Researchers from Johns Hopkins recently explored a weighty issue: How being overweight might impact the way doctors treat their patients. "There have been several studies that have demonstrated that healthcare providers have negative attitudes towards obese patients," explains Kimberly Gudzune, MD, MPH, assistant professor of medicine at Johns Hopkins University School of Medicine. "However, no one had looked at whether these attitudes potentially influence the relationship between obese patients and their physicians. We wanted to examine this question."

Exploring Doctor Bias

To do so, Gudzune and her colleagues recorded discussions that occurred among 39 primary care doctors and more than 200 of their patients, all of who suffered from high blood pressure and consented to participate in this research. Many of the patients met the clinical criteria for being overweight or obese.

What the scientists discovered is that while the medical content discussed seemed consistent regardless of weight, the doctors' attitudes were kinder toward thinner people and they showed more compassion to them, too.

Why Overweight Patients Get Short-Changed

Gudzune says that these findings, which were included in the journal Obesity in 2013, are not particularly surprising, but they do call attention to a serious problem that exists in the medical field. She feels the issue stems from a negative stereotype that exists in society toward those who are overweight and it spills into the medical setting.

"This judgment can promote a lack of empathy and compassion," she says. As a result, an overweight patient may leave his doctor's office without developing a bond with his provider or may even feel uncomfortable. Over the long-term, he may avoid seeking routine preventive care or delay treatment for various health problems, which may have a significant impact on his well-being.

Gudzune also points out that the lack of an emotional connection with a health care provider may make the patient less apt to follow her advice. "When this aspect is missing, the quality of care may suffer," she says. "In fact, other studies have shown disparities in the receipt of preventive health screenings for cervical cancer and breast cancer for obese women, which may be due in part to this factor."

What You Can Do

If this scenario sounds familiar, make an effort to develop a good rapport with your doctor—it's essential regardless of your weight. If necessary, find a new health care provider that respects both your medical and emotional needs. For physicians, it's equally important that they are aware of the potential for bias, and also to "seek out additional training in communication skills, which can help them build positive relationships with all patients regardless of body weight," says Gudzune adding that she's currently working on a follow up study to determine how a doctor's negative judgment may affect patients' weight loss outcomes.

Kimberly Gudzune, MD, MPH, reviewed this article.



Gudzune, Kimberly, assistant professor of medicine, Johns Hopkins University School of Medicine. Email interview 6 May 2013.

Gudzune, Kimberly at al. "Physicians build less rapport with obese patients." Obesity Online. Web. 6 May 2013.