It may seem harmless to not be entirely forthcoming with your doctor, but the health consequences could be huge. A recent study conducted by researchers from Middlesex Community College and the University of Utah found the main reason why patients don’t accurately tell doctors about their eating habits and other behaviors is to avoid being judged unfavorably.

Researchers presented seven common scenarios between patients and doctors. Up to 81 percent of people who took that survey admitted they avoided telling their healthcare provider the truth in at least one of them.

“Most people want their doctor to think highly of them,” says the study’s senior author Angela Fagerlin, Ph.D., chair of population health sciences at U of U Health and a research scientist with the VA Salt Lake City Health System’s Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation.

Larry Mauksch, emeritus clinical professor of family medicine at the University of Washington School of Medicine, offers suggestions on how clinicians can encourage honesty. The lesson here for healthcare providers, he says, is to be curious and ask questions.

“I’m surprised that such a substantial number of people chose to withhold relatively benign information, and that they would admit to it,” says Andrea Gurmankin Levy, Ph.D. “We also have to consider the interesting limitation that survey participants might have withheld information about what they withheld, which would mean that our study has underestimated how prevalent this phenomenon is.”