January 31, 2012
Normal Weight Doctors More Effective in Helping Overweight Patients
According to a recent national survey by a leading medical research center, a doctor´s own weight may significantly influence how effectively he or she is able to care for and diagnose patients suffering from obesity.
The study was carried out by researchers at the world-renowned Johns Hopkins Bloomberg School of Public Health and Medical Institutions in Baltimore and published online this week in the medical journal Obesity.
They found that physicians with a high body mass index (BMI) were almost half as likely to discuss weight-management issues with overweight and obese patients than doctors with normal BMIs (18% versus 30%, respectively).
The study´s lead researcher Dr. Sara Bleich says they also found that doctors with normal BMIs felt more confident in their competency to provide weight-loss advice to patients than their overweight colleagues (53% versus 37%, respectively).
Because primary care doctors in particular can be highly influential in intervening and counseling patients struggling with their weight, the study´s authors believe that a physician´s BMI may be a critical factor in a patient´s obesity care.
Bleich´s team looked at a cross section of 500 general internists, general practitioners and family practice doctors, recruiting physicians from a pool of volunteers through the Epocrates Honors panel which has a membership of some 145,000 AMA-certified doctors.
Each participating physician was asked to fill out a questionnaire with questions relating to diagnosing obesity and weight-management strategies. They were also asked to score their own effectiveness in helping patients with weight loss, including initiating counseling and prescribing weight-loss medications.
The study also examined the doctors´ perspectives on the importance of modeling healthy behavior and whether they believed that a patient´s trust in the soundness of their doctor´s advice was connected with the doctor´s weight.
The results indicated that doctors with normal BMIs were more likely than their overweight counterparts to believe that physicians have a responsibility to serve as role models for their patients in terms of maintaining healthy weight (73% versus 57%, respectively).
A similar correlation was also observed regarding how the participants thought their patients perceive the relationship between their doctor´s weight and his competence in advising them. Some 79% of the normal-weight responders believed that patients were more likely to trust the advice of a non-overweight doctor compared with 69% of the overweight or obese doctors.
The largest discrepancy came in terms of how the MDs´ perception of their own weight affected their diagnoses and treatment recommendations for overweight patients. Of the surveyed doctors, 93% reported that they were more likely to diagnose a patient as obese if they perceived that patient´s body weight as being greater than their own compared to 7% who said they wouldn´t. Approximately the same ratio held true for whether or not they would start a conversation about weight loss with a patient they thought heavier than themselves.
While the study provides researchers with some initial orientation and insight into a largely unexplored field of weight-loss studies, the authors were quick to point out their study has a number of critical weaknesses and cannot yet be treated as medical gospel.
For one thing, the study was set-up to show possible correlation only and cannot be held up as an example of causal evidence that skinnier doctors are more effective in helping patients lose weight. Moreover, because a number of the questions relied not on the physicians´ actual BMI but rather on their self-image–the accuracy of which can vary greatly from one responder to the next–exact relationships cannot be objectively determined.
Nonetheless, the team stated, some general advice can still be gleaned from the survey.
“Physician self-efficacy to care for obese patients–regardless of their BMI–may be improved by targeting physician well being and enhancing the quality of obesity-related training in medical school, residency or continuing medical education,” their report concluded.
On the Net: