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Patients With Higher BMIs Got Less Respect From Doctors in Study, Raising Care Concerns

Oct. 28, 2009 -- Heavier patients get less respect from doctors, raising concerns about the impact on the quality of care, new research indicates.

Scientists reporting in the November issue of the Journal of General Internal Medicine say they found that the higher a patient’s body mass index (BMI), the less respect their doctors had for them.

Mary Margaret Huizinga, MD, MPH, of Johns Hopkins University School of Medicine and lead author of the study, says she came up with the idea for the research from her experiences working in a weight loss clinic.

She says that patients who'd visit would, by the time they left, “be in tears, saying 'no other physician talked with me like this before,'" and had failed to listen.

“Many patients felt like because they were overweight, they weren’t receiving the type of care other patients received,” she says in a news release.

She and colleagues looked at data on 238 patients and 40 physicians. The average BMI of the patients was 32.9.

A person with a BMI of 25 to 29.9 is considered overweight, and 30 or greater obese.

In the study, patients and physicians filled out questionnaires about a doctor’s visit. They were asked questions about their attitudes and perceptions of one another at the end of their encounter. Physicians were asked to rate the level of respect they had for each patient compared to “the average patient” on a 5-point scale.

The patients for whom doctors expressed low respect, on average, had a higher BMI than patients for whom the physicians had high respect, the researchers report. The researchers note that the findings don’t show a cause/effect relationship between BMI and physician respect. Their study also didn’t investigate patients’ health outcomes.

Huizinga writes that respect is critical because some patients may avoid the health care system altogether. In other research, physician respect has been linked to more information being provided by the physician during a patient visit. She says more research is needed “to really understand how physician attitudes toward obesity affect quality of care for those patients."

“If a doctor has a patient with obesity and has low respect for that person, is the doctor less likely to recommend certain types of weight loss programs or to send her for cancer screening?” Huizinger asks. “We need to understand these things better.”

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