No matter what brings you to the doctor, the first things that happen every time you enter the exam room involve getting a thermometer in your mouth, a blood pressure cuff on your arm, and stepping onto a scale. Of course, your vital signs can be important indicators of any ailments or illnesses. But is it really important to get weighed every time you visit the doctor? Some physicians are now beginning to question the traditional measurement in hopes that it could improve their level of care.
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Stepping on the scale could be causing problems for patients.
It’s no secret that weight loss can be an intensely difficult personal battle, so much so that some people may feel so stressed about the routine measurement they avoid medical care altogether.
In a 2023 study from the University of Missouri, 384 female adult patients with a diverse set of body sizes were surveyed about recent healthcare visits. Results showed that more than half of respondents said getting weighed by the doctor negatively impacted their mental health and self-esteem. They also admitted to feeling anxious that their weight would affect how their treatment from their doctors.
“The implications of these results show that we really need to start training the health care workforce to bring light to this issue because it is urgent,” Kate Trout, PhD, an assistant professor in the College of Health Sciences at the University of Missouri, said in a press release. “From our study, we know that over 30 percent of women are refusing to be weighed, and we also know that women will even avoid health care altogether in an effort to refuse being weighed. We have to be more inclusive to ensure everyone gets the care they need, which could lead to improved health outcomes in the long term.”
Other studies have found doctors can be influenced by weight.
Unfortunately, it’s not just on the patient side. According to a recent study, between 13 and 48 percent of second-year medical residents were found to have some level of bias towards overweight patients, Prevention reports. Specifically, urologists, anesthesiologists, and orthopedic surgeons had the highest levels of prejudice. Patients can then pick up on these sentiments during their visits.
“Their provider might say something, or their body language might betray a feeling that they don’t have high hopes for you,” Sean Phelan, PhD, author of the study and professor of health services at the Mayo Clinic, told Prevention. Moreover, he added that “people often report that their providers blame a lot of things on weight.”
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Some doctors are making changes to their patients’ visits.
In light of the mounting evidence, some physicians are taking matters into their own hands by changing procedures in their offices.
“When a person comes in, the first thing we do is not check their weight,” Natasha Bhuyan, MD, vice president of in-office care and national medical director at Amazon-owned primary care practice One Medical, recently told the New York Times. “We bring them back, sit in the exam room, and just talk with them. It’s a paradigm shift: If we do feel we need to check their weight, we get their permission."
At a time when weight loss drugs like Ozempic and Wegovy have revolutionized the lengthy process for many patients, many critics of habitual scale use now say that doctors can no longer be obtuse when it comes to handling the issue. Instead, some doctors are switching to only occasionally checking for any trends.
“At an annual physical, that is definitely a time when I do want to know the patient’s weight, but what I’m looking for is a big fluctuation in one direction or another,” Alexa Mieses Malchuk, MD, a representative for the American Academy of Family Physicians, told The Times.
You can request not to have your weight taken by the doctor.
There are very few things more deeply personal than someone’s medical history and requirements. That’s why according to Carrie Dennett, a registered dietician nutritionist, it’s important to remember that you have a “legal and ethical right” to determine exactly what happens with your healthcare, including checking your vitals.
In a 2023 op-ed for The Seattle Times, Dennett says anyone uncomfortable with stepping on a scale can ask if doing so is pertinent to the current issue—and you can flat-out refuse, regardless of the answer. If you’re afraid of personal anxiety or self-doubt, you can also request a “closed weighing,” in which case your doctor won’t disclose the results or discuss your weight as an issue.
“If you are made to feel bad for your decision, your provider isn’t practicing ethical patient-centered care,” she wrote.
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The takeaway.
Mounting evidence shows that stepping on a scale every time you have a medical appointment may not be as necessary as previously thought. Naturally, this could change how you approach your next doctor's visit.
“The first step is getting the message out there that you can refuse being weighed. Most people don’t know,” Virginia Ramseyer Winter, PhD, an associate professor in the School of Social Work within the College of Health Sciences and director of the Center for Body Image Research and Policy, said in a press release. “Learning the reasons why people refuse being weighed gives us more insight on the broader relationship between people and their health care providers. We can utilize these findings to inform health care from a policy level.”
