Wait…Why are we talking about my weight?

Raise your hand if you look forward to going to the doctor…

People, Weight Bias, Weight Stigma

Me neither.

Not long ago, I had a check-up that I had been dreading more than usual. I contemplated canceling several times. As I was considering whether or not I would go to the appointment, I thought about all that would be done at the check-up. One of the first things that came to mind was getting my weight checked. Lately, I’ve encouraged several of my clients to decline weighing at the doctor’s office if not medically necessary for their care as few of my clients look at the number on the scale as “interesting data.” I felt convicted to practice what I had been preaching to my clients, so I pondered what it would be like if I said “no” to the scale that day. When I started thinking about speaking up and not getting weighed, I -much to my surprise- started to feel nervous…my heart was beating fast!

I’ve had clients share that it’s easier to just get weighed to avoid getting questions or receiving funny looks from the nurse who is in charge of getting vital signs. If this sounds like you, you are not alone. I, too, was wrestling with the idea of refusing to be weighed! Many people fear making their doctor mad, seeming ungrateful for their help, or acting like they know more than their doctor. I’ve also had clients share that they were treated differently after refusing to be weighed at a doctor’s appointment, but it wasn’t until this particular day that I began to understand why my clients struggle so much with the scale in the doctor’s office.

I chickened out.

It truly felt easier to just step on the scale that day. The nurse took note of my weight. I saw my doctor, expressed my concerns, and attempted to get my questions answered. During my appointment, the doctor was not particularly forthcoming with lots of helpful information, but I was – for some reason- completely shocked at what she was forthcoming about. Right before walking out of the room, she decided to tell me, “And just so you know, you’ve gained [x] pounds over the last year.”

I stared at her blankly, basically in shock, wondering why she felt the need to tell me this information. I certainly hadn’t asked about my weight. Before I could formulate a response (or close my mouth after my jaw had dropped), she continued, “You’re still fine. It’s just something I tell everyone just so they know.” I think I managed to utter an puny “OK?” before she left the room.

Immediately, I was so disappointed in myself. I began thinking of all the things I should’ve said in that moment. Even more, I began thinking about my clients and the weight bias and weight stigma they have experienced. My weight remains in a range that is deemed “healthy” or “normal” by the medical community’s [sometimes arbitrary] standards, so IWait...Why are we talking about my weight? Weight Stigma & Bias by Healthcare Providers cringed thinking about how this conversation may have gone for a person who was considered “overweight” or “obese.” I thought to myself, “No wonder people decide to delay or avoid medical care!

I also thought about those who have struggled to gain the weight they need to be healthy. Hearing this comment could’ve been a major trigger for them. What if a patient gains muscle, making them stronger and healthier? What if the patient was recovering from an eating disorder? What about all of the other factors that can lead to weight gain?

Apparently, I’m not the only one who felt terrible about this one-sided conversation. It’s estimated that 20-30% of people will be strongly impacted by weight stigma from professionals but will not speak up for themselves, even when they know the truth about weight and health and want to be treated accordingly. The percentage is probably higher for those who receive unsolicited comments about their weight.

When it comes to weighing and weight, what can healthcare providers say and do to respect their patients?

What will I do differently next time (and what could you do in a similar situation)?

  • Plan and rehearse some responses beforehand to prevent being caught off-guard and subsequently left speechless when comments about weight are made or when asked to step on the scale.
  • Ask my provider, “How is my weight connected to the medical problem I have?”
  • Do my best to remain calm and engaged throughout the conversation. Ask as many questions as are needed to fully understand my provider’s perspective and assess whether or not it lines up with the research.
  • Consider sharing research with the provider.

Unsolicited comments about weight are not appropriate. Period. Fortunately, I’m at a point in my life where I feel confident and content with my health, shape, and size. It certainly hasn’t always been that way for me, and I’d venture to say it isn’t that way for most people in this world. As I look back on this experience, I’m grateful for the opportunity to share my perspective and hopefully prevent similar doctor’s office incidents. I’ve learned a lot from this recent check-up and couldn’t let it go before sharing it with you.

I’d love for you to send me your feedback and share your experiences. Have you ever been the recipient of an inappropriate comment about your weight? If so, how did you respond?


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Fight the Good Fight: Health Heroes vs. Diet Industry Villains

What makes a hero?

A hero could be someone who saves lives or protects society from evil (like Superman), and a hero could also take the form of the person you strive to be. Either way, a hero is someone who departs from society’s norms to accomplish a greater goal.

Diet Industry & Nutrition Misinformation “Villains”

We live in a fast-paced world where – sadly – diets have become the norm, and the focus has shifted to appearance and numbers (weight, BMI, calorie-counting, etc.) rather than overall health. We are accustomed to obtaining answers to our questions in a single Google search or a quick click on the Internet. Let’s face it…our society prefers simple answers and fast results. Americans have spent billions of dollars supporting the diet industry that emphasizes quick weight loss rather than long-term health. The marketing of diets is alluring, but research suggests the diet industry promises way more than it can deliver in terms of lasting weight management and health.

In addition to easy answers and immediate results, our society takes great interest in food and nutrition; however, nutrition misinformation runs rampant in our culture. Since we’re still going with the “hero” metaphor, you could say the diet industry and nutrition misinformation serve as “villains.” They perpetuate the destructive diet mentality. It seems most nutrition-related messages come from the media, friends, and family, but how often do they come from Registered Dietitians? Furthermore, how many nutrition messages come from nutrition experts who reject diets, instead advocating a real food, non-diet approach?

What would life look like if we became our own heroes, fighting and conquering these “villains” who shamelessly promote the diet mentality?

What if we moved away from focusing on numbers as measures of success and instead focused on health, self-care, and fueling well?

Sharaze Colley, a client, blogger at “Passing Pinwheels”, and certainly a hero in my book writes about her experiences in moving toward health and diet freedom. She states, “I haven’t had to count calories or drastically change my diet. I don’t stress. There’s almost no real limits to what I am ‘allowed’ to eat. It’s nice. And freeing.”

Rejecting diet industry villains does not have to be complicated. In fact, diets usually end up being more complicated than a real food, non-diet approach. Though this approach often takes longer and requires perseverance, it ultimately leads to a lifetime of better health, stronger metabolism, and peace with food.

Colley states, “And that’s the amazing thing. I’m eating more. I’m not starving all the time. Fad dieting tells me the opposite should be happening, that the answer is always ‘eat less, exercise more.’ But that’s not always the case…I’m starting to think it generally isn’t that simple… something I know, but hard to actually live by because of all the messages I get all the time about food being the enemy.”

During the process of rejecting the diet mentality, remember…even Superman had his kryptonite. Likewise, sometimes the number on the scale or the nutrition label can become our kryptonite, blinding us to our progress toward health and peace with food.

Heroes are not immune to doubt, fears, and trials, but they ARE willing to face the things that scare them like moving away from diets and numbers in order to reach a greater goal. Don’t fall victim to the diet mentality another day! Become the hero who stands up to this villain and fights for overall health and peace with food.


*Note* This article was originally written for Good Health Magazine. I made some minor changes before posting here. Thank you for reading! If you enjoyed this post, you may also like:

Practicing Weight Neutrality in a Weight-Biased Healthcare System

PracticingWeightNeutrality

In recent years, our society has become more open and understanding regarding peoples’ differences, but it seems weight is one area in which our culture has miserably failed to become more accepting. When it comes to size and weight, people continue to be judged against unrealistic and arbitrary ideals. Where is weight neutrality in this picture?

Too often, larger people are criticized, shamed, and misunderstood because of their weight. Furthermore, the perception of many healthcare providers remains that “if people would just lose weight, they could be healthy.”

Where’s the weight neutrality?

How ridiculous it is to think we can begin our lives with entirely different sets of genetics and end up looking the same or staying healthy at unnatural weights for our bodies!

Non-diet dietitians are already like fish swimming upstream in a river of 61-billion dollars-worth of diets, and the current becomes even stronger when practicing weight neutrality, especially when serving as the only weight neutral provider on an interdisciplinary team.

For several months, I worked with a woman (we’ll call her Beth) whose goal was to manage her diabetes, blood pressure, and cholesterol. She wanted to be healthy and to live longer, and she initially assumed the way to do so was through dieting. Our first sessions were spent reviewing and discussing research about diets versus intuitive eating, and Beth emphatically vowed, “I’m definitely not going back to dieting EVER!!!” stating she loved the newfound freedom she had with eating.

Eating intuitively, moving mindfully

In the meantime, through learning to eat intuitively and incorporate movement mindfully, Beth managed to cut her triglycerides in half and bring her cholesterol down to a normal range. She gained incredible insight into her relationship with food and recognized how satisfied she felt when she ate healthy AND tasty foods.

Giving up the scale

But there was one major challenge she continued to face: giving up the scale. After much discussion, Beth recognized how the scale was blinding her to the progress she was making toward health. She reluctantly agreed to put the scale in the attic for a while and contact me if she felt the urge to weigh herself.

Changing the view of progress

Beth acknowledged her need to change her view of progress. She began to accept the possibility (which was becoming a reality) of being healthy in a larger body and to recognize that her size did not change her worth and value in life.

She moved away from… She moved toward…
·  Focusing on a number on the scale that she could not directly control ·  Focusing on behaviors that lead to health
·  Focusing on weight first and foremost ·  Concentrating on actions she could control
·  Asking: “How many pounds did I lose?” ·  Noticing her increased trust in herself with food
·  Questioning: “How do I look?” ·  Questioning: “How do I feel?”
·  Priding herself on having good willpower or self-control ·  Priding herself on recognizing inner body cues

(Adapted from Intuitive EatingEvelyn Tribole & Elyse Resch, 2003/2012)

At her next check-up with her primary care physician, the first topic addressed related to weight loss. The physician praised Beth, exclaiming, ”You’ve lost 9 pounds!” Immediately, her mind wandered back to the number she originally had in mind that might make her “healthy” again.

Already feeling ashamed and discouraged, Beth hesitantly told her doctor, “I’ve been feeling exhausted lately.” Her physician responded by stating, “You’re still carrying around lots of extra weight. Imagine carrying around your 10-year-old son all day. You’d feel exhausted, wouldn’t you? That extra weight is keeping you tired!”

Validate the patient’s concerns

In one conversation, Beth’s physician not only fueled her recent fantasy of weight loss as a magic bullet to solve her health problems, she also failed to validate her patient’s concerns. Rather than taking inventory of the lifestyle, psychological, or medical conditions that could be causing her fatigue and offering a plan of care to reach the root of the problem, she gave the simplistic answer: “Lose weight.”

Make evidence-based recommendations

According to the research, 97 percent of diets fail, and most people regain their lost weight in 1-5 years (Puhl, 2008). Combine dieting and weight cycling, and you have a recipe for a physical and emotional health disaster.

Leslie Schilling, MA, RDN, CSSD, LDN puts it this way: “If you were prescribed a drug with such a high failure rate, would you fill the prescription?”

People trust their providers to administer quality, evidence-based care; however, when they receive different messages from different providers, how do they know whom to trust?

It’s time all health professionals learn that the number on the scale does not define a person’s health, worth, or value. Our patients are human beings, not human bodies, and they deserve evidence-based guidance, rather than judgment, shame, or “easy answers.”

Equip people to advocate for themselves

Perhaps as you read about Beth’s experience, you felt anger, sadness, and frustration bubbling up. It is my hope that the feelings you experience throughout Weight Stigma Awareness Week will be used as fuel to begin to educate other providers and equip those with whom you come in contact to advocate for themselves.

Ignoring weight bias does not increase awareness or lead to change, but here are some practices that can:

  • Derail “fat talk” or weight-biased conversations and deflect them using research to support your case.
  • Engage in body activism and encourage body acceptance.
  • Focus on functionality versus appearance in your practice.
  • Listen to your patients and seek to validate their concerns.

And remember to start with yourself. Examine yourself, looking for weight bias in your own life. Though the previous case study only addressed weight bias from a physician, I think we’ve all been taught or heard ideas that perpetuate weight stigma in our training. I know I have.

Practice weight neutrality

As providers, let’s stop believing that differences in weight and size define a patient’s health or worthiness of quality care. Let’s practice weight neutrality. Continue to remove weight stigma and bias in the provider community by changing the view of progress, validating the patient’s concerns, making evidence-based recommendations, and equipping professionals with knowledge and people to advocate for themselves.


It was an honor to contribute this post to Binge Eating Disorder Association’s Weight Stigma Awareness Week 2015. See the original blog post here.

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