Weight-related perceptions among patients and physicians: how well do physicians judge patients' motivation to lose weight?

J Gen Intern Med. 2006 Oct;21(10):1086-90. doi: 10.1111/j.1525-1497.2006.00567.x.


Background: Prior studies suggest that patients and physicians have different perceptions and expectations surrounding weight; however, few studies have directly compared patients' and physicians' perspectives.

Objectives: (1) To measure the extent to which obese patients and their physicians have discrepant weight-related perceptions, and (2) to explore patient and physician characteristics that may influence patient-physician discrepancy in motivation to lose weight.

Design and participants: Four hundred and fifty-six obese patients (302 females; mean age = 55.1 years; mean BMI = 37.9) and their 28 primary care physicians (22 males, mean age = 44.1 years) from nonmetropolitan practices completed an anonymous survey after an office visit.

Measures: Weight-related perceptions included perceived weight status, health impact of weight, 1-year weight loss expectations, and motivation to lose weight. Correlates included patient and physician sex, age, and BMI; physicians' reported frequency, perceived patient preference, and confidence for weight counseling; and practice characteristics (e.g., years in practice).

Results: Physicians assigned patients to heavier descriptive weight categories and reported a worse health impact than patients perceived for themselves, whereas patients believed they could lose more weight and reported a higher motivation to lose weight than their physicians perceived for patients (P < .001). Physicians who believed patients preferred to discuss weight more often (P = .001) and who saw more patients per week (P = .04) were less likely to underestimate patient motivation.

Conclusions: Patients reported more optimistic weight-related perceptions and expectations than their physicians. Further research is needed to determine how these patient-physician discrepancies may influence weight loss counseling in primary care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Body Weight / physiology
  • Female
  • Humans
  • Judgment* / physiology
  • Male
  • Middle Aged
  • Motivation*
  • Obesity / psychology*
  • Perception* / physiology
  • Physician-Patient Relations*
  • Weight Loss* / physiology