Getting weighed during visits to the doctor can lead to avoiding health checkups in the future. Get tips on how to speak with your provider about alternatives.
“Empirical evidence demonstrates that the belief that weight stigma can be an effective tool to encourage weight loss amongst people living with obesity is a societal misconception.”
—Brown et al., 2020
For many people, regardless of their size and weight, stepping on the scales at the doctor’s office can be triggering—and harmful. In my clinical work as a psychologist, children, teens, and adults have shared with me the very negative effects of being weighed and having their weight discussed in healthcare settings. They have left offices feeling judged, shamed, or worse.
Yet, the way our bodies respond to genetics, growth, stress, trauma, hormonal changes, fad dieting, exercise, and food sensitivity and availability is not entirely under our control.
Weight stigma is harmful
Weight stigma includes negative attitudes and beliefs that degrade people based on their weight and size. Weight stigma can lead to poor health outcomes, both physically and mentally, and unequal access to health care as well as to opportunities.
In a 2020 study, more than 200 adolescents were asked about their experiences of weight stigma. Here are some of the findings:
- More than half of adolescents surveyed indicated increased exposure to one or more forms of weight-stigmatizing social media content.
- Increases in body dissatisfaction were reported by nearly half of all participants surveyed.
Another study, of more than 2,000 adults, revealed more disheartening news about the pervasiveness and negative impact of weight stigma:
- Weight stigma was significantly associated with disordered eating, emotional eating, substance use, and sleep difficulties.
Weight inclusivity and health at every size
Many people avoid medical treatment for fear of being weighed. When they are weighed, many report being stigmatized. Research has shown that weight stigma in the healthcare setting is likely to lead to inappropriate and unequal health care. Furthermore, individuals in larger bodies experience stigma from educators, employers, the media, and even friends and family.
“Stigma, being a form of social rejection, can cause depression, anxiety, and lowered self-esteem. Further, patients who feel stigmatized can develop anxieties over seeking health care and therefore delay or avoid it entirely.”
—Elizabeth Ewing, 2019
An important approach to reducing weight stigma is health at every size (HAES). HAES emphasizes that every individual has the ability to maintain a healthy body and achieve a state of well-being, independent of their weight. HAES identifies that health is complex and multifaceted and is more than weight and weight loss.
Why do we get weighed then?
There are instances when it may be medically advisable to monitor your weight, such as:
- During pregnancy
- To determine a child’s healthy growth
- As one parameter in a treatment protocol for individuals with eating disorders
- To work out the appropriate medication dosage
- To monitor recent diagnoses of certain diseases, such as hypothyroidism, insulin resistance, diabetes, or cancer
- To help determine whether an underlying medical issue is present
What to do if being weighed makes you uncomfortable
It is important that you leave the doctor’s office feeling empowered rather than ashamed or embarrassed. Here are some tips on making your trip to the doctor a little more comfortable:
- If your doctor must take your weight, ask if you can be blind weighed. This means you will not be told your weight verbally or on health reports that are handed to you or sent to you.
- Ask your medical provider if there are other ways they can measure your health without weighing you.
- If you are uncomfortable discussing with your doctor why you do not want to be weighed, you can get “please don’t weigh me” or “please don’t talk about weight with my child” cards. These cards state a list of reasons that the cardholder may not want to be weighed.
- Keep in mind that if your doctor needs to weigh you for a medical reason, you have every right to ask why and to enter into a dialogue about the purpose.
Take a pledge
If you want to advocate beyond your own needs, check out the International Consensus Statement for Stigma of (Medical) Obesity:
I Promise
To treat individuals of all shapes and sizes with dignity and respect.
To refrain from using words, pictures, or stories that unfairly and inaccurately negatively depict individuals in larger bodies as less motivated, energetic, disciplined, competent, or healthy.
To support initiatives that challenge harmful, simplistic, uninformed weight-bias messages.
To advocate for the dissemination of current research about body-weight regulation across settings: weight is not entirely under personal control because of biological, genetic, hormonal, and environmental factors that contribute to weight, shape, and size.
Trade sizeism for compassion and respect
Sizeism is not socially justified, even though it is pervasive. It is also imperative to understand that no one’s health is defined only by weight. Not only that, if our goal is to encourage more healthy behaviors for everyone, regardless of body size, the tough love and the shaming and blaming approaches are counterproductive.
“Scholars have previously suggested that weight stigma may play a positive role in motivating individuals to engage in health behaviors that could lead to weight loss—presumably as a way to improve health. This contention, however, is not empirically supported. Rather, stigmatizing individuals for their weight is consistently associated with negative consequences.”
—Lee et al., 2021
Increasing positive health behaviors is nuanced. Whether it’s in your own self-talk or in your communication with someone else, try using a perspective of compassion, not judgment. If your weight needs to be taken, talk with your doctor about it. You and your doctor have the same goal in mind: your whole health. After all, healthy bodies come in all shapes and sizes.
Citations:
Abrams, Z. (2022). The burden of weight stigma. Monitor on Psychology, 53(2). https://www.apa.org/monitor/2022/03/news-weight-stigma
Bombak, A. (2014). Obesity, health at every size, and public health policy. American Journal of Public Health, 104(2), 60–67. https://doi.org/10.2105/AJPH.2013.301486
Brown, A., Flint, S., & Batterham, R. (2022). Pervasiveness, impact and implications of weight stigma. eClinicalMedicine, 47, 1–9. https://doi.org/10.1016/j.eclinm.2022.101408
Ewing, E. (2019). Weight bias and stigmatisation: What is it and what can we do about it. British Journal of General Practice, 69(684), 349. https://doi.org/10.3399/bjgp19X704405
Lee, K. M., Hunger, J. M. & Tomiyama, A. J. (2021). Weight stigma and health behaviors: Evidence from the Eating in America Study. International Journal of Obesity, 45, 1499–1509. https://doi.org/10.1038/s41366-021-00814-5
Lessard, L. M., & Puhl, R. M. (2021). Adolescents’ exposure to and experiences of weight stigma during the COVID-19 pandemic. Journal of Pediatric Psychology, 46(8), 950–959. https://doi.org/10.1093/jpepsy/jsab071
Phelan, S., Burgess, D., Yeazel, M., Hellerstedt, W., Griffin, J., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews, 16(4), 319–326. https://doi.org/10.1111/obr.12266
Rubino, F., Puhl, R.M., Cummings, D.E. et al. (2020). Joint international consensus statement for ending stigma of obesity. Natural Medicine, 26, 485–497. https://doi.org/10.1038/s41591-020-0803-x
Tylka, T., Annunziato, R., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 1–18. https://doi.org/10.1155/2014/983495
Vierboom Y., Preston S., & Stokes, A. (2018). Patterns of weight change associated with disease diagnosis in a national sample. PLOS ONE 13(11), 1–13. https://doi.org/10.1371/journal.pone.0207795
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