Fat chance you'll follow doctor's orders

MICHELLE DUFF
Last updated 05:00 15/12/2013

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Research has confirmed what many of us already knew - we won't take dietary advice from a fat doctor.

A study published in the Journal of Primary Health Care this month says patients appear less likely to follow dietary advice if it's given by a portly doctor.

But a Massey University human development lecturer says the "fattism" goes both ways. Doctors are increasingly having to give weight advice, with the number of obese adults in New Zealand hitting one million this year, according to the Ministry of Health's annual report.

Patients in the study by researchers at Australia's Griffith University felt both health and weight advice was more credible if given by a doctor who was not overweight - and they were more likely to follow it.

Patients expected their GPs to be healthy role models and often felt more confident receiving advice from a doctor who appeared healthy, say researchers.

Twenty-one participants who had received healthy eating and exercise advice from a doctor were interviewed for the qualitative study.

"If the GP was grossly overweight, you would be reluctant to follow their advice because you would think ‘if your advice is so good why hasn't it worked for you?'," one woman, aged 49, said.

"I was always confident about what [my doctor] was telling me because I could see he was in pretty good shape and wasn't letting himself go in any way," another woman said.

Massey University human development lecturer Cat Pause said a large volume of research also showed that doctors held a bias towards overweight patients.

"If there was research that showed patients would be less likely to trust their fat health provider, then I would say that isn't surprising, simply because of the fact that we find across populations people are less likely to trust fat individuals - it doesn't matter whether it's a health context, a romantic context, or an employment context."

Overweight people were less likely to be given "evidence-based" healthcare, with doctors often blaming health problems on their weight rather than investigating further, she said.

"I say to people, ‘if the doctor gives you a diagnosis and prescribes weight loss as your treatment, ask what treatment they would recommend for a non-fat person and demand that'."

Dunedin School of Medicine associate professor Rachael Taylor agreed "some scepticism might exist" among patients given advice by an overweight doctor.

But other studies showed overweight patients might actually be more likely to "bond" with a doctor who was the same size as them, and could understand their weight-loss problems.

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Dr Taylor's own research focuses on how difficult doctors find it to tell parents that their children are overweight. Many doctors avoided doing it, not wanting to damage the patient-doctor relationship.

But one of her studies found 80 per cent of parents of under-10s did not realise their child was overweight until they were alerted to it by their GP.

The Griffith University study found that, along with patients' perceptions of doctors' healthiness, respect for doctors' medical knowledge and patients' own motivation to change were the biggest drivers of whether they would act on advice.

- Sunday Star Times

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