title: Patients who feel judged about their weight have lower trust in their primary care providers.
abstract: 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 ≥ 25 kg/m(2) 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].
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  Addressing provider stigma toward patients with obesity could help build trust in these patient-provider relationships and improve quality of care.
authors: 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: 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: 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; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D020407:Internet; 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; D010361:Patients / Q000523:psychology*; D010465:Perception; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011320:Primary Health Care; D012649:Self Concept; D012959:Socioeconomic Factors; D013240:Stereotyping; D035502:Trust / Q000523:psychology*
keywords: Obesity; Patient–provider; Primary care; Trust