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General Principles: Body Habitus and What Is “Normal”

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The Patient-Centered Approach to Medical Note-Writing

Abstract

Body habitus is a source of stigma for many patients, with harm furthered by stigmatizing terminology and provider bias. In this chapter we review the definition and meaning of body habitus, issues with terminology and coding, and patient preferences for terms related to weight. The concept of normality in medicine has different meanings in different contexts. We review alternative language to consider when documenting something to be “normal” when discussing test results, physical examination findings, and the definition of disease states.

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References

  1. Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298(17):2028–37.

    Article  CAS  PubMed  Google Scholar 

  2. Jayedi A, Soltani S, Zargar MS, Khan TA, Shab-Bidar S. Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies. BMJ. 2020;370:m3324.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812–21.

    Article  PubMed  Google Scholar 

  4. Kottner J, Everink I, van Haastregt J, Blume-Peytavi U, Schols J. Prevalence of intertrigo and associated factors: a secondary data analysis of four annual multicentre prevalence studies in The Netherlands. Int J Nurs Stud. 2020;104:103437.

    Article  PubMed  Google Scholar 

  5. Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–95.

    Article  PubMed  Google Scholar 

  6. Gomez MR. The clinical examination in myology. In: Engel AG, Franzini-Armstrong C, editors. Myology. New York: McGraw-Hill; 1994. p. 751.

    Google Scholar 

  7. Inker LA, Titan S. Measurement and estimation of GFR for use in clinical practice: core curriculum 2021. Am J Kidney Dis. 2021;78(5):736–49.

    Article  PubMed  Google Scholar 

  8. Sabin JA, Marini M, Nosek BA. Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and gender. PloS One. 2012;7(11):e48448.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring). 2006;14(10):1802–15.

    Article  PubMed  Google Scholar 

  10. Fernández L, Fossa A, Dong Z, et al. Words matter: what do patients find judgmental or offensive in outpatient notes? J Gen Intern Med. 2021;36(9):2571–8.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hagan S. E66.01 and our culture of shame. N Engl J Med. 2021;385(25):2307–9.

    Article  PubMed  Google Scholar 

  12. Puhl RM. What words should we use to talk about weight? A systematic review of quantitative and qualitative studies examining preferences for weight-related terminology. Obes Rev. 2020;21(6):e13008.

    Article  PubMed  Google Scholar 

  13. Volger S, Vetter ML, Dougherty M, et al. Patients’ preferred terms for describing their excess weight: discussing obesity in clinical practice. Obesity (Silver Spring). 2012;20(1):147–50.

    Article  PubMed  Google Scholar 

  14. Pearl RL, Walton K, Allison KC, Tronieri JS, Wadden TA. Preference for people-first language among patients seeking bariatric surgery. JAMA Surg. 2018;153(12):1160–2.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Evans WJ, Morley JE, Argilés J, et al. Cachexia: a new definition. Clin Nutr. 2008;27(6):793–9.

    Article  CAS  PubMed  Google Scholar 

  16. Baer HJ, Karson AS, Soukup JR, Williams DH, Bates DW. Documentation and diagnosis of overweight and obesity in electronic health records of adult primary care patients. JAMA Intern Med. 2013;173(17):1648.

    Article  PubMed  Google Scholar 

  17. Banerjee ES, Gambler A, Fogleman C. Adding obesity to the problem list increases the rate of providers addressing obesity. Fam Med. 2013;45(9):629–33.

    PubMed  Google Scholar 

  18. Stevenson A, Lindberg CA, editors. New American Oxford Dictionary. Apple Mac Software. Accessed 30 Jan 2023.

    Google Scholar 

  19. Merriam-Webster Dictionary. https://www.merriam-webster.com/dictionary/normal, https://www.merriam-webster.com/dictionary/abnormal. Accessed 30 Jan 2023.

  20. Catita M, Águas A, Morgado P. Normality in medicine: a critical review. Philos Ethics Humanit Med. 2020;15(1):3. https://doi.org/10.1186/s13010-020-00087-2.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wiley AS, Cullin JM. Biological normalcy. Evol Med Public Health. 2019;2020(1):1. https://doi.org/10.1093/emph/eoz035.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Scott Hagan .

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Hagan, S., Aalami, S., Wong, C.J. (2023). General Principles: Body Habitus and What Is “Normal”. In: Wong, C.J., Jackson, S.L. (eds) The Patient-Centered Approach to Medical Note-Writing. Springer, Cham. https://doi.org/10.1007/978-3-031-43633-8_5

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  • DOI: https://doi.org/10.1007/978-3-031-43633-8_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-43632-1

  • Online ISBN: 978-3-031-43633-8

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