title: Perceived judgment about weight can negatively influence weight loss: a cross-sectional study of overweight and obese patients.
abstract: OBJECTIVE
  To examine the association between patient-perceived judgments about weight by primary care providers (PCPs) and self-reported weight loss.
  
  
  METHODS
  We conducted a national internet-based survey of 600 adults engaged in primary care with a body mass index (BMI)≥25 kg/m(2) in 2012. Our weight loss outcomes included attempted weight loss and achieved ≥10% weight loss in the last 12 months. Our independent variable was "feeling judged about my weight by my PCP." We created an interaction between perceiving judgment and PCP discussing weight loss as an independent variable. We conducted a multivariate logistic regression model adjusted for patient and PCP factors using survey weights.
  
  
  RESULTS
  Overall, 21% perceived that their PCP judged them about their weight. Respondents who perceived judgment were significantly more likely to attempt weight loss [odds ratios (OR) 4.67, 95% confidence interval (CI) 1.96-11.14]. They were not more likely to achieve ≥10% weight loss [OR 0.87, 95%CI 0.42-1.76]. Among patients whose PCPs discussed weight loss, 20.1% achieved ≥10% weight loss if they did not perceive judgment by their PCP as compared to 13.5% who perceived judgment.
  
  
  CONCLUSIONS
  Weight loss discussions between patients and PCPs may lead to greater weight loss in relationships where patients do not perceive judgment about their weight.
authors: Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: gudzune@jhu.edu.
authors: Kimberly A
authors: KA
authors: Gudzune
authors: Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Wendy L
authors: WL
authors: Bennett
authors: Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Lisa A
authors: LA
authors: Cooper
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Sara N
authors: SN
authors: Bleich
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009341:Negativism; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D050177:Overweight / Q000523:psychology* / Q000628:therapy; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012649:Self Concept; D057566:Self Report; D012959:Socioeconomic Factors; D014481:United States; D015431:Weight Loss
keywords: Obesity; Patient–provider; Primary care; Psychosocial research