OFS is offline
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Quote:
Originally Posted by deirdra
In the 1980s, pregnant woman over 35 were recorded as having "senile pregnancies"


Which is why my ob kept saying my age was a problem. It wasn't. What was a problem was my lack of experience - which I would have had at any age.
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  #10   ^
Old Wed, Jul-26-17, 09:13
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barb712 barb712 is offline
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Quote:
Originally Posted by teaser
... I think there is an onus on the person speaking to make themself more clear to their audience.


Clear communication is always important (and not often achieved) between two people, especially doctor and patient. However, there is institutional jargon that medical professionals use among themselves which can go over the lay person's head or be misunderstood. (Same goes with other professions and industries). Since patients have more ready access to their records nowadays, IMO, some of the onus should also be on the patient to learn the jargon and not let it get the best of their fears and insecurities, etc. It's so geared that way.
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  #11   ^
Old Wed, Jul-26-17, 11:54
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teaser teaser is offline
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I do get where you're coming from. Personally it bothers me when somebody says that they're not on a diet, since the word diet without a modifier just means what a person eats on a regular basis, and didn't originally mean a temporary weight loss plan. And it bothers me when people are bothered when people use the word "fast" for anything but a strict water fast, because again, the word fast just means some sort of abstention from some class of food or other, not necessarily total avoidance of food. I have a little trouble getting everybody to use English the way I think it should be used.

I don't really understand why "severe" is supposed to sound better than "morbid," though, if you're used to the term comorbidity, severe actually sounds much worse.
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  #12   ^
Old Wed, Jul-26-17, 12:48
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barb712 barb712 is offline
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Quote:
Originally Posted by teaser
I I have a little trouble getting everybody to use English the way I think it should be used.


Me too! And everything else you said rings true for me.
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  #13   ^
Old Wed, Jul-26-17, 14:05
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cotonpal cotonpal is online now
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Language isn't static. Meanings change over time, depending on the contexts they are used in and the nature of the people using them. Language used to identify stigmatized groups may start out being non-judgmental in intent but become judgmental over time. Words that are used by one group of people may change in meaning when they are used by another. The term "morbid obesity" may not have been intended to be non-judgmental but may be either employed by some people in a judgmental fashion depending on how they judge the people to whom the term is applied or they may sound judgmental to the people who are referred to in this way. Words matter. Word meanings are not static. Intentions matters too and intentions can be varied. It can become complicated. What was intended can be different than what was received.

Jean
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  #14   ^
Old Wed, Jul-26-17, 14:16
VLC.MD VLC.MD is offline
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I can't decide which is more derogatory:

Morbid Obesity or Geriatric Pregnancy (occurs anytime a woman is over the age of 35 and gets pregnant).

I know what my wife would say.
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  #15   ^
Old Wed, Jul-26-17, 15:12
teaser's Avatar
teaser teaser is offline
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I'm happy (maybe the wrong word) using the terms depression, anxiety, mania, psychosis etc. The stigma sort of follows you home anyways, and keeping quiet about these things is maybe part of why people get the impression sometimes that psychotic equals psycho, I sort of like to think that meeting somebody like me who has been psychotic a number of times, but never stabby, is good for people.
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