Weight ratings of others: The effects of multiple target and rater features

The effect of physicians' body weight on patient attitudes: implications for physician selection, trust and adherence to medical advice

BACKGROUND

Research has documented negative stigma by health providers toward overweight and obese patients, but it is unknown whether physicians themselves are vulnerable to weight bias from patients.

PURPOSE

This study assessed public perceptions of normal weight, overweight or obese physicians to identify how physicians' body weight affects patients' selection, trust and willingness to follow the medical advice of providers.

METHODS

An online sample of 358 adults were randomly assigned to one of three survey conditions in which they completed a questionnaire assessing their perceptions of physicians who were described as normal weight, overweight or obese. Participants also completed a measure of explicit weight bias (Fat Phobia Scale) to determine whether antifat attitudes are associated with weight-related perceptions of physicians.

RESULTS

Respondents reported more mistrust of physicians who are overweight or obese, were less inclined to follow their medical advice, and were more likely to change providers if the physician was perceived to be overweight or obese, compared to normal-weight physicians who elicited significantly more favorable reactions. These weight biases remained present regardless of participants' own body weight. Inspection of interaction effects revealed opposing effects of weight bias between the obese/overweight and normal-weight physician conditions. Stronger weight bias led to higher trust, more compassion, more inclination to follow advice, and less inclination to change doctors when the physician was presented as normal weight. In contrast, stronger weight bias led to less trust, less compassion, less inclination to follow advice and higher inclination to change doctors when the physician was presented as obese.

CONCLUSIONS

This study suggests that providers perceived to be overweight or obese may be vulnerable to biased attitudes from patients, and that providers' excess weight may negatively affect patients' perceptions of their credibility, level of trust and inclination to follow medical advice.

Gendered perceptions of own and partner weight-level

This study investigates gender differences in perceptions of body weight. Previous research has found significant gender differences in perceived weight-level, but less is known about weight perceptions of the opposite gender. Based on Danish survey data (859 women and 160 men), the discrepancy between BMI weight-level and self-perceived weight-level is estimated as well as the perception of one's partner's weight-level. Two main empirical conclusions emerge. First, there are significant gender differences in weight assessment. Whereas women assess weight according to the standardized BMI weight-levels for both genders, men assess weight according to gender. The weight-level of men is often underestimated by men themselves, but both men and women tend to overestimate the weight-level of women in the lower BMI deciles compared to standardized BMI weight-levels. Second, there is greater underestimation of weight-levels for individuals in the higher BMI--especially regarding weight perceptions of the opposite gender. These findings are discussed within a framework of socio-cultural theory of body image and gendered relations.