OBJECTIVE:To examine patients' reports of the level of care that they receive from their physicians, and determine the influence of weight and gender in these reports. DESIGN: In a four-cell design, male and female, overweight and nonoverweight patients reported on the medical care that they received immediately following their appointment. SUBJECTS: A total of 125 patients affiliated to one of four large clinics in the Texas Medical Center of Houston completed this study. MEASUREMENTS:Patients reported the positivity of the care that they received, the time that physicians spent with them, and the extent to which physicians discussed weight-related topics with them. RESULTS: Overweight patients, as a whole, did not report poorer levels of care than did their thinner counterparts. Rather, the weight and gender of the patient significantly interacted across each of the measures to reveal some divergence between male and female patients' weight-based experiences. When significant differences in reported perceptions emerged, overweight men reported deficits in care relative to average weight men (eg, physicians spent less time), whereas overweight women reported enhanced care relative to average weight women (eg, better levels of care, more topics discussed). CONCLUSION: Based on patients' reports, this study reveals that physician care may not be as influenced by patient weight as previously thought. Yet, there is a discernable impact of patients' weight on physician behavior. Overweight men, who may comprise the most at-risk population, indicate that less time is spent with them than that indicated by average weight men. While this may be alarming, overweight women do not report reductions in care. We propose that not only might physicians respond to them differently, but overweight female patients may also be engaging in denial strategies or compensatory behaviors that assure them of quality care.

IntroductionCompared with other racial groups, South Asian adults develop type 2 diabetes and cardiovascular disease at a lower body mass index (BMI). Perceptions of weight and the effect of weight on health can influence weight-loss attempts but are not well described in this population. The objective of this study was to examine perceptions of weight appropriateness and the effect of weight on health among South Asian Americans.MethodsWe recruited 75 South Asian American adults from a single metropolitan area in the Midwestern United States. During individual, face-to-face interviews, we asked participants what they think about their weight and how weight affects their health. We measured their weight and height and calculated BMI. Each interview was audiotaped, transcribed verbatim, and translated into English. We conducted analyses using NVivo software. A second investigator coded 20% of interviews to verify coding consensus.ResultsSixty-seven percent of participants were overweight or obese; 40% of overweight participants and 12% of obese participants perceived themselves to be normal weight or underweight. Forty-eight percent of overweight and 82% of obese participants believed their weight affected their health. Participants commonly cited physical problems as being associated with their weight, but few connected their weight with risk for chronic diseases.ConclusionSouth Asian Americans may underestimate their weight status and the effect of their weight on their risk for chronic diseases. Interventions to promote weight loss among South Asian Americans should focus on modifying perceptions of normal weight and personalizing the relationship between overweight and chronic diseases.