Doctors are less likely to bond with their overweight and obese patients than with their patients of normal weight, a small study conducted by Johns Hopkins researchers indicates.
Bonding and empathy are essential to the patient-physician relationship. When physicians express more empathy, studies have shown that patients are more likely to adhere to medical recommendations and respond to behavior-change counseling—all vital elements in helping overweight and obese patients lose weight and improve health.
Results of the study, which included 39 primary care doctors and 208 of their patients, are published online in the journal Obesity.
"If you aren't establishing a rapport with your patients, they may be less likely to adhere to your recommendations to change their lifestyles and lose weight," says Kimberly A. Gudzune, an assistant professor at the Johns Hopkins University School of Medicine and leader of the study. "Some studies have linked those bonding behaviors with patient satisfaction and adherence, while other studies have found that patients were more likely to change their dietary habits, increase exercise and attempt to lose weight when their physicians expressed more empathy. Without that rapport, you could be cheating the patients who need that engagement the most."
Obese patients may be particularly vulnerable to poorer physician-patient communications, Gudzune says, because studies show that physicians may hold negative attitudes toward these patients. Some physicians have less respect for their obese patients, which may come across during patient encounters.
Gudzune says physicians should be mindful of any negative attitudes, make an effort to bond, and then spend time with overweight and obese patients discussing psychosocial and lifestyle issues. If they do, physicians may find their obese patients more responsive to weight-loss counseling.
"If patients see their primary care doctors as allies, I think they will be more successful in complying with our advice," says Gudzune, whose practice focuses on weight-loss issues. "I hear from patients all the time about how they resent feeling judged negatively because of their weight. Yes, doctors need to be medical advisors, but they also have the opportunity to be advocates to support their patients through changes in their lives."
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