Many patients fear the wrath of stern hospital matrons and stressed doctors.
But new research suggests that fat patients have more reason to worry than their thinner counterparts.
Researchers at John Hopkins University School of Medicine in Baltimore, U.S., found that hospital doctors are nicer to thin patients than those who are overweight.
They discovered that doctors are no less professional in diagnosing or treating large patients’ illnesses, but that their bedside manner changes when they address them.
Hospital doctors are nicer to thin patients than those who are overweight, research has found
The researchers believe this could be because health professionals have less respect for the overweight people they treat because they feel they should be doing more to help themselves.
This attitude could have a negative impact on the health of overweight patients as the research also shows that a lack of empathy between a doctor and their patient can reduce the effectiveness of health advice.
A patient is less likely to take on board tips about lifestyle changes if there is no rapport between them and the professional giving the advice.
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The researchers looked at 39 primary care doctors and the kind of relationships they built up with 208 of their patients.
They found that the physicians had far less of an 'emotional rapport' with overweight patients than with those of normal weight.
While there was no difference in the quality of treatment, diagnosis or the actual advice handed out by doctors to all their patients, there was a noticeable difference in the style, manner and general empathy levels depending on whether the patient was overweight or not.
Health professionals have less respect for the overweight people they treat because they feel they should be doing more to help themselves
Professor Kimberly Gudzune, who lead the research, said: ‘Bonding and empathy are essential to the patient-physician relationship.
‘When physicians express more empathy....patients are more likely to adhere to medical recommendations and respond to behaviour-change counselling, all vital elements in helping overweight and obese patients lose weight and improve health.’
She added: ‘Without that rapport, you could be cheating the patients who need that engagement the most.’
The team studied recordings of conversations between doctors and patients who had gone to see them suffering from high blood pressure.
A lack of empathy between a doctor and their patient can reduce the effectiveness of health advice
They looked at personal details of the patients, the diagnosis, and the treatment given in that meeting, and analysed the language used by the doctor during the appointment.
Doctors spent just as long with fat patients as thin ones and gave the same level of advice and treatment, so they were no less professional in a strictly medical sense.
However, their language when dealing with overweight patients contained far less emotive phrases and showed less concern for their general well being, said the researchers.
For instance, when they were being empathetic, a physician would say something like: ‘I can see how frustrated you are by your slow progress, anyone would be’.
In contrast, a lack of empathy would include little emotional language and a far more clinical approach to the advice dished out.
Professor Gudzune said: ‘Obese patients may be particularly vulnerable to poorer physician-patient communications.
‘Studies show that physicians may hold negative attitudes toward these patients. Some physicians have less respect for their obese patients, which may come across during patient encounters.
‘I hear from patients all the time about how they resent feeling judged negatively because of their weight.
‘Yes, doctors need to be medical advisors, but they also have the opportunity to be advocates to support their patients through changes in their lives.’