Are Doctors Nicer to Thinner Patients?

The New York Times, reporting on a study by Johns Hopkins researchers, reports on the attittude of some doctors toward overweight patients:

Are doctors nicer to patients who aren’t fat?

A provocative new study suggests that they are — that thin patients are treated with more warmth and empathy than those who are overweight or obese.

For the study, published in the medical journal Obesity, researchers at Johns Hopkins obtained permission to record discussions between 39 primary care doctors and more than 200 patients who had high blood pressure.

Although patients were there to talk about blood pressure, not weight, most fell into the overweight or obese category. Only 28 were of normal weight, meaning they had a body mass index below 25. Of the remaining patients, 120 were obese (B.M.I. of 30 or greater) and 60 were classified as overweight (index of 25 to 30).

For the most part, all of the patients were treated about the same; there were no meaningful differences in the amount of time doctors spent with them or the topics discussed.

But when researchers analyzed transcripts of the visits, there was one striking difference. Doctors seemed just a bit nicer to their normal-weight patients, showing more empathy and warmth in their conversations. Although the study was relatively small, the findings are statistically significant.

“It’s not like the physicians were being overtly negative or harsh,” said the lead author, Dr. Kimberly A. Gudzune, an assistant professor of general internal medicine at the Johns Hopkins School of Medicine. “They were just not engaging patients in that rapport-building or making that emotional connection with the patient.