Fat doctors ‘far less likely to help obese patients lose weight’
- ‘Physical attributes of physicians have a much bigger contribution to their care of patients than I realized before’, says scientist
By Sadie Whitelocks
Overweight doctors are less able help patients shed the pounds, research suggests.
A study revealed that physicians with a Body Mass Index (BMI) of 25 or more were less effective at tackling obesity than those of a normal weight.
Researchers found they were less likely to diagnose obese patients, felt more embarrassed about offering weight loss advice, and shied away from discussing the topic with clients.
Medics of with a normal BMI however were more successful at treating the condition.
Lead researcher Sara Bleich, from Johns Hopkins University said: ‘Our findings indicate that physicians with normal BMI more frequently reported discussing weight loss with patients than overweight or obese physicians.
‘Physicians with normal BMI also have greater confidence in their ability to provide diet and exercise counseling and perceive their weight loss advice as trustworthy when compared to overweight or obese physicians.’
Using a national cross-sectional survey of 500 primary care physicians across the U.S., the research team assessed the impact of physician BMI on obesity care,.
The study, published in the Obesity journal, also looked at how much faith the doctors had in themselves to treat obesity – both in giving advice and in their perceptions of patient trust in their advice.
The biggest disparity of all was in the way physicians actually assessed patients.
Normal weight doctors had a 93 percent probability of recording an obesity diagnosis in overweight patients, compared with only 7 percent of overweight doctors.
CASE STUDY: DR ONSLOW
Dr Onslow before her weight loss
GP Lady Arabella Onslow, 41, who at her heaviest weighed 22st and had a BMI of 46.2 found it difficult to offer lifestyle advice while she was grossly overweight.
She said: ‘When I had to tell a patient they would benefit from losing weight, I felt they were judging me. You could hardly ignore the fact I was obese.
‘I knew that at the very least I was giving tacit approval to someone who was overweight.
‘If their own doctor, the person they went to for health advice, could be that fat, then surely it was OK for them to be fat, too.’
After losing 10st 7lb in 14 months, by cutting down portion sizes and joining a slimming club she said: ‘I don’t think I am a better doctor because I am no longer obese.
‘But I do think I am a better role model for my patients.’
They were also more likely to provide recommended obesity care and targeted treatment.
In short, if a patient’s body weight matched or exceeded the doctor’s own body weight, the patient was more likely to be judged obese.
Bleich added: ‘In addition, obese physicians had greater confidence in prescribing weight loss medications and were more likely to report success in helping patients lose weight.
‘For me, the results raise a lot of questions.
‘I’d be surprised if this behavior is intentional. I think a lot of it is subconscious.
‘What this study suggests is that physical attributes of physicians have a much bigger contribution to their care of patients than I realized before.’
Further research is now needed to understand the full impact of physician BMI and obesity care.
Bleich suggests medical training in this area might be a way of tackling the trend.
In 2008, the latest year with available figures, nearly a quarter of adults (over 16 years of age) in England were obese (had a BMI over 30).