Do you really need to get weighed at the doctor? Some doctors say no
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6 min read . Updated: 12 Mar 2022, 12:22 PM IST More doctors are de-emphasizing weigh-ins or are trying to make stepping on the scale less stressful
Do You Really Need to Get Weighed at the Doctor? Some Doctors Say No
BY SUMATHI REDDY | UPDATED 3月 07, 2022 05:30 午前 EST
More doctors are de-emphasizing weigh-ins or are trying to make stepping on the scale less stressful
The obligatory stepping on the scale is a dreaded part of doctor visits for many patients. Now, some doctors are letting people opt out of weigh-ins.
More doctors are de-emphasizing weight as a barometer of health as patients in recent years have lobbied to reduce focus on weight. Health professionals say they are trying to avoid stigmatizing patients and want to make sure that discomfort with weigh-ins doesn’t dissuade people from coming in.
“There’s a trend in healthcare to understand that weight isn’t the be-all-and-end-all," says Natasha Bhuyan, a Phoenix-based primary-care physician and regional medical director at One Medical, a membership-based primary-care practice with offices around the country. “Someone’s health is not reflected by one number."
Many doctors say weight is still an important indicator of health that shouldn’t be abandoned, but they are taking steps to make the routine weigh-in less stressful.
At One Medical, doctors ask patients whether they are comfortable getting their weight taken at annual wellness visits. The practice moved away from mandatory weight-recording when it redesigned its wellness visits two years ago, says Dr. Bhuyan. Doctors look at a range of metrics to assess patients’ health, such as blood pressure, cholesterol, stress, family history and alcohol intake, she adds.
“We know that checking weight can be triggering for a lot of different people," says Dr. Bhuyan.
If patients do consent to be weighed, doctors give them the option of not seeing or hearing the actual number. Patients may choose to hide their weight when accessing their post-visit summary.
The weigh-in has been a bedrock of doctors’ visits for years. Students in medical school are taught to record weight as a vital sign, says Sterling Ransone, president of the American Academy of Family Physicians and a family physician in Deltaville, Va.
Many insurers also require the recording of certain vital signs, such as weight, in order to bill them for a patient visit, particularly at annual wellness visits, says Dr. Ransone.
For some medical conditions, taking and recording a patient’s weight is essential for monitoring a patient’s health, he says. This includes monitoring congestive heart failure, in which weight is so important that Dr. Ransone uses a telemedicine platform that notifies him of those patients’ weight every day. A variance of more than 3 pounds could be dangerous and require attention.
For other issues, such as depression or anxiety, weigh-ins generally aren’t necessary, he says.
For most patients, Dr. Ransone says his office still does weigh-ins but takes steps to make patients less self-conscious. Practitioners may let patients get on the scale backward so they don’t have to see the number, or take their weight in an isolated area to avoid potential embarrassment. He instructs the staff to ask, “Is it OK to get your weight? Do you feel comfortable doing that?" He says it is rare for patients to say no, but if they do his staff will flag that to him when they give him the patient’s paperwork.
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“Having an office that is welcoming and accepting of people who are overweight is really important," says Dr. Ransone. “A lot of people feel that they are judged based on their weight." During the pandemic, many people have gained weight and may feel more uncomfortable getting on the scale.
Doctors’ evolving approach to weight is happening as more patients lobby to de-emphasize it and social movements encourage embracing and appreciating a greater range of body types.
Getting weighed at the doctor’s office can also create particular anxiety for people who have had eating disorders. In 2019, Ginny Jones, a 46-year-old in Santa Monica, Calif., who says she had an eating disorder, began printing cards that say: “Please don’t weigh me unless it’s (really) medically necessary."
Demand for the cards has surged so much that Ms. Jones began charging for them. She says she has distributed more than 73,000 cards since 2019. Most have been bought by individuals, but dietitians and doctors have bought them too, she says.
The intent behind the cards isn’t that patients should never get weighed, Ms. Jones says. But she believes patients, especially those for whom the experience is stressful, don’t need to be weighed at every visit unless it is medically necessary.
Lesley Williams-Blackwell, a family physician at Mayo Clinic in Phoenix, ordered cards a few months ago and has offered them to patients. She generally weighs patients at most visits but wants to make sure patients don’t feel like weight is always the main issue.
For patients with eating disorders, she often does “blind weights" where they don’t see the number because they stand backward, or will have a sticky note block the number.
Rebekah Fenton, an adolescent medicine fellow and pediatrician at Lurie Children’s Hospital at Northwestern University Feinberg School of Medicine in Chicago, was pleased recently to see a sign that a nurse put up above the scale in their clinic. It read: “This scale can only give you a numerical reflection of your relationship with gravity. That’s it. It cannot measure beauty, talent, purpose, life force, possibility, strength or love."
She recalls that as a resident, she once started discussing a growth chart with a 12-year-old patient and the girl started crying. Dr. Fenton didn’t think she had said anything stigmatizing, but the episode made her try harder to “disconnect health from weight."
Now, she talks more with patients about the quality of their diet and physical activity. She asks if they want to talk about their weight. If they do, she will show them the trajectory of their growth. Patients can decline to get weighed, or can opt out of seeing the number.
Most don’t decline. “My patients are still growing. That’s why I think it’s still helpful to know their weight," she says.
Anita Ravi, a primary-care doctor in New York City, sees patients who are survivors of gender-based violence, such as domestic-abuse and human-trafficking victims. She says she previously worked for a community health center whose protocol included recording weight at every visit. “The weigh-in would hinder some patients’ care," she says.
When she opened her own practice in November, she decided to move the weigh-in to the end of a visit and to explain why she is taking it. She takes steps such as allowing patients to take off their shoes or subtract pounds for clothing to both improve accuracy and make them feel better.
“At the end of the day I’m not going to force somebody on a scale," she says.
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