Skip to main content

Advertisement

Log in

Physician Respect for Patients with Obesity

  • Brief Report
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

INTRODUCTION

Obesity stigma is common in our society, and a general stigma towards obesity has also been documented in physicians. We hypothesized that physician respect for patients would be lower in patients with higher body mass index (BMI).

METHODS

We analyzed data from the baseline visit of 40 physicians and 238 patients enrolled in a randomized controlled trial of patient-physician communication. The independent variable was BMI, and the outcome was physician respect for the patient. We performed Poisson regression analyses with robust variance estimates, accounting for clustering of patients within physicians, to examine the association between BMI and physician ratings of respect for particular patients.

RESULTS

The mean (SD) BMI of the patients was 32.9(8.1) kg/m2. Physicians had low respect for 39% of the participants. Higher BMI was significantly and negatively associated with respect [prevalence ratio (PrR) 0.83, 95% CI: 0.73–0.95; p = 0.006; per 10 kg/m2 increase in BMI]. BMI remained significantly associated with respect after adjustment for patient age and gender (PrR 0.86, 95%CI: 0.74–1.00; p = 0.049).

CONCLUSION

We found that higher patient BMI was associated with lower physician respect. Further research is needed to understand if lower physician respect for patients with higher BMI adversely affects the quality of care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Puhl R, Brownell KD. Bias, discrimination, and obesity. Obes Res. 2001;9:788–805.

    Article  CAS  PubMed  Google Scholar 

  2. Myers A, Rosen JC. Obesity stigmatization and coping: relation to mental health symptoms, body image, and self-esteem. Int J Obes Relat Metab Disord. 1999;23:221–30.

    Article  CAS  PubMed  Google Scholar 

  3. Puhl RM, Moss-Racusin CA, Schwartz MB. Internalization of weight bias: Implications for binge eating and emotional well-being. Obesity (Silver Spring). 2007;15:19–23.

    Article  Google Scholar 

  4. Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans, 1995–1996 through 2004–2006. Obesity (Silver Spring). 2008;16:1129–34.

    Article  Google Scholar 

  5. Maddox GL, Liederman V. Overweight as a social disability with medical implications. J Med Educ. 1969;44:214–20.

    CAS  PubMed  Google Scholar 

  6. Klein D, Najman J, Kohrman AF, Munro C. Patient characteristics that elicit negative responses from family physicians. J Fam Pract. 1982;14:881–8.

    CAS  PubMed  Google Scholar 

  7. Price JH, Desmond SM, Krol RA, Snyder FF, O’Connell JK. Family practice physicians’ beliefs, attitudes, and practices regarding obesity. Am J Prev Med. 1987;3:339–45.

    CAS  PubMed  Google Scholar 

  8. Kristeller JL, Hoerr RA. Physician attitudes toward managing obesity: differences among six specialty groups. Prev Med. 1997;26:542–9.

    Article  CAS  PubMed  Google Scholar 

  9. Merrill E, Grassley J. Women’s stories of their experiences as overweight patients. J Adv Nurs. 2008;64:139–46.

    Article  PubMed  Google Scholar 

  10. Drury CA, Louis M. Exploring the association between body weight, stigma of obesity, and health care avoidance. J Am Acad Nurse Pract. 2002;14:554–61.

    Article  PubMed  Google Scholar 

  11. Olson CL, Schumaker HD, Yawn BP. Overweight women delay medical care. Arch Fam Med. 1994;3:888–92.

    Article  CAS  PubMed  Google Scholar 

  12. Amy NK, Aalborg A, Lyons P, Keranen L. Barriers to routine gynecological cancer screening for White and African-American obese women. Int J Obes (Lond). 2006;30:147–55.

    Article  CAS  Google Scholar 

  13. Fontaine KR, Faith MS, Allison DB, Cheskin LJ. Body weight and health care among women in the general population. Arch Fam Med. 1998;7:381–4.

    Article  CAS  PubMed  Google Scholar 

  14. Wee CC, McCarthy EP, Davis RB, Phillips RS. Obesity and breast cancer screening. J Gen Intern Med. 2004;19:324–31.

    Article  PubMed  Google Scholar 

  15. Maruthur NM, Bolen SD, Brancati FL, Clark JM. The Association of Obesity and Cervical Cancer Screening: A systematic review and meta-analysis. Obesity (Silver Spring). 2009;17:375–81.

    Google Scholar 

  16. Beach MC, Duggan PS, Cassel CK, Geller G. What does ‘respect’ mean? Exploring the moral obligation of health professionals to respect patients. J Gen Intern Med. 2007;22:692–5.

    Article  PubMed  Google Scholar 

  17. Beach MC, Roter DL, Wang NY, Duggan PS, Cooper LA. Are physicians’ attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? Patient Educ Couns. 2006;62:347–54.

    Article  PubMed  Google Scholar 

  18. Cooper LA, Roter DL, Bone LR, Larson SM, Miller ER 3rd, Barr MS, Carson KA, Levine DM. A randomized controlled trial of interventions to enhance patient-physician partnership, patient adherence and high blood pressure control among ethnic minorities and poor persons: study protocol NCT00123045. Implement Sci. 2009;4:7.

    Article  PubMed  Google Scholar 

  19. Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.

    Article  PubMed  Google Scholar 

  20. Bertakis KD, Azari R. The impact of obesity on primary care visits. Obes Res. 2005;13:1615–23.

    Article  PubMed  Google Scholar 

  21. Wiese HJ, Wilson JF, Jones RA, Neises M. Obesity stigma reduction in medical students. Int J Obes Relat Metab Disord. 1992;16:859–68.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported, in part, by grants from the National Heart, Lung and Blood Institute (R01HL069403 and K24HL083113). MMH was supported by the Johns Hopkins Clinical Research Scholars Program (NCR 5K12RR023266). The authors would like to acknowledge Kathryn Carson for her assistance with data management.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mary Margaret Huizinga MD, MPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huizinga, M.M., Cooper, L.A., Bleich, S.N. et al. Physician Respect for Patients with Obesity. J GEN INTERN MED 24, 1236–1239 (2009). https://doi.org/10.1007/s11606-009-1104-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-009-1104-8

KEY WORDS

Navigation