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 ;)
Download your free hunger scale now!
The first step to healing our relationship with food is reconnecting with the signals our body gives us. 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.