Words have power. The language we use to describe ourselves and others has real implications for perceptions of health, self-worth, and overall performance. Whether in casual conversation or within the walls of the doctor’s office, the words we use to describe our bodies and health can uplift or weigh us down.
Think of how labels such as “obesity,” “overweight,” or even “detox” play a part in medical diagnoses, but also in how people view themselves. These words can carry a heavy social and emotional burden that oftentimes promotes stigma, shame, and even self-sabotage that may jeopardize one’s physical and mental health.
Evolution of medical labels
Medical labels and diagnoses were created with the intent of differentiating and describing, generally without regard to the broader context in which these terms would live. Medical terminology can, at once, prove to be as clear as crystal in diagnosis and treatment, yet may also reinforce stereotypes and misinformation when outdated or poorly chosen.
Thinking critically about the ways we use language in medicine can have broader impacts beyond describing a condition.
Anatomy of a term
As a PhD student, I spent three years trying to define “successful aging,” a term created in the 1960s to create a more positive conceptualization of aging, in contrast to largely pathology-based conceptualizations. The trouble with this term, though, is the subjective interpretation of “success” and the value judgment attached to this term.
As a result, my review of the ways in which researchers were using the term identified 105 unique operational definitions of “successful aging.” Although it was being used in academic literature, there was no consensus about what this term meant. (You can imagine what it would feel like to have the way you were growing older described as “unsuccessful.”)
A person—not their condition
A people-first approach prioritizes the person and their humanity by using person-first language: placing the person before their condition. Current trends have been to move from terms that use disease or disorder nouns, such as “diabetics” or “schizophrenics,” to phrases like “people living with diabetes” or “those living with schizophrenia.”
It follows from this position that a person’s condition is not thought of or described as if it is their descriptor. These terms are deemed respectful because they identify a person first as a human being, which conveys empathy and less negative stereotypes.
Unintended consequences
Researchers have shown that the words and labels used in medical settings have powerful psychological consequences. For example, when people are labelled or categorized using stigmatizing terms, such as “obese” or “schizophrenic,” they often respond with a range of negative emotions, such as decreased self-esteem, anxiety, and even depression.
These feelings may be exacerbated by the internalization of these labels by the patients themselves, who may then view themselves through this negative perception. This can, in turn, indirectly contribute to feelings of helplessness or worthlessness.
One of the more damaging results of labels of stigma is aversion to seeking medical care. Patients would rather avoid the doctor altogether, for fear of facing further stigmatization, feeling judged or defined by their diagnosis, leading to the vicious cycle of delayed diagnosis and worsened health conditions. Further, patients are likely to show less compliance with treatment if they feel reduced into their medical condition rather than being regarded as a whole person.
Consider “obesity”
The term “obesity” is a common example of how medical language creates judgment within society. Whereas “obesity” is a clinical term referring to individuals within a specific range of the body mass index, the term has taken on cultural overtones.
When the word “obese” is heard by individuals in our culture, without thought to genetics, environment, and emotions that affect body weight, they immediately envision a person who is lazy, lacks willpower, or eats unhealthily. It has, therefore, brought about discrimination against people who are termed obese, leading to biases in healthcare, employment, and social settings.
People of increased body weight often claim that they’re subjected to differential treatment by those who assume that they live an inadequate life or have a lack of character based on just looking at their appearance. The consequence is that they suffer a double burden: they don’t only have to deal with the health effects of being obese but also with the emotional consequences because of a stigmatizing environment.
Consider “hysterectomy”
Another example of the problematic area of medical terminology can be found in the etymology of the term “hysterectomy,” which literally means the removal of the uterus. The word comes from the ancient Greek word hystera, meaning uterus. The term also shares an etymological relationship with “hysteria,” an old, discredited medical diagnosis believed to be caused by disturbances in the uterus.
For centuries, the label “hysteria” was applied to pathologize women’s emotions, entrenching sexist ideas of female irrationality and emotional instability.
While hysterectomy is still a valid medical practice, the etymology of the term from these dated, sexist notions concerning people with uteruses has changed how this terminology is used. Most medical practitioners today have moved to more neutral terms, considering that language reinforces stereotypes, and it informs patients about their conditions.
A collaborative effort is required to bring about the much-needed evolution of medical language. Just as use of terms, such as “hysteria,” has been replaced by more specific and respectful descriptions of medical conditions, updating terms no longer serving the best interest of patients is critical in their care.
In so doing, we have the possibility of creating a far more inclusive, supportive healthcare system where individuals are seen as more than just their diagnoses, and language is utilized to empower, not marginalize.
Neutral terms for more patient-centred care
One of the major strategies that can be implicated in healthcare with the aim of destigmatization is concern for non-stigmatizing language in the medical record. For example, in a 2018 study published in the Journal of General Internal Medicine, patients who were described using neutral terms received more empathy and received better care. For instance, instead of describing someone as “narcotic dependent,” it should be worded as “opioid use.”
Aside from avoiding blame or negative stereotype-implying labels, clinicians are able to reduce bias and help provide more patient-centred care. This approach has great importance in the remediation of disparities in health and the improvement of outcomes for groups that suffer stigma.
This article was originally published in the January 2025 issue of alive magazine.
Theodore D. Cosco, PhD (Cantab) CPsychol, is an Assistant Professor of Mental Health and Aging (Simon Fraser University) and Research Fellow (Oxford Institute of Population Ageing, University of Oxford).
Brendan Rolfe, CPHR, BA, DipA
Daniela Ginta, MSc
Matthew Kadey, MSc, RD