If getting exercise and maintaining a healthy body weight are so important, particularly for patients with prediabetes or diabetes, have you ever wondered why your physician may not have really emphasized to you the need for exercise and losing weight, that is if you need to lose weight? As it turns out, a study published in the January issue of Obesity suggests physicians that maintain a more normal body weight themselves are more likely to recommend to their overweight or obese patients the need for weight loss and feel comfortable doing so.
The objective of the study, conducted between February 9 and March 1, 2011 by researchers in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health, was to look at the impact of physician BMI on obesity care, physician self-efficacy, perceptions of role-modeling weight related health behaviors, and perceptions of patient trust in weight loss advice.
Bleich and colleagues discovered that physicians with a normal BMI were more likely to discuss weight loss with their obese patients than their colleagues with a higher BMI score. As I mentioned previously, the study showed that physicians with a normal BMI also had greater confidence in their ability to provide diet and exercise counseling to patients (53 percent vs. 37 percent, P=0.002).
Eighty percent of the physicians with a normal BMI felt that overweight or obese patients would be less likely to pay attention to weight loss advice from overweight or obese physicians, while only 69 percent of the physicians with an elevated BMI felt the same way.
Physicians with a normal BMI were more likely to believe that they should serve as role models to their patients in regards to maintaining healthy weight-related behaviors and performing regular exercise. And finally, something that I find very interesting, physicians with an elevated BMI were far less likely to record an obesity diagnosis or bring up the subject of weight loss with obese patients, unless the physician's perceptions of the patients' body weights met or exceeded their own body weight.
I find this study useful in helping us to understand why doctors, within the same specialty, diagnose and treat patients with the same illness in different ways. As this study suggests, perhaps it is influenced by the physician's own state of health. Could it be that the medication the doctor prescribes a patient for high cholesterol is the one that seems to work best in treating his own cholesterol? Maybe a lot of health care providers do feel uncomfortable prescribing exercise and weight loss, and therefore don't do it, if they themselves are quite overweight and cannot find the motivation to get out and get it done. Interestingly, I have heard countless times of physicians that tell their patients that they need to quit smoking but smell of cigarettes themselves.
I do believe that people involved in the health care industry, particularly doctors, nurses, dietitians, therapists and educators, should serve as healthy examples to their patients and that they be people that patients can aspire to.
Maybe this is one reason why doctors don't recommend exercise to patients with diabetes with the enthusiasm that patients need to hear.
Maybe it's because of their own personal situation and the attitudes they have toward exercise. In any case, good study. We need more on this topic.
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