Do Doctors Treat Thinner Patients Differently, Nicer? [STUDY]

Your doctor’s bedside manner may depend on your weight. The less you weigh, the nicer your physician will be to you, and the more you weigh, well, let’s just say your doctor won’t necessarily be meaner, just less nice.

In a new study published by medical journal Obesity, researchers at Johns Hopkins University gained permission to record the discussions between 39 primary care physicians and more than 200 patients, all of whom had high blood pressure.

Of those patients, 28 patients weighed normally (BMI of under 25), 60 were overweight (BMI between 25 and 30) and 120 were classified as obese (BMI of 30 or greater).

While there were no differences in time spent between the doctors and the patients, when it came to the transcriptions of the patient-doctor interactions, researchers noticed that, indeed, doctors are nicer to patients who are thin or have normal weight.

But the lead author of the study, Dr. Kimberly A. Gudzune, assistant professor of general internal medicine at Johns Hopkins School of Medicine, points out that the physicians were not “being overtly negative or harsh.”

Gudzune told the New York Times, “They were just not engaging patients in that rapport-building or making that emotional connection with the patient.”

She said that doctors were more encouraging of their thinner patients, saying things like “I’m glad you’re feeling better” to a patient who was having hot flashes and “That can be frustrating” when a patient was upset and complained about how long it took to get an appointment. Those types of comments were noticeably absent in the transcripts between doctors and heavier patients, Gudzune said.

Another example was when a woman was feeling bad about a scar on her leg after having surgery on it, which forced her to wear ugly shoes.

“You went through a lot,” her doctor said to her, then continuing, “You still got great legs. Chunky shoes are still in. Get something pretty, something for spring. That always makes you feel good.”

And these comments have an effect on the patient. A doctor’s bedside manner correlates with how patients take care of themselves, according to other studies.

“When there is increased empathy by the doctor, patients are more likely to report they are satisfied with their care, and they are more likely to adhere to recommendations of physicians,” 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 control or cholesterol is better controlled.”

Dr. David Katz, director of the Yale-Griffin University Prevention Research Center, offered that doctors are people too and are subject to “prevailing influences in our culture.”

"If we want to banish obesity bias -- and we should -- we need to address it culture-wide,” Katz said. “Doctors will address this better when our culture addresses it better: with more understanding and an emphasis on what truly helps."

Katz noted that doctors are trained to deal with immediate medical problems that have specific solutions.

Have high blood pressure? Take this pill. Have itchy skin from an allergic reaction? Take this topical cream.

“When we can’t fix what is broken, we tend to behave badly,” he said.

And Katz stressed the importance of the patient-doctor relationship.

He added that if you can’t be honest with your doctor and how he or she is treating you, it’s time to find a new health care provider.