When patients and physicians need to communicate, there is a list of the toughest topics—ones in which it is much easier for the conversation to cause misunderstandings.

Patients long have felt that doctors dislike obese patients and that dislike affects their care.

Weight, or more specifically, obesity, is at the top of the list. Although the word, epidemic, is now used often, epidemic is the correct term for the obesity issue. Americans, as well as others in developed countries, show alarming rates of obesity which foretell many serious medical complications.

This study is important in that it shows that, whatever their attitudes, the physicians in this study went after the issues which could affect an obese patient just as they would any other patient.

However, this study has three design limitations which are named below by the researchers themselves. It would be wise to do more research to tease apart where there may be real differences in the ways physicians respond to obese patients, if any.

This issue needs to be fully aired because it can stop obese patients from seeking care.

This issue needs to be fully aired because doctors could use some help in winning the confidence of obese patients—that extra precautions are needed because obesity is a risk factor for other diseases.

Separately from this study, new studies have shown that fast food chains and food processors do not display accurate calorie counts. There are other factors at work in the obesity epidemic, it is becoming clear. No patient can count a calorie no one has mentioned. Doctors are starting to understand that controlling weight is not only about willpower.

The obesity conversation is changing right now. The multiple factors in obesity—genetic, environmental, issues with the food supply and, yes, personal choice—are just now beginning to become more clear. These studies will help the patient-doctor communications on this subject, too.

Medpage Today

“Despite concerns that doctors don’t like them, heavier patients receive care that’s just as good as normal-weight patients, researchers have found.

In fact, in some areas — such as diabetes management — they appear to receive even better care, Virginia Chang, MD, of the University of Pennsylvania, and colleagues reported in the April 7 Journal of the American Medical Association.”

…”Research has shown that some physicians do express dissatisfaction in caring for obese patients. At the same time, obese patients feel that clinicians may be biased or disrespectful because of their weight, and become concerned that they may receive lower quality care.” (Emphasis added)

…”The study was limited by its inclusion of only eight quality assessment parameters, some self-reported data, and a lack of generalizability to care in younger populations. (Emphasis added)

“Even though physicians might harbor negative attitudes towards obese patients, it doesn’t seem to be borne out in the quality of care they’re delivering,” Chang said, “so I think both physicians and patients can feel some degree of relief on that front.” (Emphasis added)

Source: Medpage Today, April 7, 2010

Citation: Journal of the American Medical Association.JAMA 2010; 303(13): 1274-81.