Overweight patients more susceptible to diet advice from like-bodied docs


According to a recent study carried out by researchers at the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins University School of Medicine, dieting advice comes easier from physicians who are themselves overweight.

Delving into the concept of diagnosis receptiveness on the basis of a primary care physician’s BMI, the study team came to find that for overweight and obese patients specifically, it is easier to trust a doctor’s counsel on weight-related topics if that MD is of similar build. 

"With respect to overall trust, our results suggest that overweight and obese patients trust their primary care physicians, regardless of their body weight," said Sara Bleich, PhD, associate professor with the Bloomberg School's Department of Health Policy and Management, in a prepared statement. "However, with respect to trust in weight-related advice, we found that patients more strongly trusted diet advice from overweight primary care physicians as compared to normal BMI primary care physicians. In addition, we found that patient perceptions of weight-related stigma increased with physician BMI. Patients seeing obese primary care physicians, as compared to normal BMI physicians, were significantly more likely to report feeling judged because of their weight."

A total of 600 patients characterized as overweight or obese underwent a national cross-section survey which investigated overall trust and, narrower, the level of trust placed upon weight-related advice. Trust was measured on a numerical scale, and presented to patient discretion in the following manner: "Using any number from 0 to 10, where 0 means that you do not trust this doctor at all and 10 means that you trust this doctor completely, what number would you use to rate how much you trust this doctor?" 

Regarding counsel on weight, participants were asked: “How much do you trust the advice from this doctor about how to control your weight; improve your diet or increase your physical activity, a great deal; a good amount; only some or very little?"

Thereafter, researchers employed a multivariate regression analysis to determine if participant answers correlated at all to a physician’s BMI.

"While weight-related stigma has been documented among health professionals for decades, as well as lower physician respect toward patients with a higher BMI, our finding that weight-related stigma increases with physician BMI was quite surprising," Bleich concluded. "Recent changes to obesity coverage among the publicly insured makes understanding primary care physicians' barriers to providing effective obesity care critical. Existing research suggests that primary care physicians face numerous challenges to providing optimal obesity care which include knowledge deficits, negative attitudes and structural barriers. Future research should further examine the impact of physician BMI on obesity care. In particular, why patient-perceived physician stigma is higher among heavier primary care physicians and why the patterns we observed between physician BMI and trust in weight-related counseling differ by the type of counseling."

The study is to be featured online in the upcoming issue of journal Preventive Medicine.