The Scale at the Doctor’s Office: The Decision Is Yours
A letter to the eating disorder community.
Posted May 24, 2018 | Reviewed by Ekua Hagan
Dear Eating Disorder Community,
For many people, the worst part of going to the doctor’s office is not the waiting time, the required co-pays, the thought of getting your blood drawn, or having a pap smear. One of the biggest fears is getting on the scale and having your weight announced.
Stepping on the scale at the doctor’s office is always daunting, especially since they always move the slider on the beam towards the upper numbers until they find the perfect balancing act so the beam does not tip towards one side or another; a practice that seems like it takes an eternity. Closing your eyes, taking a deep breath, and silently thinking, “I don’t want to know this number,” are all common practices we do until the staff member announces that dreaded number aloud and writes it down in your chart.
There may be times when it is medically necessary for you to be weighed—preoperatively when ascertaining certain medication doses, or in the tracking of life-threatening conditions like kidney failure and congestive heart failure. However, most of the time, you are weighed because it is part of the “rooming” process for the medical assistant to collect some basic information before you see the doctor.
Something to keep in mind is that you always have the right to refuse to be weighed. This right often surprises people and for some, this may feel like a bold stance to take. You may even get some pushback from the medical staff, but this is your right and your stance to take.
Research states women are less likely to visit the doctor if they are weighed
Researchers at the University of Pennsylvania performed a study that was published in the medical journal Appetite. The results showed that women experienced high degrees of discomfort at the prospect of being weighed in the presence of others.
They surveyed 482 college-age men and women to determine how sensitive they were to the disclosure of personal information, including their weight. These researchers believe some women may be avoiding the doctor just to avoid being weighed in front of other people. As a result, these women are skipping important cancer screening tests such as mammograms, pap smears, and colonoscopies. Part of the problem is that many busy doctors’ offices put the scale in a well-trafficked hallway or a common room, where other patients can witness the weigh-in. The other part of the problem is that many individuals are not aware that they have a right to refuse to be weighed, which can dramatically ease their anxiety.
Consequences of doctor weigh-ins during eating disorder recovery
If you are in eating disorder recovery or are currently battling an eating disorder, this weigh-in can cause some serious harm. This routine circumstance can trigger thoughts about restriction, weight loss, and eating disordered behaviors like purging or compulsive exercise. Being told your weight has the potential to disrupt months, if not years, of progress to reclaim body trust and practice weight-neutral self-care.
Although the majority of medical professionals understand sensitivity behind weight and eating disorders, unfortunately not all understand or empathize with the dangers of weigh-ins, and as a result, some will give you push back even if you express that you are in eating disorder recovery. If you are struggling with how to express that you do not want to be weighed: Below are ways to handle this issue:
- “Could I not be weighed today, please?”
- “I can estimate how much I weigh for your records.”
- “I haven’t gained or lost a significant amount of weight recently.”
The flaws behind Body Mass Index (BMI)
Your weight is always recorded next to your height and the doctor deciphers whether or not you are underweight, normal weight, or overweight strictly based on your weight and height by using a formula known as the body mass index or BMI. The BMI is defined as the body mass divided by the square of the body height and is universally expressed in units of kg/m2, resulting from mass in kilograms and height in meters. Commonly accepted BMI ranges are underweight: under 18.5 kg/m2, normal weight: 18.5 to 25, overweight: 25 to 30, obese: over 30.
Body mass index does not take into account muscle or fat composition, which can drastically alter an individual’s BMI. A size 4 female can be deemed overweight if she has a muscular body type with a larger breast size because BMI only takes into account height and weight.
Many professionals in the medical community believe that BMI should be disregarded and luckily, medical professionals are realizing the flaws in this BMI measurement. However, it still does not eliminate the fear that many individuals have of stepping on that scale, undressed in a gown, at the doctor’s office. Keep in mind that this is your right to practice.
Although I have never been a victim of an eating disorder, I have been practicing my right not to be weighed at my doctor’s office for over eight years.