Whether a doctor’s weight interferes with his or her ability to diagnose patients is a question I would normally consider stupid and insulting. But new research shows this actually might be the case—at least when that diagnosis is obesity. According to a study published this month in the journal Obesity, doctors who were overweight or obese were far less likely to diagnose obesity than docs in the normal weight range.
The study, conducted by researchers at Johns Hopkins University, surveyed 500 doctors across the United States. Researchers found doctors with a ‘normal’ BMI—between 18.5 and 25—treated patients differently than doctors whose BMIs placed them in the overweight to obese range. Normal-BMI doctors were more likely to talk to obese patients about weight loss 30% versus 18%) and to give advice on diet and exercise.
These are findings that bring up all sorts of questions. Do obese doctors fail to bring up weight, diet and exercise as often because they feel like patients won’t take them seriously? Or are these genuinely issues that seem less pertinent, noticeable or damaging to overweight physicians? Maybe overweight doctors just know what it’s like to constantly be barraged with weight loss advice, and decide to spare overweight patients yet another nudge or nag. Surveys do show that many overweight patients feel stigmatized by their doctors.
But the most stunning figure in the study has nothing to do with what doctors chose to talk to patients about. The researchers found the probability of a normal-BMI doctor actually recording an obesity diagnosis for an obese patient was 93%. For high-BMI doctors, the probability was just 7%.
“The probability of a physician recording an obesity diagnosis or initiating a weight loss conversation with their obese patients was higher when the physicians’ perception of the patients’ body weight met or exceeded their own personal body weight,” the researchers wrote.
Obesity diagnoses shouldn’t be subjective. Whether you believe in BMI as an adequate measure for obesity or not, that’s the current medical standard, and diagnoses are supposed to reflect this. But I have to wonder: Does a diagnosis of obesity actually do anything for a patient? If it’s just an arbitrary label, then what does it really matter?
I guess we can’t really know the ‘whys’ behind this study—maybe all of my speculations above are true, maybe none of them are. If researchers explore this topic more in the future, however, I think it would be interesting for them to ask high-BMI doctors why they rarely diagnose obesity. Maybe they’re doing overweight patients harm. Maybe they’ve figured out something about treating overweight patients that normal-weight doctors haven’t.