Physician Bias Toward Weight Loss Related to Gender

Carol Peterson, PhD, and her colleagues sent a survey presenting 3 hypothetical patients, at 3 levels of body mass index (BMI), 32, 29, and 25 mg/kg2, to 700 randomly selected physicians. Half of the physicians received a version of the questionnaire that described the 3 patients as male. The second group of physicians received the same questionnaire, except that this time the 3 patients were described as female. The questionnaire asked physicians whether or not the patients should lose weight, the extent to which the physician would recommend and encourage weight loss, and specific treatment approaches and strategies the physician would offer the patients. The results of the study were reported at the Eating Disorders Research Society Meeting in Albuquerque.

Advice to women: diet; Advice to men: accept it

For the fictional patients with BMIs of 25, physicians were significantly more likely to encourage weight loss for a female patient and more likely to discourage dieting and emphasize acceptance of weight for males. The physicians were also much more likely to consider weight loss strategies for women than for men, including cutting calories (76% for women, 39% for men), reducing fat intake (96% for women, 87% for men), and increasing activity (98% for women, 89% for men).

Referrals to weight loss programs, such as Weight Watchers, were much more common for women than for men (50% of women, 21% for men). The same pattern was seen for referral to a dietitian: 84% of women were referred, compared to 55% for men. The physicians also recommended a weight-loss specialist for 26% of women but for only 10% of men. One area broke the pattern: referral to a mental health specialist was more commonly prescribed for the male patients than the female patients (27% of men, but only 14% of women).

Interestingly, for fictional patients in the higher BMI groups, the physicians were equally likely to recommend weight loss for male and female patients.