Being “too skinny” or “too fat” has always come down to the number on the scale when a doctor is reading a patient’s body mass index. However, a recent study led by the Johns Hopkins Bloomberg School of Public Health, linked patients’ weight diagnosis to the weight of their doctors.
“Our findings indicate that physicians with normal BMI more frequently reported discussing weight loss with patients than overweight or obese physicians,” the lead author of the study, Sara Bleich, said in a Johns Hopkins Bloomberg School of Public Health news release.
The study said that 93 percent of normal-weight doctors would likely diagnose a patient as obese if the patient’s BMI was the same or greater than their own.
Bleich, an assistant professor with the school of public health, said physicians with normal BMI have a greater confidence in their ability to provide diet and exercise counseling and perceive their weight loss advice as trustworthy when compared to overweight or obese doctors.
Only 7 percent of overweight and obese doctors were likely to report feeling the same.
The study was titled “Impact of Physician BMI on Obesity Care and Beliefs” and was published in the online research journal “Obesity.” The research was conducted from a national cross-sectional survey of 500 primary care doctors. Bleich and other researchers from the Johns Hopkins School of Medicine determined that physicians with a self-reported BMI below 25 were of “normal-weight.” Any BMI above 25 were considered overweight, and over 30 — obese.
Weight and height are used to calculate a patient’s BMI, said Dr. Nate Haecker, chief of staff of the University Health Center at U. Nebraska-Lincoln.
“The University Health Center sees many students who are obese,” Haecker said. “About one-third of U.S. adults are obese so it is a problem in all health care settings.”
Haecker said the health center probably sees slightly less obesity than a typical clinic in the community because less than 20 percent of obese patients are adolescents — a different patient population than what the UHC receives.
“But it is still a problem on college campuses,” he said.
According to the Centers for Disease Control and Prevention, obesity is estimated to cost $147 billion annually in health care costs. Obesity increases a person’s risk of diabetes, high blood pressure, high cholesterol and heart disease.
The Johns Hopkins Bloomberg School of Public Health said that only one-third of overweight and obese patients report receiving an obesity diagnosis or weight-related counseling from their physicians. In addition, an article in the Associated Press reported that many doctors aren’t talking to overweight kids about their weight, according to a study conducted by U. North Carolina.
Haecker said there wasn’t much formal education about non-surgical weight management and nutrition options for doctors when he was attending medical school. Despite this, Haecker said his years of practice have made him very comfortable about discussing obesity with his patients.
He also said that he thinks most health care providers feel obligated to practice what they preach, yet there are still lots of physicians that do a poor job of caring for their own body.
“One of the best physicians I’ve ever met was an overweight smoker but was adored by his patients and provided wonderful care,” Haecker said. “His patients appreciated the fact that he was ‘real’ and admitted to struggling with the same issues they did.”
Jason Thomas, a first-year medical student at the U. Nebraska Medical Center, said doctors who are in shape are more likely to talk to their patients about getting in shape.
“A lot of taboo things that need to be talked about are overlooked in the doctor’s office,” Thomas said.
Tyler White, a UNL senior pre-med and biology major, said that it’s tough for the doctor. He said that although he understands the weight of younger doctors coming out of medical school who work 30 to 40 hour weeks during their residency, he would have a hard time taking advice from a 35-year-old obese doctor.
“It’s frustrating for doctors when patients don’t take their advice and then repeatedly come back with more complaints,” White said. “You can’t be there every second to slap their hand away from that cookie.”