Doctor's Weight and Obesity Diagnosis and Treatment

A recent study by one of our own JHSPH faculty found that physicians with a BMI of 25 or higher (i.e., overweight or obese) are less likely to diagnose obesity in their patients and less likely to discuss obesity with their patients.  One suggestion is that physicians think that there is nothing wrong with them and this leads them to conclude that there is nothing wrong with the patients.

Perhaps, let's put more of an economic twist on this.  Physicians will provide care until the marginal cost of providing more care is just equal to the marginal revenue from doing so.  We usually think in terms of monetary costs.  However, there are also psychological costs.  Perhaps physicians who are overweight themselves find a higher psychological cost of bringing up weight issues with their patients and this makes them less likely to undertake this type of care.

Which seems more likely?  Physicians thinking that they and their patients are okay?  Or ,physicians knowing that both they and their patients are not okay but choosing not to do something about it because they find it psychologically costly to tell someone else to do something that they have demonstrated that they do not do themselves.  And, how would we test which on is actually closer to the truth?  The policy recommendations may be much different depending on which explanation is correct.