You’re at the doctor for a routine primary care visit, when it’s time to step on the scale. Next thing you know, it feels like your provider is once again prescribing weight loss during your visit, even when you are otherwise healthy. It can be frustrating, disheartening and isolating to hear this, especially if you’ve tried to lose weight before.
If this has ever happened to you, you’re not alone. Doctors often shame patients for their weight, whether they realize it or not. Not only can this be embarrassing, but it also paves the way for misdiagnosis or poor care.
So, is it possible to advocate for yourself when you’re unsure why your weight is a recurring topic? Yes, it is. But first, it’s important to understand what a person’s overall health should look like.
Does size determine health?
What’s healthy might look different from one person to another.
“Health is not merely the absence of disease or illness,” says Dr. Mansi Shah, a primary care provider at UW Medicine. “I think there are many ways to understand what it means to be healthy. Being healthy could mean getting regular sleep or routine movement. Being healthy might also mean managing your chronic conditions as best as you can.”
When your doctor says to lose weight
There’s always a possibility that a doctor might recommend weight loss based on a health concern. Unfortunately, many people have had an experience at their doctor’s office where they return for a routine check-up or unrelated concern, and the conversation evolves into a weight loss conversation, and not the intended purpose of the visit.
“This happens a lot,” Shah says. “People go to the doctor for routine things that have nothing to do with their weight, like common colds and infections, and they’re told that they’re experiencing these symptoms because of their weight. Medicine is part of society, and therefore, contributes to fatphobia and anti-fat bias.”
For example, your doctor might acknowledge that a higher weight can put you at a higher risk for certain diseases or illnesses, but they should also mention that the higher weight doesn’t inherently mean you have the illness. This awareness is key.
“Having a higher weight can make certain medical procedures higher risk, or could require the use of different techniques,” Shah says. “But that’s not the patient’s responsibility — it’s the medical field’s responsibility to have the tools to help everyone, regardless of their size.”
How to advocate for yourself, your weight and your health
If a doctor is suggesting that your weight could be impacting your health, it’s important to ask for specifics. What exactly is the threat your weight is causing to your health? Is it crucial that you must lose weight to be healthy? If you feel your doctor is pushing weight loss without insight into how it could affect you, it’s OK to push back.
“Ask the doctor exactly why your weight is relevant,” Shah says.
Shah gives a few suggestions on how to advocate for yourself in your doctor’s office, including:
- Ask not to be weighed at every visit.
- Ask ahead of the appointment if your doctor practices the Health At Every Size approach, which recognizes that health outcomes are driven by social, economic and environmental factors, and supports people of all sizes in adopting healthy behaviors.
- Bring a friend or family member to your appointment to help you hold the conversation around your weight and health.
“You shouldn’t have to feel sick and also have to take on the burden of advocating for yourself,” Shah says. “Sometimes the extra support from family, friends or the right provider can lessen that burden, but that won’t be the right approach for everyone.”
As the needle continues to shift in the conversation around health, it’s important to keep listening to your doctor — but also essential to keep trusting your gut. Work together with your provider to define what health looks for you, before answering the question: Do I really need to lose weight?