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Research already demonstrates that physicians are sometimes
uncomfortable talking about weight with their obese patients.
Now, a new study shows that the doctors' weight makes a
difference too.
Physicians who pack on the pounds discuss weight loss less
frequently with obese patients than doctors who have normal
body mass indexes (18 percent versus 30 percent), according to
the report published
this week[1] in the
medical journal Obesity.
And they're significantly less confident of their ability to
provide effective counseling about diet (37 percent vs. 53
percent) or exercise (38 percent vs. 56 percent).
The findings come from an Internet survey of 498 family
doctors, internists and general practitioners conducted early
last year by researchers at Johns Hopkins. Two-thirds of the
physicians were male, almost three-quarters were 40 years old
and 53 percent were overweight or obese.
The results matter. More than two-thirds of American adults are
overweight or
obese[3] and their
medical costs total $147 billion. If heavy doctors won't
acknowledge that patients have a problem and offer help, that
can be a barrier to effective care, says Sara
Bleich[4], lead
author of the new study and an assistant professor of health
policy at Johns Hopkins Bloomberg School of Public Health.
A notable finding in the study speaks to the problem: 93
percent of physicians of normal weight said they would be more
likely to identify an obese patient when that person was as
large or larger than they were. By contrast, this was true of
only 7 percent of obese or overweight physicians.
"It seems to be the case that doctors are less likely to
diagnose the patient until the patient's weight meets or
exceeds their own," Bleich says. This could be because
physicians' sense of what's normal changes as they put on
pounds and see more excessively heavy patients in their
practices, she speculates.
Asked what might explain heavier doctors' reluctance to discuss
weight loss, Bleich says, "It could be that they feel that
their advice will not hold a lot of weight with their patients,
because they themselves are heavy."
Overweight and obese physicians expressed greater confidence in
prescribing weight-loss drugs than other doctors, perhaps
because they've had personal experience with the medications or
with the difficulty of behavior change, she observes.
This isn't the first time that research has shown a link
between physicians' personal characteristics and their
willingness to advise patients on lifestyle issues. "We know
that physicians who follow healthy dietary practices themselves
are more likely to spend time counseling patients about diet,"
says Dr. Robert
Kushner[5], a
professor of medicine at Northwestern University Feinberg
School of Medicine and clinical director of Northwestern's
Comprehensive Center on Obesity.
Other research has shown that physicians who smoke are less
likely to help patients quit.
Bleich and her co-authors close their study by suggesting that
doctors, who also report high levels of stress, substance abuse
and depression, need to be encouraged to take better care of
their health, both for their own sake and patients.
References
- ^ report published this week
(www.nature.com) - ^
(www.npr.org) - ^ overweight or obese
(www.npr.org) - ^ Sara Bleich
(www.jhsph.edu) - ^ Dr. Robert Kushner
(fsmweb.northwestern.edu)
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Heavy Doctors Avoid Heavy Discussions About Weight
