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Obese patients may trust diet advice more from heavy doctors

Los Angeles Times


June 07--If a doctor is going to tell a patient he's obese and needs to lose weight, that patient seems more likely to trust the advice if the doctor is overweight too, scientists say.

It might seem that patients want role models in their primary care doctors, but in matters of weight, that doesn't seem to be the case. Researchers from John Hopkins Bloomberg School of Public Health set out to see what effect a doctor's weight might have on patients; they published their findings in the June issue of Preventive Medicine.

Some things are already known about what happens to overweight or obese people in doctors' offices. Doctors have been shown to consider obese patients as "noncompliant, lazy, lacking in self-control, weak-willed, dishonest and unsuccessful," the researchers, led by Sara Bleich from the Bloomberg school, said.

The researchers say these issues are growing in importance because Medicare will soon begin covering obesity screening and treatment, and private insurers could follow suit. And trust, they said, is "a critical precursor to behavior change."

They surveyed 600 overweight and obese patients in April 2012 about their trust of their doctors and about any stigma they felt related to weight.

The patients had a very high degree of trust in their doctors overall -- above an 8 on a 10-point scale -- but that fell when the patients were asked about their trust in weight-related advice. In those cases, patients said they had more trust in heavier doctors.

The researchers speculated that could be because heavier doctors and heavier patients "improves the relationship from the patient perspective." Patients might like feeling that their doctors know what it's like to be them.

But other research has shown that normal-weight doctors are more likely to discuss weight loss with patients, and feel more confident about doing so.

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