Physician Respect for Patients with Obesity
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
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).
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.
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).
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.
- Puhl R, Brownell KD. Bias, discrimination, and obesity. Obes Res. 2001;9:788–805. CrossRef
- 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. CrossRef
- 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. CrossRef
- 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. CrossRef
- Maddox GL, Liederman V. Overweight as a social disability with medical implications. J Med Educ. 1969;44:214–20.
- Klein D, Najman J, Kohrman AF, Munro C. Patient characteristics that elicit negative responses from family physicians. J Fam Pract. 1982;14:881–8.
- 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.
- Kristeller JL, Hoerr RA. Physician attitudes toward managing obesity: differences among six specialty groups. Prev Med. 1997;26:542–9. CrossRef
- Merrill E, Grassley J. Women’s stories of their experiences as overweight patients. J Adv Nurs. 2008;64:139–46. CrossRef
- 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. CrossRef
- Olson CL, Schumaker HD, Yawn BP. Overweight women delay medical care. Arch Fam Med. 1994;3:888–92. CrossRef
- 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. CrossRef
- 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. CrossRef
- Wee CC, McCarthy EP, Davis RB, Phillips RS. Obesity and breast cancer screening. J Gen Intern Med. 2004;19:324–31. CrossRef
- 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.
- 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. CrossRef
- 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. CrossRef
- 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. CrossRef
- 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. CrossRef
- Bertakis KD, Azari R. The impact of obesity on primary care visits. Obes Res. 2005;13:1615–23. CrossRef
- Wiese HJ, Wilson JF, Jones RA, Neises M. Obesity stigma reduction in medical students. Int J Obes Relat Metab Disord. 1992;16:859–68.
- Physician Respect for Patients with Obesity
Journal of General Internal Medicine
Volume 24, Issue 11 , pp 1236-1239
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- obesity stigma
- physician respect and body mass index
- Industry Sectors
- Author Affiliations
- 1. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 1-500, Baltimore, MD, 21205, USA
- 3. Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
- 2. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA