Obese and overweight patients are just as likely to get recommended preventive medical care as normal-weight patients, and in some cases, treatment of the heavyset is more likely to meet standard guidelines for care, a new study shows.
Previous research has shown that some physicians find it awkward to work with obese patients and have low expectations for success. And heavy patients have reported feeling that doctors are biased and disrespectful because of their extra weight.
To examine whether such attitudes translate into differences in actual practice, researchers at the University of Pennsylvania School of Medicine and the Philadelphia Veterans Affairs Medical Center evaluated the medical care of nearly 70,000 patients. They were Medicare beneficiaries or received care from Veterans Affairs (VA) hospitals.
The scientists compared how likely heavy and normal-weight people were to meet standard guidelines for preventive care, including diabetes care (eye exams, sugar and cholesterol testing), flu vaccines, pneumonia vaccines and screenings for breast, colorectal and cervical cancers.
Among the findings reported in Wednesday's Journal of the American Medical Association:
*Obese and overweight patients were just as likely to have all those tests and procedures as normal-weight patients in both the Medicare and VA populations.
*Obese and overweight patients were actually more likely to get recommended care on several measures. The largest advantages were seen on cholesterol and sugar testing in obese Medicare patients with diabetes.
"Physicians appear to be doing a good job at preventive care, despite surveys suggesting that physicians have negative attitudes toward obesity and patients' perceptions that their doctors are biased," says lead author Virginia Chang, an assistant professor of medicine and sociology at the University of Pennsylvania.
About one-third of adults in the USA are obese, which is roughly 30 or more pounds over a healthy weight, according to government data. Obesity increases the risk of heart disease, diabetes, several types of cancer and other diseases.
"It's important to ensure that obese patients are getting equitable preventive care, as these services can save lives and reduce costs down the road," Chang says.
Still, questions remain. "Our findings do not address patients' satisfaction with their care," she says. "And these findings may not be true of younger populations where the stigma of obesity may be greater."
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