I am at a place in my life where I choose not to weigh myself. I’ve thrown out my scale. I also refuse, politely (unless I have to be more assertive), to be weighed when I go to the doctor. Fortunately, living in Portland, Oregon, and having the privilege of having choice in my healthcare, I often have the ability to visit providers that don't give me any trouble about that....for the most part.
However, recently, I had been referred to see a Gastrointestinal (GI) doctor via telehealth. I was checked in by the medical assistant and they had forms for me to fill out. We all know what's on those forms, specifically our weight and height. I just left the weight blank and when the medical assistant asked again I told them that I didn't want to share my weight. I got some pushback. This looked like the assistant saying, "well, it's really important that we get that information, especially for anything related to your GI."
I disagree with that!
Especially for the reasons I was seeing a doctor for. I don't believe my problem was influenced by weight. Even if it was, I'm not willing to pursue weight loss, because it's harmful. My response to them was that I don't feel that it's pertinent to my health care. I disagree with the messaging that it is actually more important to get weight for GI than it is any other time. After a bit more push back, I told them to write on the form "the patient refuses."
There is a myth out there that your insurance won't pay for your visit if you refuse to share your weight or be weighed. In reality they need only two vital signs; typically they like it to include weight but it is not mandatory. In fact, for some doctors, they don't require ANY vital signs. I went to the dermatologist and they never asked me to be weighed at all and didn’t take my vital signs. They even asked if I wanted to wear a gown or if I wanted to keep my clothes on. It was the best experience ever. It was a very patient centric experience. It was really lovely not being asked to get on a scale or be measured, instead they simply addressed my concerns.
Sometimes it's the culture in the office, sometimes it's that particular person being uneducated or unable to see their own Anti-Fat Bias. No matter the reasons, we all deserve the freedom to refuse to be weighed and not be judged for it.
A big piece of the problem with this weighing culture is the BMI. So many people believe the fallacy that BMI is a good measure of whether a person is "healthy" or not. There is a New York Times Article that talks about how the BMI is bogus and I think it's totally worth checking out.
One of the problems with being weighed is that it can activate your shame wiring causing undue stress. For some, that can activate the desire to restrict food or increase preoccupation about food and your body. Some people suggest turning around so you don't see it when you are on the scale. That's an option but even if you tell them you don't what to know how much you weigh, they will put it on the form and you'll probably end up seeing the number. They may even just make a small comment, like "Oh, you weigh less than the last visit." Whether you weigh more or less it can trigger shame and preoccupation and nobody needs that.
If you've lost weight, positive affirmation and focus on your weight is still harmful. You'll oftentimes become more preoccupied in figuring out what you were doing to lose weight and how to keep doing so. Not only can it ruin your day, it can send you down a weird spiral.
The other problem with weighing culture is that often the provider focuses on the weight rather than focusing on your actual health concern. Something like this changes the focus of the entire visit. Your health concern might be dismissed or you might not get the full treatment you deserve because the provider is blaming it on your size.
It can be really freeing to disconnect your healthcare experience from weight.
Here are some things you can say to the person requesting the weight:
"No, thank you."
“I don’t want to be weighed today.”
“Being weighed negatively impacts my mental health.”
“Please write that the patient refuses.” or “I have a right to refuse.”
Questions you can ask your doctor if they push for a weight:
"What's this going to change about my treatment plan?"
"How does not having my weight impact my treatment plan?"
"What treatment would you give to someone in a normal BMI category? I'd like that treatment."
If you need to be weighed you can ask them not to comment on your weight or ask them not to mention the number to you. You can also mention to the doctor's assistant and the doctor that you don't want to be counselled about your weight or on dietary changes.
The practice of refusing to be weighed is to make space for the visit to be focused on the issue at hand. After visiting a doctor you shouldn't feel shame, you deserve to feel like you've taken one step closer towards wellness.
There are a few caveats to refusing to be weighed. If your doctor (not just the assistant) is saying they really need your weight, ask why. There are a few times it impacts your treatment. For example, If your medication is dose dependent, if you are having surgery and need anesthesia, or if you have a condition like congestive heart failure or kidney disease where they need to be measuring water weight, then it is important for the doctor to know your weight.
An alternative to refusing is to get to a place of a much more secure attachment with yourself in your body. Coming to a place of complete neutrality over that number; where that number doesn't impact you whether it's gotten higher or lower or stays the same, it's just a number. Your value and worth is in no way changed by your weight. Knowing that on a deep level is part of secure attachment and freedom.
For me personally, I refuse to be weighed as a way to actively reject the idea of weight as being an important measure in your health. I also believe it helps educate when I do refuse to be weighed. I'm so thrilled that I have been able to heal my relationship with food and my body, but it wasn't an easy road. I love helping others in their journey. I am in obese category on the BMI scale and have experienced doctors diminishing my concerns and telling me to just lose weight. Still, I am in a more culturally accepted sized body so I know I experience much less weight stigma and bias than those in a larger body and/or people who are marginalized in additional ways. With all of my privilege and my desire to change Diet Culture and Anti-Fat Bias, I feel like I have a responsibility to speak up wherever I can including at the doctors office. And I do enjoy being a bit rebellious ;)
I get asked about sugar addiction all the time….!!
The reality is that the jury is out about whether sugar addiction is even real and right now it's looking like not so much.
Diet culture tells us that if we binge or crave sugar we are addicted and we should “cut sugar out”.
Unfortunately, bingeing and craving sugar is often the RESULT of restricting sugar - so those messages make it worse. Research shows that when we restrict, we then have an increased desire for sugar. You want what you can't have.
I personally thought I had a sugar addiction and couldn't be trusted with chocolate, ice cream, cake, etc. Then I found Intuitive Eating and healed my relationship with food. Now, I always have multiple pints of ice cream, chocolate, and whatever else I want in my house. I rarely even think about it, unless the mood strikes. I typically want it a few times a week, and when I want it, I eat it! I enjoy it so much more now that it doesn't come with a side of shame.
Gone are the days of eating so much of it that I feel sick.
Think you have a sugar addiction?
There are so many reasons you might feel addicted to sugar. Know that it's common to feel that way but the answer is NOT restriction - it's building connection and trust with yourself.
Harmful diet culture messages could be the culprit. One common message I hear is that the response to sugar is a dopamine response like cocaine.
Sugar is not like cocaine. Food for thought on this…
1. Cocaine hijacks your neurobiology and sugar does not.
2. You build physiological dependence and tolerance to cocaine and other drugs, but not to sugar.
3. People lose jobs, go to jail and die from substance use disorder. Have you ever known someone who lost a job or went to jail over sugar?
4. If people were addicted to sugar, wouldn’t they want to eat straight sugar? Most people do not eat it out of the bag. We crave the way foods make us feel- taste, smell, texture, etc.
5. Lots of things light up pleasure and reward centers of our brains- babies, laughter, hugs, games like candy crush, etc.
6. In the mice studies - sugar had been restricted. Diets actually cause an increased desire for sugar.
Here are some other really valid reasons you might feel like you are addicted to sugar:
-You’ve been restricting sugar or telling yourself you “shouldn’t” have it – so your inner rebel comes out.
-You are hungry. If you aren’t getting enough to eat, you will crave food in a way that feels out of control - called primal hunger. You might be bingeing all night to make up for it. (many people think they are eating “too much” but not really eating enough during the day- leading to this pattern)
-Eating patterns can be habit forming (habits are not addictions). You are simply used to eating a pint of ice cream every night so it feels hard to make a different choice.
-You are preoccupied with food and binge often (again diet culture and food restriction often contribute wildly to this).
-You think you have an addiction to sugar because it feels like you can't stop (cravings do not mean you have an addiction and there are many reasons for cravings).
-You have been told that there is something wrong with liking sweets (they are yummy- food is meant to be enjoyed).
-You eat sweets to soothe and think that means it's bad (soothing doesnt mean its an addiction).
However, here's the thing...most of these are A) completely normal AND
B) created or made worse by dieting/restricting and diet culture messages. The real issue is a lack of being attuned with your body AND using self judgement/beating yourself up instead of using curiosity and discernment.
Diet culture tells us to judge ourselves and restrict when you struggle with sugar, but again, this only makes things worse. With Intuitive Eating the solution is to get curious about what is really going on for you. Curiosity helps with body attunement and makes changing patterns easier. Some questions to ask yourself if you are struggling with sugar…
- When do I usually crave sugar?
- Am I overly hungry before I start eating?
- Am I eating enough throughout the day? (if not, it could be primal hunger)
- Was my day stressful? (you may need to start focusing on regulating your nervous system)
- What was it about the sweet that I really wanted or enjoyed?
- How did I feel when I was eating it?
- How do I feel after? (ask this without judgement)
- Am I getting enough sleep?
- Is there a health issue that needs to be addressed? (such as chronic pain)
- Did anything change when I started craving sugar more? (such as a diet, stopping drinking, going back to school, etc)
- Are there emotions I am avoiding feeling?
- Do I need to set a boundary or address a life circumstance that is making me unhappy?
It is so important that we ask these questions WITHOUT judgement- judgements are just narratives, they don’t help us change, and they block body attunement. Another key is not to try to control or manage the behavior of eating sugar, but instead address the underlying issue. For example, if you are not getting enough quality sleep, focus on sleep. If that is leading to sugar cravings, when you start getting enough sleep, the sugar cravings will naturally diminish.
Unfortunately, much of the research that supports the idea of sugar addiction, is completely biased. It doesn't control for restriction. It is often based on people who are self reporting as well- so it is not objective. So before you go on that rabbit hole of beating yourself up because you read an article about sugar addiction, ask yourself the questions. Take some time, be honest, listen to your body. Again, the answer is building connection and trust with yourself.
Download your free hunger scale now!
The first step to healing your relationship with food is reconnecting with the signals your body gives you. One of the ways to do that is by checking in with your hunger before you eat. Here's my spin on the traditional hunger scale..