Patients with obesity experience psychosocial consequences because of their weight and report physician bias. We examined whether obesity is associated with lower patient satisfaction with ambulatory care among 2,858 patients seen at 11 academically affiliated primary care practices in Boston. Compared with normal weight patients (body mass index [BMI], 19.0 to 24.9 kg/M 2), overweight (BMI, 25.0 to 29.9 kg/M 2) and obese patients (BMI ≥30 kg/M 2) reported lower overall satisfaction scores at their most recent visit; the scores were 85.5, 85.0, and 82.6 out a possible 100, respectively ( P = .05). After adjustment for potential confounders including illness burden, obese patients reported lower scores but the difference was not statistically significant (mean difference, 1.23 [95% confidence interval −0.67 to 3.12]). Patient satisfaction with their usual provider and their practice did not vary by BMI group. Obesity is associated with only modest decreases in satisfaction scores with the most recent visit, which were explained largely by higher illness burden among obese patients.