Strategies for Dealing with Routine Weigh-Ins At The Doctor

Weigh-ins Part 2

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In part one I made the case for ending routine weigh-ins. While they are still standard procedure for many healthcare providers, I wanted to talk about how to deal with this.

To be clear, we shouldn’t have to learn these techniques. We should not have to strategize just to go to the doctor – and the difficulty is compounded for those at the highest weights and those who experience additional oppression like racism*, transphobia, homophobia, and health issues like anxiety, depression, chronic illness and more. Our medical system is currently rife with weight stigma and that’s not our fault, but since it becomes our problem it can be a harm reduction intervention to know about our options.

Patients have a right to informed refusal/consent of medical interventions, which includes the option to refuse weigh-ins (though be aware that an HCP can, in some cases, choose not to treat people who aren’t willing to submit to a weigh-in.) And, as I wrote about in part one, the weigh-in is almost never medically necessary.

Personally, if I don’t feel like educating around the issues with this, I have found it effective to just say “no thanks” and keep on walking. If they push me, I say something like “If we find that knowing my weight is medically necessary then I’ll be willing to discuss it, otherwise let’s move on.” If it applies and you want to disclose, you can explain that you have a history of disordered eating or eating disorders and that a weigh-in can be triggering, with no upside for you.

Sometimes patients are offered the opportunity to be weighed in, but not see the weight on the scale (sometimes called a “blind weigh-in"). Be aware that even if they don’t tell you the weight while you are on the scale, it will likely still be documented in your chart, possibly discussed in your appointment, and you may receive further information from your healthcare/insurance provider around weight and weight loss. For this reason, unless the weigh-in is medically necessary, I refuse.

If they ask to guess your weight (yes, it happens!) you can simply decline. If you feel like it, you can point out that if it’s ok to guess a number, that is a good sign that it is not medically necessary (I have had to decline blood pressure on multiple occasions when they didn’t have a properly sized blood pressure cuff, and they have never offered to guess my blood pressure.) Or, you know, explain that this is not the County Fair and nobody will be guessing anybody’s weight today (which is what I said the first time it happened because I was so surprised that anyone would ask to guess what they were claiming was a medically relevant number, that it’s the first thing that came into my head.)

It can also be helpful to call ahead, let them know that you do not wish to be weighed, and ask them to make a note of it, then remind them of it at check-in.

Taking someone with you can also be incredibly helpful. They can help advocate for you, and HCPs who are prone to fatphobia tend to behave more appropriately when there is someone else there.

Here are some more additional resources to help:

In the time between when I started writing this series and and publishing it, Virginia Sole-Smith wrote a very detailed piece about weigh-ins for her truly excellent Burnt Toast newsletter. I highly recommend checking it out here!

More-Love.org has created these cards to help patients decline weight in and/or for practitioners to keep in their offices to help patients feel comfortable exercising their right to informed refusal.

Dr. Asher Larmie (@FatDoctorUk) has created the No Weigh Website that has a lot of information about this and more.

Finally, I have a video workshop on dealing with fatphobia at the doctor’s office (there is a pay-what-you-can afford option to make sure money isn’t a barrier.) You can check it out here.

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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.