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Related Experiment Video

Updated: May 13, 2026

Multidisciplinary Approach to Obesity Management: A Case Report

Multidisciplinary Approach to Obesity Management: A Case Report

Published on: May 30, 2025

Physicians build less rapport with obese patients.

Kimberly A Gudzune¹, Mary Catherine Beach, Debra L Roter

¹Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Obesity (Silver Spring, Md.)

|March 21, 2013

Summary

Physicians showed less emotional rapport with overweight and obese patients. This impacts patient-physician relationships and adherence to medical advice.

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Area of Science:

Medical Communication
Patient-Physician Relationship
Obesity Medicine

Background:

Physicians' negative attitudes towards patients with obesity are documented.
The impact of these attitudes on patient-physician communication remains unclear.

Purpose of the Study:

To examine the association between patient body mass index (BMI) and physician communication behaviors.
Focus on biomedical, psychosocial/lifestyle, and rapport-building communication during primary care visits.

Main Methods:

Analysis of audio-recorded outpatient encounters from 39 primary care physicians (PCPs) and 208 patients.
Roter Interaction Analysis System used to quantify communication behaviors.
Multilevel Poisson regression models assessed the relationship between patient BMI and PCP communication.

Main Results:

PCPs exhibited significantly less emotional rapport with overweight and obese patients compared to normal-weight patients.
No significant differences were found in biomedical or psychosocial/lifestyle communication based on patient BMI.

Conclusions:

Reduced emotional rapport in visits with overweight/obese patients may harm the patient-physician relationship.
This could lead to decreased patient adherence and less effective behavior change counseling.