Friday, February 17, 2012

Before the doctor, I talked to the nurse

"No. I'd prefer to tell you how much I weigh. I weighed myself at home this morning."

The nurse stares at me. Did she hear me? I tell her how much I weigh. She continues to stare.

Finally, she says: "I think it would be better to weigh yourself on this scale, so we have an accurate benchmark"

I reply with a firm "no."

I have a feeling this is the first time she's heard someone say no to the scale.

Before I was a teen and before I started worrying about getting fat or perceiving myself as fat, I didn't mind stepping on the scale. It was fun, a sign that I was growing up. However, somewhere along the line, as puberty hit and my swim coaches started to monitor my weight, that changed. Stepping on the scale is now stressful and not something I want to do in public.

To be honest, I hadn't thought of the weight bias in health care, and I've only been touched by it a couple of times. But then I read an eye-opening Weighty Matters post on the topic (watch the video - it's good) and thought about the scale at my doctor's office.

Some weight bias is obvious such as a doctor ignoring a patient's request for help or condescending, rude and appalling remarks from a doctor (see Munchberry's comment). Some bias is more subtle, such as how a patient's weight is taken and recorded. Of course, there is nothing wrong with tracking a patient's weight, but the manner in that a person is weighed can be done in either a sensitive or an inconsiderate way. Placing the scale in an public area does not take the patient's feeling or need for privacy into consideration.

At my doctor's office, patients are called from the waiting room to the second floor where examination rooms, doctors' offices and a procedure room are connected by a long hallway. The last time I saw a doctor (earlier in the year) the big physician's scale was located at the beginning of the hallway so anyone moving about the second floor can see how much the person on the scale weighs. So, this year, instead of stepping on the scale in the hallway, I decided to weigh myself at home and tell the nurse my weight.

When you think about it, why is it absolutely necessary to be weighed by the nurse in the first place? Why can't I decline? Why is it frowned upon to tell the nurse my weight rather than stepping on the scale? The nurse accepts my word when I tell her that I'm 5'7". Why can't she accept my word when I tell her what the scale said at home? Plus, is the result between the scale at home and the scale at the office that different? Is a couple of pounds either way going to make a difference in my health or impede my doctor's ability to do her job?

Furthermore, how can an accurate benchmark be established when weight fluctuates up and down throughout the day and over a week. With more than a year between annual check-ups, I'll be wearing different clothes, I could have eaten a smaller/bigger meal before the appointment or I may or may not have food sitting in the digestive system (you know what I mean). The only way to get a good benchmark is to weigh yourself in the morning, sans clothing, before eating breakfast, but after the morning pee.

In any case, have some fun the next time you are at your doctor's office. See what happens when you say "no thank you" to the scale.

Interesting to note: a patient must have complained about the location of the scale. The scale is now located at the end of the hall. Which is better, but why not offer complete privacy for patients and place scales in the individual examination rooms? 


  1. Kudos to you for doing what feels right!

  2. I haven't weighed myself or allowed anyone else to weigh me since mid-2009. My doctor respects this. As you know, I do have a regular doc who does an annual physical/pap/BP/resting heart rate/etc. but I also see a naturopath and a hormone specialist. The hormone guy tracks my cholesterol, sugar, thyroid, and other blood work. I share those numbers with my regular doc. As far as I am concerned, they are the only numbers that matter.

    1. That's great that your doctors respect your wishes and work together with your blood work. You've got them well trained!

  3. I had a completely rude situation at my old gyno's office about 5 years ago. I blogged on it because that incident was like a tripwire for me. A decision not to go to the doctor anymore because I did not want to endure being weighed.

    I finally went because I absolutely had to. I spent the whole night before not sleeping, but conjuring up the various ways it was going to play out the next morning. I wanted to say - hey - I am not weighing because when last I did I had this bad thing happen and I ended up going off my diet and gaining. But what did I do? I weighed. I have been in several times since with foot problems and it dawned on me that I still have a choice. So last time in (which was just a month or so after the previous time I went in) I declined to be weighed. The nurse started to tell me I had to. I just laughed and put my hand up to stop her. I said, if you had not just weighed me and were doing something like dosing me with something where you needed to know my weight or if I were here for weight counseling - fine. But I am not so no. We stood there briefly, she coped an attitude and we went to the treatment room where she then took my BP and it was high. She commented on it and I said she caused it! Lordy.

    Flip side - and it shows how much I have changed I think - a month ago I went to my new beloved gyno and they weighed me. I thought it unnecessary, but I got on... with my heavy wool peacoat, clogs and a sweater on. She did not bat an eye. I weighed 220 with all of the stuff on. It just goes to show you how really meaningless all the weighing is.

    "Tell me why and I will decide." That should be the standard answer.

    1. "Tell me why and I will decide" - I like it.

      See, why insist on weighing everyone if it is going to cause some patients to stop seeing the doctor and/or initiate an eating binge? I'm sure some health care professional don't make the connection, but will put the blame the patient for not having will-power.

      You should write a complaint letter to office about the incident with the nurse. She was utterly unprofessional. Really, you have to?

  4. I refuse to be weighed, unless I think my weight could impact my condition or medication. But for a sore throat? Sore neck? NO! I refuse! If they get into it with me, I simply state I have an eating disorder. But they usually are just shocked, & don't ask questions. If I DO decide to get weighed I do it backwards with my eyes shut. AND I remind the nurse she had better not tell me how much it is.

  5. UGH I dread doctors visits for this very reason. I have told my nurse repeatedly that her scale and mine are vastly different (hers always says Im heavier) so I would rather go by my scale and my numbers which I am used to. No dice. I always have to weigh in there. :-/

    1. That's terrible. There is no reason for not allowing you to go by your scale at home. I'm glad the nurse didn't continue to challenge me, I'm unsure if I would have relented or not.

  6. I used to hate it, but not I just deal with it. The people at my new clinic are so impersonal, it doesn't even matter if It said 500 or 200. THey would write it down, slam the pen down and walk you at a break neck speed to your exam room. They're nutty. LOL

  7. I stopped weighing away from home, unless I am having surgery, several years ago. I have only had one nurse get nasty with me. She backed down, if she had not, I would have asked for a new nurse.

    When I started my weight loss process, maybe about a year in, I was singing a whole different tune. Then I was calling every office I had ever visited asking them to see what records they had of my various weights. I even went back thru old school records looking for weights. I wanted to compile a time line to see if it would help me understand what had happened to me. And it did help.

    Another year I rounded up every picture I could find of me and put them in chronological order. I expected to be looking at my weight in those pictures, but instead I found many of my answers inmy eyes, starting at about age 6.

    My reason for not getting on random scales in a variety of clothes now, is simply that I do not want random numbers floating around out there. I like factual data.

    This was a very good post and I smiled when I saw it. I am not sure I have heard another blogger say no to the scale (besides me).


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