This past week, a woman was banned from a tanning salon in an Akron, OH suburb because she was, supposedly, too fat to use their tanning beds. This was after she had just purchased a contract for a full month.

You would think that medical professionals who have the mission of 'do no harm' would be on a level above that type of pettiness. But a new report out of Johns Hopkins shows that doctors form weaker emotional bonds with their overweight and obese patients than their lower weight patients. The study looked at 39 primary care physicals and 208 of their patients.

Previous studies have shown time and time again that the better the rapport a doctor has with a patient the more likely a patient will adhere to recommendations, medical advice, and behavior-changing counseling. But when it comes to the patients that need those bonds the most — those that need to lose weight to improve their health — doctors don't seem to form tight bonds.

"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," says Kimberly A. Gudzune, MD, MPH, an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine and leader of the study. "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."

Although the actual healthcare and medical advice administed didn't change depending on patient weight, there were signficant differences in the quality of human interaction. For example doctors showed more empathy and concern for lower weight patients as compared to overweight and obese patients. Dudzune mentioned that studies show physicians may hold negative attitudes towards ovwerweight patients and some physicians may have less respect for their obese patients, which may come across during patient encounters.

"If patients see their primary care doctors as allies, I think they will be more successful in complying with our advice," says Gudzune, whose practice focuses on weight-loss issues. "I hear from patients all the time about how they resent feeling judged negatively because of their weight. Yes, doctors need to be medical advisors, but they also have the opportunity to be advocates to support their patients through changes in their lives."

"Patients want information and treatment, but they also need the emotional support and attention that can help them through the challenges that accompany weight loss and the establishment of a healthy lifestyle," Gudzune says.

Just as the woman, Kelly McGrevey, who was stopped from using a tanning bed felt "I was just so shocked and embarrassed and humiliated," many patients feel the same way.

The study research is published in the in the journal Obesity.