Study says patient, physician perceptions don't match up
A new study done by researchers from the Universities of Kansas and Minnesota shows that patients are generally more optimistic about their overall health and ability to lose weight, than are their physicians who assign them to heavier weight classifications.
The study also shows that physicians typically perceive patients as less healthy than they actually are and that patients are often more motivated to lose weight than doctors suspect.
“A lot of data says physicians can have a large impact on these patients,” said Dr. Christie Befort who works in the Department of Preventative Medicine and Public Health at the KU Medical Center in Kansas City, Kan.
Befort is concerned with her findings because obesity can lead to more morbid health conditions, like high blood pressure, diabetes and mental disorders.
In fact, she found a large percentage of the patients she used in her study already had some of these illnesses and many of the participants were meeting with their physicians because of these conditions and not specifically for obesity.
Dr. Patricia Denning, Chief of Staff at Watkins Health Center, agreed that obesity can lead to symptoms associated with diabetes, chronic heart tension and arthritis because obese patients carry more weight than their legs and ankles were designed for.
She said patients’ perceptions about losing weight are highly variable.
“Some will say ‘I’ve tried a multitude of things,’ and they haven’t lost weight,” she said. “A percentage of them will say they need medication to lose weight.”
She said the majority of obese students she meets don’t even view their obesity as a problem.
Overall, Befort said, obese patients tend to be more optimistic about losing weight while physicians are less optimistic and even more negative about their patients' abilities to shed pounds.
Her study was published in October 2006 on the Blackwell-Synergy web site, which primarily publishes scholarly and professional journals.
Befort said that a lot of research has been documented about the amount of time physicians spend with their patients discussing obesity and particularly the most effective weight loss methods.
But physicians are not spending enough time discussing these issues with their patients, she said.
“It shows there’s a lot of room for improvement as far as communication,” Befort said.
She said the study she worked on involved 456 patients and 28 physicians in family medicine or general internal medicine primary care facilities throughout the state of Kansas. All 30 practices were in cities with populations of less than 50,000 residents and the study lasted for six weeks.
Researchers in the study were trained to get simultaneous reports from patients and physicians through a survey they would both fill out after their visit.
At each practice, one obese patient from a morning appointment and one obese patient from an afternoon visit were asked to fill out a survey rating how they perceived their obesity an how their weight issues were being addressed.
Later, the physician who met with both patients would fill out surveys regarding both patients and their individual obesity levels.
The surveys from the physicians were matched with their patients to find any correlation between their obesity perceptions.
“I think the finding most pronounced was perceived motivation,” Befort said. “It was enlightening to show that the patient wanted to lose weight and the physician didn’t think they could.”
Befort said these perceptions could influence how patients lose weight and that the next step is to more directly monitor how perceptions impact weight loss.
Denning also said some obese patients she works with who smoke don’t want to quit because they fear they may gain more weight.
“I do usually warn people they will gain weight as they are quitting,” Denning said.
She emphasized that many students use tobacco as a stress reliever, and upon quitting, they use eating as way to calm themselves. She wrote a paper on smoking cessation, and it opens as a PDF file.