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  1. Umoren, Olivia BS
  2. Cody Stanford, Fatima MD, MPH, MPA
  3. Shieh, Carol DNSc, RNC-OB, FAAN
  4. Draucker, Claire PhD, RN, FAAN

Article Content


In their article, "Self-Monitoring Lifestyle Behavior in Overweight and Obese Pregnant Women" (Clin Nurs Spec. 32(2):81-89), Shieh and colleagues explored the experiences of pregnant women with overweight and obesity who monitored their eating and physical activity as a way to prevent excessive gestational weight gain. Throughout the article, people-first language was not incorporated because the study participants were continuously referred to as "overweight and obese pregnant women." Labeling a person by their weight status dehumanizes them and contributes to weight bias.1 Referring to individuals by their condition may cause them to think negatively about themselves and their health. It influences the way they feel about their condition and how likely they are to seek medical care.2 Instead of the terms that would be used, we would encourage the authors to reword their language so that they state "pregnant women with overweight and obesity," which acknowledges that these women have these clinical entities but are not defined by them.


We encourage Clinical Nurse Specialist to begin using obesity-specific people-first language in all articles and publications. Societal assumptions such as the notion that individuals with obesity are to blame for their weight impact their emotional and physical health. It has been agreed that stigma undermines public health; however, this principle is rarely applied to the obesity epidemic.3 Making an effort to use people-first language will continue to help remove bias and stigmatization of people with obesity.


Olivia Umoren, BS


Fatima Cody Stanford, MD, MPH, MPA




1. Fruh SM, Nadglowski J, Hall HR, et al. Obesity stigma and bias. J Nurse Pract. 2016;12(7):425-432.


2. Kyle TK, Puhl RM. Putting people first in obesity. Obesity. 2014;22(5):1211.


3. Puhl RM, Peterson JL, Luedicke J. Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. Int J Obes. 2013;37:612-619.



Thank you for the opportunity to respond to the reader's concern regarding our use of the term "overweight and obese pregnant women" in our recently published article "Self-Monitoring Lifestyle Behavior in Overweight and Obese Pregnant Women: Qualitative Findings" (Clin Nurs Spec. 32(2):81-89). It certainly was not our intention to dehumanize or stigmatize our participants. We used the term to be consistent with practice guidelines recommended by leading organizations. For instance, the Institute of Medicine1 and the American College of Obstetricians and Gynecologists2 use "overweight and obese women" to refer to this population. However, we agree with the reader's arguments and will in the future be more cognizant of using "people-first" language when discussing issues of overweight and obesity. We agree that obesity is a sensitive topic, and it can be difficult for both patients and care providers to initiate conversations about the health consequences of obesity. We encourage advanced practice nurses to openly discuss obesity prevention and treatment with their patients/clients in a sensitive and respectful manner.


Carol Shieh, DNSc, RNC-OB, FAAN


Claire Draucker, PhD, RN, FAAN




1. Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press, 2009.


2. American College of Obstetricians and Gynecologists. Committee opinion: challenges for overweight and obese women. 2014. Number 591. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Commi. Accessed May 28, 2018.