Doctors seem to treat obese just as well as others

NEW YORK (Reuters Health) - Despite surveys that show doctors have negative attitudes about heavier people, older obese patients don’t get short shrift at the doctor’s office, according to a new study.

Two audience members watch the 2007 "Farm Aid" concert in New York in this September 9, 2007 file photo. REUTERS/Lucas Jackson

The new study, of nearly 70,000 patients, found that obese and overweight patients were just as likely to be offered quality medical care as normal weight patients.

The findings, published in the April 7, 2010 issue of the Journal of the American Medical Association contradict earlier work that suggested the obese might get substandard care because many doctors don’t like treating them.

The findings of this study surprised the researchers.

“We were not expecting these findings,” lead author Dr. Virginia Chang of the Philadelphia Veterans Affairs Medical Center told Reuters Health. “We were fully expecting to find that obese patients got lower quality care and were less likely to get recommended care.”

Chang and colleagues looked at data collected by the Veterans Health Administration and the Centers for Medicare and Medicaid Services.

The researchers did not examine whether medical care reduced illness or death but rather whether the care was offered as recommended by accepted treatment guidelines.

They looked at quality-of-care measures for 8 common preventive services including diabetes management, flu and pneumonia vaccines, and cancer screening and concluded that there is “no evidence” that obese and overweight men and women get less care on common preventive services.

To the contrary, they may receive better care. Compared to their normal-weight counterparts, obese patients were more likely to get the flu vaccine, and breast, colorectal, and cervical cancer screenings.

Obese diabetics in the study populations were also more likely to be offered two recommended blood tests - cholesterol and other blood fats -- and the HbA1c test, which measures blood sugar levels over the long term.

The authors note that the quality-of-care measures were higher across all weights (under-weight, normal weight, overweight, and obese) for VA patients compared to the Medicare population.

Chang said her team divided overweight patients into three tiers of obesity to see if people at the extremes of obesity were denied good care. They weren’t.

Whether the same holds true for obese patients under age 64 is not addressed in the Pennsylvania research. The authors point out that the findings might not hold because of social bias.

“Physicians may be less biased toward older populations,” Chang said, adding that “cultural pressures to be thin vary by age and are completely different for young people.”

SOURCES: Journal of the American Medical Association, April 7, 2010.