The Ethics of Using Triggering Terminology Like “Obese” in Eating Disorder Research

​By: Lisa Michelson, M.A

​Upon hearing about the experiences my lab had at the 2018 International Conference on Eating Disorders in Chicago, Illinois, we discussed the controversial nature that exists when researchers use “triggering,” terminology. Audience members became upset with certain researchers who used words such as “overweight,” and “obese,” which were used to describe study participants. These words have been part of the terminology present in fat-shaming, fat discrimination, and micro aggression towards a population that society has deemed to have above average weight. Furthermore, these words become associated with individuals that society has frequently labeled as “lazy” or “incapable” as dictated by their portrayals in films, television, and other media outlets. However, this begs the question: Should researchers use these words if they are so triggering in the public domain? The answer is complicated.
 
“Obese,” comes from the latin “obesus,” which means “fat, stout, plump.” It was believed that Hippocrates recognized obesity as a medical condition as it gave rise to the onset of other diseases (Christopoulou-Aletra & Papavramidou, 2004). The modern term “obesity,” one that became stigmatized by society today, took shape in 1942, when The Metropolitan Life Insurance Company began to determine mortality rates based off of age and weight. For the first time, individuals were standardized and the notion of what an individual “should” weigh was popularized (Statistical bulletin of the Metropolitan Life Insurance Company). While initially designed to determine “desirable weight” dependent on age, height and mortality values, the insurance company changed the medical term into one that society was able to pass medical judgment on, completely discounting the innate nature in which all bodies are different.
 
Researchers Meadows and Danielsdottir (2016) said it best, “Part of the problem is that the very act of labeling is a process of othering, one that creates a distinction between us and them; which raises the question: who is entitled to do the labeling and why, and in what conditions is such a distinction needed?” Within research, othering is needed in order to determine differences between two groups of individuals. However, when presenting research, the two groups must be labeled in order for other researchers to understand what populations the research is being done on. The questions Meadows and Danielsdottir (2016) raise are both legitimate and further contemplation could give rise to an ethics paper worth developing.
 
However, I argue, researchers ought to be allowed to use the triggering word, upon critical consideration, as long as its intent is to use the word as it originally appeared in the dictionary and not one that was shaped from societal norms. I recognize this statement contains many caveats, like “what if the word in the dictionary was created offensively in the first place?” It is the responsibility of researchers to develop a common word that can be used for research purposes.
 
Let’s say for instance, researchers were to change the word of a specific demographic every time social norms dictate it as “triggering.” Not only would this be a disservice to the population in which the research was presented on, but also could have a negative impact on the research itself. For example, if researchers cannot come up with a common language for the subject in which they are communicating, then the ability to share research will be dependent on how long the terminology within that research is deemed “acceptable.” For this reason, when reporting on demographics, researchers ought to be careful in the first place of the terms they do use.
 
In the end, I believe that “obese” as a research term ought to continue to be used, reporting results unbiased without regard to social norms. Further, if new information comes to light, for example if it was discovered that Hippocrates used “obese” as a derogatory term, then it is the ethical responsibility of researchers to utilize different terminology for this demographic.