The change in our view of obesity from a shameful social problem to a medical disorder worthy of attention is to be commended. The treatment of obesity, however, is not necessarily synonymous with the treatment of patients who are obese. This study, which has the advantage of being large and population based, adds to the evidence from smaller studies that overweight women do not receive adequate health care. Although the data from this study are correlational, and we cannot determine whether the reasons for this failure were physician or patient driven, it is most likely that both were important. Physicians' attitudes toward obese patients reflect those of society in general.
Clinicians tend to view obese patients as lazy, sad, and lacking in self-control.
Concomitant health problems such as diabetes mellitus or hypertension that are more frequent in obese persons may push preventive services to a lower priority. From a patient perspective, large patients report being treated by physicians and other medical personnel with disdain and disrespect. This is not fully explained, but it may be because obtaining mammography merely requires a prescription by the referring physician and does not require disrobing and hands-on examination in the physician's office. Awareness of the possibility that health care professionals may be disenfranchising a substantial proportion of their patients is a good first step. While not negating the importance of obesity as a health problem, physicians need to remember that not every health problem is obesity related.