This article examines whether obese patients receive lower quality of care than normal-weight patients based on eight common performance measures. Previous research has found that physicians have negative attitudes toward obesity and obese patients, and that obese patients feel that their doctors are biased because of patients’ weight. However, little is known about whether these perceived biases translate into a substandard level of care.

The authors examined populations from two national databases: 36,122 individuals from the Medicare Beneficiary Survey (1994-2006) and 33,550 individuals from the Veterans Health Administration (2003-2004). Performance measures included three measures of diabetes care, pneumococcal and influenza vaccination, and colorectal, cervical and breast cancer screening.

Key Findings:

• Obese and overweight patients received the same level of recommended care as normal-weight patients across most measures. There was no evidence of obese patients receiving substandard care for any of the eight performance measures.
• Obese Medicare patients were more likely to receive recommended care than normal-weight patients for some aspects of diabetes testing and care.
• The authors noted that the results of their study may not be fully applicable to the entire population, since the sample population was older on average than the population of the United States.

This research suggests that while physicians may have unfavorable attitudes toward obese patients, this bias does not translate into substandard care as measured by eight of the most common measures of performance. For several of the measures related to diabetes, obesity corresponded to higher rates of recommended care.