Fat chance of getting the skinny from overweight docs

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It s an unfortunate fact that doctors all too often fail to discuss weight management with their obese patients. But to make matters worse, a new study published in the journal Obesity has found that doctors who are themselves overweight are even less likely than their normal-weight counterparts to discuss weight loss with their patients.

Those are the results of an online survey of almost 500 general practitioners, family doctors, and internists, conducted by researchers at Johns Hopkins. While doctors with a normal BMI (body mass index) counseled their obese patients on weight loss about 30 percent of the time already a discouragingly low number Âonly 18 percent of overweight physicians were likely to do so. The overweight physicians were also significantly less confident in their ability to give effective counseling on exercise and diet to their patients.

Furthermore, doctors were much more likely to diagnose a patient as obese or to bring up the topic of weight loss if they perceived that the patient s weight was equal to or greater than their own. For a physician to use a subjective perception of weight, based on how much he himself weighs, to determine whether a patient is obese, says ACSH s Dr. Gilbert Ross, is inappropriate and likely to compromise his or her ability to offer sound medical care.

But as the lead study author notes, overweight doctors may feel that their patients won t respect their weight loss advice. Previous research has demonstrated that physicians often have difficulty broaching topics with their patients that they themselves find difficult: Doctors who smoke, for instance, are less likely to assist their patients with smoking cessation. Conversely, those who follow a healthy diet are more likely to counsel their patients on eating appropriately.

Since two-thirds of the country s adults struggle with obesity, physicians failure to encourage their patients to lose weight is a serious inadequacy of health care, notes Dr. Ross. We re not talking about high-tech equipment that costs millions of dollars, he says. In the case of obesity and helping patients to understand the toll of excess weight on their health, a five-minute discussion with their practitioner can really make a difference.