Primary care physicians (PCPs) are less likely to bond with overweight and obese patients, according to research published online March 20 in Obesity.

Kimberly A. Gudzune, M.D., M.P.H., from Johns Hopkins University in Baltimore, and colleagues used the Roter Interaction Analysis System to analyze the frequency of communication behaviors based on audio-recorded outpatient encounters from 39 urban PCPs and 208 of their patients.

The researchers found that PCPs showed significantly less emotional rapport with overweight and obese patients (incidence rate ratios, 0.65 and 0.69, respectively) than with normal-weight patients. There were no differences in PCPs’ biomedical or psychosocial/lifestyle communication based on patient body max index.

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“If you aren’t establishing a rapport with your patients, they may be less likely to adhere to your recommendations to change their lifestyles and lose weight,” Gudzune said in a statement. “Some studies have linked those bonding behaviors with patient satisfaction and adherence, while other studies have found that patients were more likely to change their dietary habits, increase exercise, and attempt to lose weight when their physicians expressed more empathy. Without that rapport, you could be cheating the patients who need that engagement the most.”