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People of all sizes might choose to decline the weigh in at the healthcare practitioners office. For some (of all sizes) the weigh-in can trigger disordered eating/eating disorders and declining is a way to avoid that. For fat folks, the weigh in can be fraught in a lot of ways. It can trigger trauma of past weight stigma. Giving the healthcare provider a number can increase their fixation on weight which can make it even more difficult to get ethical, evidence-based care for whatever you are actually at the HCP for.
There are rare situation where a weight is necessary (for example when medication is dosed by weight, or for someone has a health condition that requires them to measure water retention etc. ) but making a weigh-in standard for every appointment doesn’t do much to help anyone, and it harms a lot of people.
I’ve adopted a simple approach in most cases - when they point me towards the scale I cheerfully say “no thank you” and keep walking. At that point they usually come after me and we move on.
But there are lots of ways to decline a weigh-in, so today tell us the methods that you use to decline the weigh-in!
What I'd really like is to see is a movement started with fat people and their thin allies refusing to be weighed unless it was absolutely medically necessary (medication dosed by weight, etc). There is no condition (except extremely rare genetic diseases) where being fat is an absolute indicator of a disease. Thin people get all the same diseases that fat people get: sleep apnea, hypertension, cancer, diabetes, etc, etc. A doctor knowing someone's BMI doesn't tell them anything about whether they have any of these diseases or not. Being fat is not a definitive screening tool.
I say "I'd prefer not to be weighed." That's been all I've needed to say. I do allow them to weigh me before surgery (since anesthesia can need that info for med dosages) and once a year at my physical. But, as Elizabeth said, weighing me at the doctor office with my clothes (and I live in a cold climate, so it can be a lot of clothes), shoes/boots, two legs braces...it's not an accurate weight. I've had medical providers say they'll subtract 5 pounds for my braces...but not all of them do! So an already flawed measurement is even more inaccurate.
I find it interesting that if I'm in my wheelchair when I go to the doctor, they do not ask me to be weighed--even though they know I can get out of the wheelchair and stand. (I usually need it for flare days/longer distances.) It's almost as if the measurement isn't important!
I have one of those rare conditions -- dilated cardiomyopathy, aka congestive heart failure -- that require me to monitor my weight to make sure I'm not retaining fluid. But I still don't allow a weigh-in at the doctor's office. **I** weigh myself every morning, and if my weight goes up more than 3 pounds overnight, I have to call the cardiologist. That's what matters. Whether my weight is up (or down) a few pounds from the last time the doctor saw me months ago is meaningless. So -- when the PA says "I need to get your weight," I say "I'll just tell you what I weighed at home this morning, okay?" They sometimes look a little surprised but almost never object. When they DO object, I point out, politely but firmly, that consistency is key in monitoring my condition, and that means taking my weight at the same time daily, on the same scale, wearing nothing. Weighing me on a different scale, after I've eaten, and when I'm fully clothed is meaningless. At that point, the few hold-outs have always backed down.
The consistency thing is so important!! One thing that bothers me more than ever is that they seem so unconcerned about weighing us with all our clothes and shoes (not that I’m okay with getting undressed there for a weight measurement, either), while still saying “even 10 lbs is an improvement!” When trying to prescribe wt loss. Okay great— I’ll take off my shoes and go have a poop, and we’ll be there… now can we get to the evidence-based care?
At a few doctors in the past, they’ve used cheap ass bathroom scales where I couldn’t even stand on the whole thing because they’re so tiny (I wear size 10 women’s shoes and the scale was shorter than my shoes! Plus I have a spinal cord injury and can be wobbly on my feet), which means there’s no way it was an accurate read.
And for people with conditions like yours, accuracy is FAR more important than the ritual of this inaccurate weigh-in.
I’m convinced that doctors who are unaware that their in-office scales are only screening tools at best are the same doctors who would reuse needles if allowed, or be comfortable using a dull scalpel in surgery. They are ignorant to the point of dangerous.
At one clinic, I asked them to put "Don't ask this patient to be weighed" in my chart. And they never asked me afterwards. Maybe they think I have an eating disorder - I'm not sure - no one has ever asked. At the next clinic, there was too much of a showdown to ask for that but I will ask the next time they ask me to get on a scale. They haven't the last few times that I've been there.
It’s interesting (read: actually very horrifying) that no one’s asked you why you don’t want to be weighed… you’d think they’d want to find out if you have an ED and/or make sure all your needs are getting met, and get you ED counseling if you need it.
I use me "crap, I'm at the fatphobic drs office stern voice" and I simply say "no thank you." They already have my file marked with the "o" word. I feel like that's more than enough. No one has ever pushed back and while they look a little perplexed, they take me to my room.
I'm lucky - the medical clinic I go to is generally weight neutral, in part because they serve people from all walks of life, and recognize that a majority of factors of body weight are way out of many people's control or ability. I also use a mobility scooter almost everywhere except in the house, so sometimes they will ask, "Are you able to step on the scale?" to which I will reply, "No" and they always say "OK" and move on.
My weight has been doing weird things, so I want my dietitian to get a blind weight on me somewhat regularly. Unfortunately, she's 2 hours away, so I see her via telehealth.
For a while, after some disastrous encounters with a former doctor, I had a trusted friend do a blind weight for me and text it to my dietitian. Eventually, I found a nurse and doctor I trusted. "My" nurse weighs me while I look away, jots it down on a sticky note, and sends it off. The doctor doesn't even see it and it doesn't go in my chart.
If I can't see my usual doctor, I still ask the nurse I trust to do a weight on me briefly. If she isn't available, I refuse. "I'm recovering from an eating disorder and I need to not see my weight. My weight is not relevant to why I'm here today."
As I think about it, I don't like the fact that I feel I need to mention the eating disorder. My reasons are not more or less valid than those of other people; it doesn't take an ED to want to skip the scale.
At some point, my Kaiser stopped showing me my weight (it doesn't show on the electronic scale) and not telling me what my weight is (unless, of course, I ask). They see the weight on a separate readout that I cannot see. For whatever reason, I don't mind getting weighed; and the times when I'm not willing to be weighed, I get a lot of pushback at Kaiser - they demand that I state that I am refusing to be weighed. Okay. Yes. I am refusing to be weighed because my visit has nothing to do with my weight and/or I was just here and I'm assuming you wrote that number down somewhere, so you don't need it again. I'm diabetic and a sign of ill-controlled diabetes is unexplained weight loss; also I am a breast cancer survivor and ditto.
I also say “no thank you!” In a friendly way but it usually catches them off guard and we have to discuss it. They say “what?” And I say “I said no thanks.”
Once, someone said “but you have to.” “No, I really don’t.” “I have to put something down.” “Then put down that I refused, please.” “But the doctor needs it.” “The only thing you need my weight for today is if its needed for dosing medications, and none of my meds are on weight-based dosing.” “It says you’re here for med refills, so we need your weight.” “No thank you.” At that point, she got exasperated and showed me to the exam room. Once we were in the room, she pushed for “my best guess” and I was so frustrated and exasperated that I did give her my best guess.
In hindsight, I wish I’d stuck to my guns OR I wish I’d said “100 pounds.” I had to see that doc for 3 years, and the electronic chart notes in every single visit included “obesity counseling” and a prescription for “weight loss with low carb diet,” even though we never talked about those things in any of my appointments. The EHS system must have that BS automated or something, so they can get extra reimbursements because I’m a fat patient on Medicare.
What I'd really like is to see is a movement started with fat people and their thin allies refusing to be weighed unless it was absolutely medically necessary (medication dosed by weight, etc). There is no condition (except extremely rare genetic diseases) where being fat is an absolute indicator of a disease. Thin people get all the same diseases that fat people get: sleep apnea, hypertension, cancer, diabetes, etc, etc. A doctor knowing someone's BMI doesn't tell them anything about whether they have any of these diseases or not. Being fat is not a definitive screening tool.
I would love love love to see/hear thin allies refusing to be weighed!
I say "I'd prefer not to be weighed." That's been all I've needed to say. I do allow them to weigh me before surgery (since anesthesia can need that info for med dosages) and once a year at my physical. But, as Elizabeth said, weighing me at the doctor office with my clothes (and I live in a cold climate, so it can be a lot of clothes), shoes/boots, two legs braces...it's not an accurate weight. I've had medical providers say they'll subtract 5 pounds for my braces...but not all of them do! So an already flawed measurement is even more inaccurate.
I find it interesting that if I'm in my wheelchair when I go to the doctor, they do not ask me to be weighed--even though they know I can get out of the wheelchair and stand. (I usually need it for flare days/longer distances.) It's almost as if the measurement isn't important!
I have one of those rare conditions -- dilated cardiomyopathy, aka congestive heart failure -- that require me to monitor my weight to make sure I'm not retaining fluid. But I still don't allow a weigh-in at the doctor's office. **I** weigh myself every morning, and if my weight goes up more than 3 pounds overnight, I have to call the cardiologist. That's what matters. Whether my weight is up (or down) a few pounds from the last time the doctor saw me months ago is meaningless. So -- when the PA says "I need to get your weight," I say "I'll just tell you what I weighed at home this morning, okay?" They sometimes look a little surprised but almost never object. When they DO object, I point out, politely but firmly, that consistency is key in monitoring my condition, and that means taking my weight at the same time daily, on the same scale, wearing nothing. Weighing me on a different scale, after I've eaten, and when I'm fully clothed is meaningless. At that point, the few hold-outs have always backed down.
The consistency thing is so important!! One thing that bothers me more than ever is that they seem so unconcerned about weighing us with all our clothes and shoes (not that I’m okay with getting undressed there for a weight measurement, either), while still saying “even 10 lbs is an improvement!” When trying to prescribe wt loss. Okay great— I’ll take off my shoes and go have a poop, and we’ll be there… now can we get to the evidence-based care?
At a few doctors in the past, they’ve used cheap ass bathroom scales where I couldn’t even stand on the whole thing because they’re so tiny (I wear size 10 women’s shoes and the scale was shorter than my shoes! Plus I have a spinal cord injury and can be wobbly on my feet), which means there’s no way it was an accurate read.
And for people with conditions like yours, accuracy is FAR more important than the ritual of this inaccurate weigh-in.
I’m convinced that doctors who are unaware that their in-office scales are only screening tools at best are the same doctors who would reuse needles if allowed, or be comfortable using a dull scalpel in surgery. They are ignorant to the point of dangerous.
When I go to a new doc's office, I bring the HAES cards with me & make a point of giving one to
the nurse before she can even mention going near a scale. Occasionally I've had pushback and my
response is to ask "Are YOU prescribing a med that's dosed by weight?" That works every time.
Now, if neither of these things works, I'll just say "Time for me to hire another doc. Goodbye".
At one clinic, I asked them to put "Don't ask this patient to be weighed" in my chart. And they never asked me afterwards. Maybe they think I have an eating disorder - I'm not sure - no one has ever asked. At the next clinic, there was too much of a showdown to ask for that but I will ask the next time they ask me to get on a scale. They haven't the last few times that I've been there.
It’s interesting (read: actually very horrifying) that no one’s asked you why you don’t want to be weighed… you’d think they’d want to find out if you have an ED and/or make sure all your needs are getting met, and get you ED counseling if you need it.
I’ve never been asked why i refuse either.
I use me "crap, I'm at the fatphobic drs office stern voice" and I simply say "no thank you." They already have my file marked with the "o" word. I feel like that's more than enough. No one has ever pushed back and while they look a little perplexed, they take me to my room.
I'm lucky - the medical clinic I go to is generally weight neutral, in part because they serve people from all walks of life, and recognize that a majority of factors of body weight are way out of many people's control or ability. I also use a mobility scooter almost everywhere except in the house, so sometimes they will ask, "Are you able to step on the scale?" to which I will reply, "No" and they always say "OK" and move on.
My weight has been doing weird things, so I want my dietitian to get a blind weight on me somewhat regularly. Unfortunately, she's 2 hours away, so I see her via telehealth.
For a while, after some disastrous encounters with a former doctor, I had a trusted friend do a blind weight for me and text it to my dietitian. Eventually, I found a nurse and doctor I trusted. "My" nurse weighs me while I look away, jots it down on a sticky note, and sends it off. The doctor doesn't even see it and it doesn't go in my chart.
If I can't see my usual doctor, I still ask the nurse I trust to do a weight on me briefly. If she isn't available, I refuse. "I'm recovering from an eating disorder and I need to not see my weight. My weight is not relevant to why I'm here today."
As I think about it, I don't like the fact that I feel I need to mention the eating disorder. My reasons are not more or less valid than those of other people; it doesn't take an ED to want to skip the scale.
Something for me to think on-- thank you!
At some point, my Kaiser stopped showing me my weight (it doesn't show on the electronic scale) and not telling me what my weight is (unless, of course, I ask). They see the weight on a separate readout that I cannot see. For whatever reason, I don't mind getting weighed; and the times when I'm not willing to be weighed, I get a lot of pushback at Kaiser - they demand that I state that I am refusing to be weighed. Okay. Yes. I am refusing to be weighed because my visit has nothing to do with my weight and/or I was just here and I'm assuming you wrote that number down somewhere, so you don't need it again. I'm diabetic and a sign of ill-controlled diabetes is unexplained weight loss; also I am a breast cancer survivor and ditto.
I also say “no thank you!” In a friendly way but it usually catches them off guard and we have to discuss it. They say “what?” And I say “I said no thanks.”
Once, someone said “but you have to.” “No, I really don’t.” “I have to put something down.” “Then put down that I refused, please.” “But the doctor needs it.” “The only thing you need my weight for today is if its needed for dosing medications, and none of my meds are on weight-based dosing.” “It says you’re here for med refills, so we need your weight.” “No thank you.” At that point, she got exasperated and showed me to the exam room. Once we were in the room, she pushed for “my best guess” and I was so frustrated and exasperated that I did give her my best guess.
In hindsight, I wish I’d stuck to my guns OR I wish I’d said “100 pounds.” I had to see that doc for 3 years, and the electronic chart notes in every single visit included “obesity counseling” and a prescription for “weight loss with low carb diet,” even though we never talked about those things in any of my appointments. The EHS system must have that BS automated or something, so they can get extra reimbursements because I’m a fat patient on Medicare.
I'm a small fat and always refuse to be weighed, in solidarity. I tell them my weight if they need it for dosing.