A new study suggests doctors treat thin patients with more empathy than overweight ones, The New York Times reported.
The study, which was published in the journal Obesity, looked at more than 200 patients who had high blood pressure and the discussions those patients had with 39 primary care doctors. The lead author, Dr. Kimberly A. Gudzune, an assistant professor of general internal medicine at John Hopkins School of Medicine got permission to record discussions between the patients and the doctors.
Twenty-eight of the patients were at a normal weight (body mass index below 25), 60 were deemed overweight (BMI of 25 to 30) and the rest were obese (BMI of 30 or greater).
At first glance, it appeared all patients were treated equally and doctors seemed to spend the same amount of time with each patient.
But when researchers analyzed the transcripts of the discussions between doctors and patients, they found big differences.
Doctors tended to act more warmly towards thinner patients, they realized.
With patients of normal weight, doctors showed more concern. In one medical visit a doctor told a woman experiencing hot flashes, “I’m glad you’re feeling better.” And when a patient of normal weight had difficulty setting up an appointment with a specialist, her doctor showed concern. One patient showed her doctor a scar on her leg and complained about the shoes she had to wear. Her doctor replied, “You still got great legs. Chunky shoes are still in.”
But, these types of friendly discussions didn’t take place with patients who had higher BMIs, researchers noticed.
Empathetic conversations, like the ones above, make a difference when it comes to medical care, studies have shown.
When patients feel their doctor empathizes with them, they are more likely to follow the physician’s advice and have a healthier outcome, Gudzune said.
“There is evidence to show that after visits with more empathy, patients have improved clinical outcomes, so patients with diabetes have better blood sugar or cholesterol is better controlled,” he added.
Dr. David L. Katz, director of the Yale-Griffin University Prevention Research Center, agreed, saying that overweight patients have told him doctors seem critical about their weight, sacrificing other health issues.
“You come in with a headache, and the doctors say, ‘You really need to lose weight,’” Katz told the Times. “You have a sore throat, and the doctor says, ‘You really need to lose weight.’ These patients feel like the doctor doesn’t help them, and they insult them, and so they stop going.”
Katz said medical students need better training, and doctors should recognize the many facets of obesity, as well as identifying their biases (which may be subconscious).
“I think a lot of them are compassionate and don’t realize this is going on,” Katz said.