Doctor Bias Against Fat Patients; Best-Liked Insurers; More

Neil Chesanow

September 06, 2016

Can Physician Focus on Obesity Harm Patients?

Studies show that even doctors may be biased against patients who are fat, associating them with being lazier, dumber, and more worthless than thin patients, an article in the online journal Stat reports.^[1]

Obesity is a health risk for many conditions, including high blood pressure, diabetes, heart disease, and stroke. But some doctors are so overly focused on patients' obesity that they miss more serious and immediate problems.

One overweight woman with a persistent cough saw 11 doctors over 7 years, the article noted.^[1] She was diagnosed with airway irritation, acid reflux, allergies, bronchitis, and pneumonia—and advised to lose weight. When serious respiratory symptoms and a fever landed her in the emergency department, CT revealed that she had cancer; an entire lung had to be removed.

The patient blamed the misdiagnoses on "fat-shaming" by her physicians. In one survey of over 700 women at risk for heart disease, only 16% had been told of this risk by their doctors^[1]; they were more commonly told they should lose weight, although the National Heart, Lung, and Blood Institute does not factor in weight in assessing people's 10-year risk for having a heart attack.^[2]

Focusing too much on a patient's weight may harm the doctor/patient relationship, the article asserts; doctors may miss the chance to discuss more serious problems the patient has.^[1] One half of the women in the survey said they had cancelled or postponed their next visit with the doctor until they could shed a few pounds.

Although judging others is human, experts observe, doctors should try to overcome their "attribution biases."^[1] Regardless of their weight, patients get sick, and a doctor's feelings about obesity shouldn't interfere with good care-giving.