Physician BMI impacts obesity care

2 February 2012

MedWire News: Physicians with a normal body mass index (BMI) are more likely to provide obesity care to their patients, and feel confident doing so, than their overweight or obese counterparts, report researchers.

Sara Bleich (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA) and colleagues assessed the impact of physician BMI on obesity care, physician self-efficacy, perceptions of role-modeling weight-related behaviors, and perceptions of patient trust in weight loss advice.

They surveyed 500 primary care physicians (general practitioners, family practitioners, and general internists) between February and March 2011.

Physicians were considered to be overweight if their self-reported BMI was 25 kg/m² or more and normal weight if their self-reported BMI was less than 25 kg/m².

The researchers found that normal-weight physicians were more likely to engage their obese patients in weight loss discussions than overweight/obese physicians (30 vs 18%). They were also more confident providing diet (53 vs 37%) and exercise (56 vs 38%) counseling to their obese patients.

Eighty percent of normal-weight physicians believed that overweight/obese patients would be less likely to trust weight loss advice from overweight/obese doctors, while just 69% of their overweight/obese counterparts had this belief.

Normal-weight physicians were more likely to believe that physicians should model healthy weight-related behaviors; 72% believed that physicians should maintain a healthy weight and 73% believed they should exercise regularly. This compared with a respective 56% and 57% of overweight/obese physicians having these beliefs.

Reporting in Obesity, Bleich et al observed that when the physicians’ perception of the patient’s bodyweight met or exceeded their own personal bodyweight they more frequently recorded an obesity diagnosis (93 vs 7%) and discussed weight loss (89 vs 11%) than when the patient’s bodyweight was less than their own bodyweight.

However, they note that overweight/obese physicians had greater confidence in prescribing weight loss medications than normal-weight physicians and were more likely to report success in helping patients lose weight.

The authors suggest that physician self-efficacy to care for obese patients, regardless of their BMI, “may be improved by targeting physician well-being and enhancing the quality of obesity-related training in medical school, residency or continuing medical education.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

Obesity 2012; Advance online publication