Perceived judgment about weight can negatively influence weight loss: a cross-sectional study of overweight and obese patients

Prev Med. 2014 May;62:103-7. doi: 10.1016/j.ypmed.2014.02.001. Epub 2014 Feb 9.


Objective: To examine the association between patient-perceived judgments about weight by primary care providers (PCPs) and self-reported weight loss.

Methods: We conducted a national internet-based survey of 600 adults engaged in primary care with a body mass index (BMI)≥25 kg/m(2) in 2012. Our weight loss outcomes included attempted weight loss and achieved ≥10% weight loss in the last 12 months. Our independent variable was "feeling judged about my weight by my PCP." We created an interaction between perceiving judgment and PCP discussing weight loss as an independent variable. We conducted a multivariate logistic regression model adjusted for patient and PCP factors using survey weights.

Results: Overall, 21% perceived that their PCP judged them about their weight. Respondents who perceived judgment were significantly more likely to attempt weight loss [odds ratios (OR) 4.67, 95% confidence interval (CI) 1.96-11.14]. They were not more likely to achieve ≥10% weight loss [OR 0.87, 95%CI 0.42-1.76]. Among patients whose PCPs discussed weight loss, 20.1% achieved ≥10% weight loss if they did not perceive judgment by their PCP as compared to 13.5% who perceived judgment.

Conclusions: Weight loss discussions between patients and PCPs may lead to greater weight loss in relationships where patients do not perceive judgment about their weight.

Keywords: Obesity; Patient–provider; Primary care; Psychosocial research.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Negativism
  • Obesity / psychology*
  • Obesity / therapy
  • Outcome Assessment, Health Care
  • Overweight / psychology*
  • Overweight / therapy
  • Physician-Patient Relations*
  • Primary Health Care
  • Self Concept*
  • Self Report
  • Socioeconomic Factors
  • United States
  • Weight Loss*