Patients who feel judged about their weight have lower trust in their primary care providers

Patient Educ Couns. 2014 Oct;97(1):128-31. doi: 10.1016/j.pec.2014.06.019. Epub 2014 Jul 7.


Objective: To evaluate whether overweight and obese patients have less trust in their primary care providers (PCPs) if they feel judged about their weight by these PCPs.

Methods: We conducted a national internet-based survey of 600 adults engaged in primary care with a BMI ≥ 25 kg/m(2) in 2012. Our dependent variable was high patient trust in their PCP (score ≥ 8/10). Our independent variable was "feeling judged about my weight by my PCP" dichotomized as "often/sometimes" versus "never." We conducted a multivariate logistic regression model adjusted for patient and PCP factors using survey weights.

Results: Overall, 21% felt that their PCP judged them about their weight. Respondents who perceived judgment were significantly less likely to report high trust in their PCP [OR 0.55, 95% CI 0.31-0.98].

Conclusion: While only a fifth of overweight and obese patients perceived weight-related judgment from their PCPs, these patients were significantly less likely to report high trust in these providers. Given patients' decreased trust in providers who convey weight-related judgment, our results raise concerns about potential effects on the doctor-patient relationship and patient outcomes.

Practice implications: Addressing provider stigma toward patients with obesity could help build trust in these patient-provider relationships and improve quality of care.

Keywords: Obesity; Patient–provider; Primary care; Trust.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Cross-Sectional Studies
  • Emotions
  • Female
  • Humans
  • Internet
  • Logistic Models
  • Male
  • Middle Aged
  • Negativism
  • Obesity / psychology*
  • Obesity / therapy
  • Outcome Assessment, Health Care
  • Overweight / psychology
  • Overweight / therapy
  • Patients / psychology*
  • Perception
  • Physician-Patient Relations*
  • Physicians, Primary Care*
  • Primary Health Care
  • Self Concept
  • Socioeconomic Factors
  • Stereotyping*
  • Trust / psychology*