Obese Physicians

The January web volume of the journal Obesity contained an article "Impact of Physician BMI on Obesity Care and Beliefs".

It found that physicians with normal BMI were more likely to engage their overweight and obese patients in conversations about weight loss than their obese colleagues. These docs also had greater confidence in their ability to counsel obese patients about exercise and diet. These docs also felt that the patients of doctors who are themselves obese would not trust those obese docs to give advice about their patients' obesity.

They also found that 93% of the docs would only diagnose a patient with obesity if they were confident that the patient weighed more than they did.

There are a couple of implications to these findings that I find concerning.

The first is that obese docs don't trust themselves to help their patients with obesity. It makes sense. Obese docs may feel ashamed that they are unable to control their own weight. I see it more like an AA sponsorship though. A doc who has dealt with weight issues may be better able to share their experiences and help patients avoid pitfalls. There may be less judgement. Though in AA, a sponsor has achieved sobriety. With obesity, it may be the doc who reaches a normal BMI who is best able to provide this support. One study showed that the patients of obese docs are more likely to have a normal BMI than the patients of doctors with normal BMIs. The Cardiac Exercise Research Group compared this to smoking doctors who are less likely to counsel their patients to stop smoking.

The second is that docs with normal BMIs have so little faith in their obese counterparts. Given the squeals of "ew" when images of MRIs of obese patients were shown in class during med school, I shouldn't be so surprised. I wonder what it would take to change these beliefs?

A third is that docs are most comfortable diagnosing obesity in patients who weigh more than them. The implication here is that even docs who have a normal BMI are judging their weights against that of their patients. That's sad.

What I find most disturbing about this article though is how other media have been presenting its findings. E.g. "Fat Doctors Can't Help Fat Patients"

While I wasn't able to find articles on patients' perceptions of fat doctors, the comments on some of the articles I looked at speak volumes. Essentially that they wouldn't give a fat doctor's advice on weight loss much weight, if you pardon the pun. I wonder if this would be different though if they actually met the doctors and developed a relationship with the doc.

When you learn about the ways to help a patient lose weight, we learn about motivation and goals. It may be my goal to be a doctor with a normal BMI, but my motivation is to be a doctor who will earn the trust of her patients. Further motivation for me to follow my New Year's resolution of following the advice I give to my patients.