A Study of Anti-Fat Bias among Danish General Practitioners and Whether This Bias and General Practitioners' Lifestyle Can Affect Treatment of Tension Headache in Patients with Obesity

Objectives: The study investigated whether treatment options for episodic tension-type headache vary among general practitioners (GPs) in Denmark depending on the patients' weight status and gender, and whether these decisions can be explained by the GPs' own anti-fat bias and lifestyle. Methods: A cross-sectional questionnaire study with responses from 240 GPs on measures of anti-fat bias, healthiness of GPs' lifestyles, and reported patient treatment decisions. Results: GPs tended to exhibit negative explicit and implicit anti-fat bias. There were no differences in choice of medical treatment for patients with obesity and those of a normal weight. GPs were more likely to advise a general health check to a patient with obesity (p < 0.001). GPs treating a male patient with obesity were less likely to believe that their patient would comply with the advised treatment compared to those with a male patient of normal weight. Compared with other patient types (4.4-7.7%), GPs who treated a male patient with obesity (27.9%) were more likely to advise a general health check only and no diary-keeping or follow-up consultation (p < 0.001). This was explained by the healthiness of the GPs' lifestyles (Spearman's rho = 0.367; p < 0.01). Conclusion: Despite the presence of clear anti-fat bias, there were no differences in medical treatment, and GPs managed the general health of patients with obesity proactively. The fact that the GPs' own lifestyle influenced the likelihood that they would recommend diary-keeping and follow-up consultations for male patients with obesity is remarkable and requires further investigation. (C) 2018 The Author(s) Published by S. Karger GmbH, Freiburg