Obese Patients Need More Empathy From Their Physician
April 23, 2013

Doctors Less Likely To Connect With Overweight And Obese Patients

redOrbit Staff & Wire Reports - Your Universe Online

Doctors are less likely to bond or empathize with patients who are overweight or obese, according to a new study published online in the journal Obesity.

The research, which was led by Kimberly A. Gudzune, an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine, looked at 39 primary care physicians and 208 of their patients. Gudzune and her colleagues discovered that those doctors tended to build “much less of an emotional rapport” with their overweight or obese patients than with those of normal weight.

“If you aren't establishing a rapport with your patients, they may be less likely to adhere to your recommendations to change their lifestyles and lose weight,” Gudzune said in a statement. “Some studies have linked those bonding behaviors with patient satisfaction and adherence, while other studies have found that patients were more likely to change their dietary habits, increase exercise and attempt to lose weight when their physicians expressed more empathy. Without that rapport, you could be cheating the patients who need that engagement the most.”

Gudzune and her colleagues studied recordings of those 208 patients, who have high-blood pressure and saw 39 primary care doctors in Baltimore, Maryland, between 2003 and 2005. Those recordings showed no difference related to body mass index (BMI) in terms of the amount of time spent with each patient or in weight counseling. However, when each recording was analyzed for expressed words of concern, encouragement or empathy, the researchers discovered more instances of those words and phrases in interactions with normal-weight patients.

The Johns Hopkins researchers explained that empathy and bonding are key components to a relationship between a patient and his or her physician. If a doctor expresses more empathy, then a patient is more likely to adhere to medical recommendations and respond to behavior-charge counseling, previous research has discovered. Getting these patients to follow these types of suggestion is essential for doctors hoping to help overweight or obese patients to shed pounds and improve their overall health.

The researchers found that the amount of health-related questions asked by doctors, medical advice given, counseling or treatment regimen discussions were not impacted based on the patient´s body weight. However, doctors were “significantly more likely” to express things like empathy, concern or understanding to normal weight patients compared to overweight or obese patients, regardless of the health-related topic being discussed.

According to Gudzune, obese patients are far more likely to be affected by subpar patient-physician communications, because studies have shown that doctors could view these individuals in a negative light. Some physicians have less respect for overweight or obese patients, and that could come across during consultations.

“If patients see their primary care doctors as allies, I think they will be more successful in complying with our advice,” she said. “I hear from patients all the time about how they resent feeling judged negatively because of their weight. Yes, doctors need to be medical advisors, but they also have the opportunity to be advocates to support their patients through changes in their lives.”

Gudzune advised doctors to be aware of any negative attitudes they might have towards overweight patients, then make an effort to bond with them and spend time discussing psychosocial and lifestyle issues. If they make the effort, they might find that those patients become more responsive to weight-loss counseling.

“Patients want information and treatment, but they also need the emotional support and attention that can help them through the challenges that accompany weight loss and the establishment of a healthy lifestyle,” she said.