Impact of patient obesity on the patient-provider relationship

Objective: Health professionals' weight bias may impair obese patients' interactions with providers. However, few studies have examined how negative provider attitudes affect the patient-provider relationship for obese patients. We hypothesized that higher patient body mass index (BMI) would be negatively associated with patient-provider relationship quality. Methods: We analyzed data from the 2007 Health Tracking Household Survey. BMI was the independent variable, and patient-perceived quality of the patient-provider relationship was the outcome. We performed log-binominal regression analyses accounting for complex survey design to examine the association of BMI with the patient-provider relationship. Results: Of the 15,197 adult survey respondents, the 6427 who answered the quality of care questions were eligible for analysis. Overall, 29% had a normal range BMI, 34% were overweight, and 37% were obese. We found few differences in ratings of the patient-provider relationship for overweight and obese respondents when compared to respondents with a normal range BMI. Conclusion: These unexpected findings may have occurred due to patients' inability to perceive providers' weight bias, measurement error in questionnaire items, or decreasing weight bias among health professionals. Practice implications: Patient's positive perceptions of providers may indicate promise for health professionals acting as motivators of behavior change in obese patients. (C) 2011 Elsevier Ireland Ltd. All rights reserved.