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Many blogs have been written emphasizing the importance of weight loss in terms of preserving lower extremity joint function, lowering the risk of developing rheumatoid arthritis, and improving quality of sleep—not to mention quality of life. For many overweight patients, the first step on the healthy path to weight loss is into the office of the primary care physician, with the humble expectation of at least moral support.
But what if your primary care physician is, well, kind of turned off by your endomorphic presentation? What if your physician is just blind to the lithe soul trapped inside a Macy’s Woman or Big ‘N Tall body?
Unfortunately, a study to be published in an upcoming issue of the journal “Obesity” did indeed find that primary care physicians developed less emotional rapport with overweight and obese patients. This can only make the prospect for successful behavioral change, such as that which can lead to weight loss, all the more difficult to achieve.
I find the actual numbers more than a little concerning: Compared with their feelings toward patients who are not overweight or obese, these physicians were 35% less likely to have an emotional rapport with the overweight; and 31% less likely to develop an emotional connection with obese individuals.
Other studies, some discussed previously on this website, have shown that a strong empathetic bond between physician and patient increases the likelihood of patient compliance with the health care plan—resulting in a healthier patient. More specific to the immediate subject at hand, patients are more likely to modify their approach to food, increase exercise, and make a truer effort to lose weight when their physicians express a greater degree of empathy in the course of the doctor-patient interaction.
A lack of bond-building can be considered the moral equivalent of an unjustified withholding of treatment from a patient.
The irony in all this is that doctors would really rather not deal with obesity, as over time the obese state will in many cases lead to a host of other medical problems, including diabetes, heart disease, and degenerative joint disease: In other words, a lot more work for the overworked doctor. One would think the health care provider would place an emphasis on establishing a rapport with the motivated (or not) overweight patient.
Physicians should weave a certain mindfulness in among the patches of pharmacologic and physiologic knowledge, spending time with the overweight and the obese, discussing the psychosocial issues that prove obstacles to a healthy approach toward life.
And if this is not happening, then patients should consider finding another physician.
