Obese patients more likely to argue with their doctors about losing weight

TOULOUSE, France — Overweight patients tend to disagree with their doctors in a big way when it comes to health advice, according to a new study. Scientists report the more overweight the individual, the more likely they are to not see eye-to-eye with their healthcare provider on subjects including weight loss, exercise, and nutrition.

It’s no secret that obesity is a major global health issue. The World Health Organization notes that obesity rates have nearly tripled between 1975 and 2016. Obviously, general practitioners and doctors play a big role in tackling this problem, but the relationship between practitioner and patient is a nuanced one.

Researchers say there needs to be a certain amount of mutual trust. The quality of information, mutual comprehension, and agreement between a doctor and their patient has a direct impact on that patient’s health outcomes, compliance, satisfaction, and overall confidence towards his or her doctor.

Notably, however, prior research reveals that doctors and patients often disagree when it comes to weight. Generally speaking, patients tend to blame factors outside of their control for excess weight gain, such as genetics or hormones. Doctors, on the other hand, emphasize the importance of making healthy lifestyle decisions (like proper nutrition and regular exercise).

At the end of the day, both genetic and behavioral factors influence a person’s weight outcomes, but study authors explain this frequent difference of opinion between doctors and their patients can lead to a loss of trust and degrade doctor-patient interactions.

Patients have pretty lukewarm relationships with their doctors

Study authors set out to analyze whether interactions between patients and their doctors varied in connection with patients’ BMI. The team measured these interactions based on the level of disagreement or agreement between the two parties regarding medical information and advice given during a consultation.

A total of 27 general practitioners and 585 patients from three regions in France took part in the project between September and October 2007. Each participant filled out surveys that collected data on general practitioners’ and patients’ perceptions pertaining to the advice given during a consultation.

Study authors then explored differences among the patient’s and doctor’s declarations in reference to actions, information, and advice given during the same visit, the patient’s health status, and the perceived quality of their relationship. Questions asked about weight loss included “did your doctor advise you to lose weight during the consultation?”  (answered by patients) and “did you advise this patient to lose weight during the consultation?” (answered by doctors).

The team then used the fluctuations and differences in the answers to define any disagreements.

Overall, agreement between patients and their doctors turned out to be either fairly weak (20-40%) or moderate (40-60%) for most questions — including those focusing on actions, information, advice, and patient’s health status. Agreement was even weaker (less than 20%) when it came to the perceived quality of the patient-doctor relationship.

People don’t like to talk about their weight

Study authors noticed a clear trend: the more overweight a patient was, the more observed doctor-patient disagreement. These differences of opinion were especially apparent for doctor’s advice on weight and lifestyle issues. In comparison to other patients with normal BMI, overweight individuals were more likely to disagree with their doctor over advice on how to lose weight, eat healthier, and exercise more often.

“An exploration of the patient’s representations and difficulties related to weight could be offered by the general practitioners as a basis for discussion and appropriate support,” says lead study author Laëtitia Gimenez in a media release.

The study is published in the journal Family Practice.

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