The truth hurts?

So I was having a discussion with a colleague (another health psychologist) a while ago and she asked me if it was okay to call people fat. It led to an interesting discussion – some of which I will share in this blog.Obviously it is not ok to call people “fatty lardarse”!! And the terms fat/fattie have become pejorative. However what about saying someone is obese? There is a lot of evidence that shows that having a BMI over 30 (which means you are obese unless you’re an athlete or a weightlifter) is associated with increased health risks such as type 2 diabetes and heart disease. And saying that you have  big bones is the oldest excuse going – only athletes and those who exercise alot have denser bones.

So is it ok then to tell someone they are obese? Obviously health professionals can (and that includes health psychologists) but what about if you are a friend or a family member? Well it depends on (a) whether they have asked you or not and (b) on what stage they are in for their health behaviour – so someone who is in the pre-contemplation phase will not want to hear it as they are quite happy as they are, but someone who is in the contemplation or preparation stages will probably have started questioning themselves e.g. through discussion on Facebook. However some people  in the contemplation stage may be experiencing cognitive dissonance (conflicting thoughts) and therefore may react negatively when you tell them they are obese.

However it does work the other way too – some people who think they know everything about everything may tell a family member or friend they are fat and need to do something about their weight – however that is just an opinion – for example if someone has a BMI of 24 and a waist of 32 they are healthy, but maybe they have an apple shape which would result in a bit of a tummy – so others may think they are overweight when they are not. And remember that opinions are not facts, so you don’t have to believe them.

In conclusion then, can you tell someone they are obese? Well unfortunately some people now think that the term “obese” is also pejorative – when in fact it is just a clinical description of someone’s health, like saying they have arthritis. Also the other problem (see professor Jane Ogden’s research on this) we in the West have become used to a bigger average body size, so that overweight has become the new norm and people think being obese only applies if you are over size 18! So to answer the question: yes you can tell them they are obese – if you are a health professional or if they have asked (either directly or indirectly) and if the person in question is not an athlete and you know they have a BMI over 30. Otherwise keep your thoughts to yourself!BMI chart