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Overweight Doctors Slim on Weight Loss Talks with Patients

Overweight docs mum on weight loss talk

If your doctor is overweight and you are too, then chances are he or she will not have the weight loss talk with you or give you a diagnosis of obesity. That’s the finding of a new study from researchers at the Johns Hopkins Bloomberg School of Public Health.

Doctor, heal thyself?

The epidemic of overweight and obesity in the United States—and around the world—is a growing problem and one that is taking its toll on health in a variety of ways, ranging from a greater risk of heart disease, stroke, and diabetes to greater pain and disability related to arthritis and osteoporosis, among other health problems.

In this new study, Sara Bleich, PhD, lead author and assistant professor with the Bloomberg School’s Department of Health Policy and Management, and her colleagues evaluated the effect of a doctor’s body mass index (BMI) on patient care regarding obesity, physician self-efficacy, perceptions of role modeling, and perceptions of patient trust in their advice on weight loss.

The study group included 500 primary care physicians who were classified according to self-reported BMI: less than 25 kg/m2 were considered to be normal weight, and 25 mg/m2 or greater was considered to be overweight or obese.

The researchers found that compared with overweight or obese doctors,

  • Doctors who had normal BMI more often reported talking about weight loss with their patients
  • Doctors with normal BMI had more confidence in their ability to provide dietary and exercise counseling to their patients
  • Doctors with normal BMI perceived their weight loss advice as trustworthy

Overall, normal BMI doctors were more likely (30%) to talk to their obese patients about weight loss than were overweight or obese doctors (18%). In addition, normal BMI doctors were much more likely (93%) than overweight or obese doctors (7%) to diagnose a patient as obese if they thought their patient’s BMI met or exceeded their own.

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In other words, if your doctor is overweight or obese and you are too, there is little chance he or she will tell you so. However, Bleich and her team also noted that “obese physicians had greater confidence in prescribing weight loss medications and were more likely to report success in helping patients lose weight.”

In 2006, Michael Dansinger, MD, who was then an obesity researcher at Tufts-New England Medical Center and who currently is assistant professor in the department of medicine and the nutrition doctor for NBC's The Biggest Loser, noted during a presentation that “physicians who fail to recognize and treat obesity are often the ones who personally fail to heed lifestyle recommendations, and these doctors may sometimes lose credibility with their own patients.”

In July 2009, Lord Darzi of Denham, a surgeon and health minister in the United Kingdom, told The Times that overweight doctors should be encouraged to change their lifestyle so they could serve as examples of healthy living.

In other words, physician, heal thyself and the rest may follow.

Bleich noted that “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.” It remains to be seen whether this advice or that of previous physicians will have an impact on overweight doctors and how they handle weight loss with their patients.

Dansinger M. Tight white-coat syndrome: physician heal thyself. Medscape 2006 May 15
Johns Hopkins Bloomberg School of Public Health: Impact of physician BMI on obesity care and beliefs, by Sara N. Bleich, Wendy L. Bennett, Kimberly A. Gudzune, and Lisa A. Cooper

Image: Courtesy of Wikimedia Commons



Here are two good questions about weight loss the answers of which I don't know. I question how a patient can lose weight when his or her doctor is overweight. Second, how can an overweight doctor give a good weight loss advice to an obese patient?
I agree. Here's another good question: How can you trust a doctor who smokes to give you good health advice?