Obese docs often miss obesity in their patients: Study

By Dr. Ananya Mandal, MDJan 31 2012

According to researchers at Johns Hopkins University physicians with normal body mass index or weight-to-height ratios are more likely to discuss weight loss with patients than overweight doctors.

They add that these normal weight physicians were about nine times more likely to diagnose a patient as obese if they thought the patient's BMI was equal to or higher than their own. They surveyed about 500 primary care doctors during the study. In addition they note that physicians of normal weight had more confidence in giving diet and exercise counseling and were more likely to feel patients would trust their advice.

The study was published this month in the journal Obesity. Results showed normal-BMI doctors were more likely to talk to their obese patients about weight loss (30% versus 18%). They were also more likely to give advice on diet (53% versus 37%) and exercise (56% versus 38%). Surprisingly a normal-weight doctor actually recording an obesity diagnosis for an obese patient was 93%. For overweight or obese doctors, it was just 7%.

Interestingly, the gap seemed to narrow a bit when physicians were asked whether they thought patients would be less likely to trust weight loss advice from an overweight or obese doctors. An overwhelming 80% of normal-BMI doctors agreed, but so did a very respectable 69% of overweight and obese doctors.

The likelihood that a physician would diagnose a patient as obese or talk to them about weight loss was higher, the researchers wrote, “when the physicians' perception of the patients' body weight met or exceeded their own personal body weight.”

“I was totally surprised by the findings,” says lead author Sara Bleich, an assistant professor of health policy at Johns Hopkins Bloomberg School of Public Health. “For me, the results raise a lot of questions,” says Bleich. “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.”

“If we improve physician well-being, and improve their lifestyles toward weight loss or weight maintenance, that can go a long way toward influencing the care they provide their patients,” says Bleich. Doctors who have successfully lost weight and who eat well and exercise regularly may be more likely to share their own experiences with patients, making it more likely that their patients will in turn follow their advice, Bleich says. “By making physicians healthier, we are making patients healthier, and helping two groups at one time,” she says.

The Centers for Disease Control and Prevention says more than one-third of adults in the U.S. are obese. Further estimates show that obesity costs nearly 150-billion dollars every year because of health problems that severely overweight people can develop such as heart disease, stroke and high blood pressure.