A doctor who packs a few extra kilos may be unlikely to advise you to shed your own excess weight, a new study suggests.
Overweight physicians who responded to a survey disclosed that they're less likely than other doctors to talk to their obese patients about weight control.
When it comes to talking to patients about losing weight, "in general, doctors are not doing a good job. But you can't look at overweight doctors and say, 'You're the problem," said study author Sara Bleich, an assistant professor of health policy at Johns Hopkins Bloomberg School of Public Health.
Why? Because doctors of normal weight don't tend to bring up weight loss with their heaviest patients either.
The researchers did find that doctors of normal weight were more confident than their overweight counterparts about their ability to counsel obese patients about diet and exercise.
Bleich said she came up with the idea for the study after going to a dentist who had bad teeth. "I thought, 'How are you going to take good care of my teeth if you can't take good care of your own?' "
She decided to see a different dentist and began thinking about overweight doctors and their heftier patients. After all, she noted, doctors who smoke are less likely to provide information about quitting.
So last year, Bleich and her colleagues sent a survey to 500 primary care physicians, who received $25 each for taking part. About two-thirds were male, 70% were white and almost three-quarters were at least 40 years old.
About half were overweight or obese, a category that encompasses people who are a step beyond simply carrying a few extra kilos. Two doctors were underweight, and the researchers didn't include them in their analysis.
The study appears in an issue of the journal Obesity.
Talking about weight-loss
Only about one-third of doctors of normal weight said they talked to obese patients about weight loss, compared to 18% of those doctors who were overweight. Just over half of the normal-weight doctors had confidence in their ability to talk to their patients about diet and exercise, compared to about 38% of the overweight doctors.
Also, 80% of normal-weight doctors thought overweight patients would be less likely to trust guidance about weight control from overweight doctors; the number was 69% among overweight doctors, the survey found.
Normal-weight doctors were also more likely than their overweight peers to believe that physicians should "model" healthy behaviors, such as keeping a healthy weight and exercising regularly.
"For physicians, weight matters when it comes to obesity care," Bleich said.
The findings appear to be sound, said Dr Robert Post, who has studied obesity in doctors and serves as research director of Virtua Family Medicine Residency, which trains physicians in New Jersey. "I find it troubling that any physician would bring their own issues into any encounter with a patient and avoid talking about weight," he said. "But a previous study I authored showed most doctors do not address weight with their overweight patients."
What to do? Bleich said electronic record-keeping may help doctors do a better job of treating overweight patients because the body mass index (BMI) of patients can be automatically calculated. The BMI is a commonly used measure of whether a person's weight isn't normal for his or her height.
(HealthDay News, January 2012)
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