Patients who feel judged about their weight have lower trust in their primary care providers

Objective: To evaluate whether overweight and obese patients have less trust in their primary care providers (PCPs) if they feel judged about their weight by these PCPs. Methods: We conducted a national internet-based survey of 600 adults engaged in primary care with a BMI ≥25kg/m² in 2012. Our dependent variable was high patient trust in their PCP (score ≥8/10). Our independent variable was "feeling judged about my weight by my PCP" dichotomized as "often/sometimes" versus "never." We conducted a multivariate logistic regression model adjusted for patient and PCP factors using survey weights. Results: Overall, 21% felt that their PCP judged them about their weight. Respondents who perceived judgment were significantly less likely to report high trust in their PCP [OR 0.55, 95% CI 0.31-0.98]. Conclusion: While only a fifth of overweight and obese patients perceived weight-related judgment from their PCPs, these patients were significantly less likely to report high trust in these providers. Given patients' decreased trust in providers who convey weight-related judgment, our results raise concerns about potential effects on the doctor-patient relationship and patient outcomes. Practice implications: Addressing provider stigma toward patients with obesity could help build trust in these patient-provider relationships and improve quality of care.