Is Weight Really a Vital Sign?
“Advocating for yourself in weight-centric spaces can be hard and exhausting. But it’s worth it in the fight to cultivate a healthier relationship with your body and take the focus off of weight. Weight alone tells us very little about a person’s health. And the number on the scale simply isn’t vital to your immediate survival.”
You’ve probably experienced this scenario dozens of times: You go to a medical appointment and the first thing the nurse has you do is put on some kind of blood pressure cuff then tell you to step on the scale as part of taking your “vital” signs.
For many of the people I work with the number they see on the scale often brings with it feelings of dread about whether or not their provider is going to bring up weight during their visit. I hear all the time from clients who went in for a routine visit and left feeling defeated after they were told to lose weight, even though their provider never asked about an eating disorder history, their actual eating patterns, weight history, dieting patterns, movement, and likely didn’t consider the effects of weight stigma on overall health.
We can easily avoid some of this by simply not stepping on the scale in the first place. And you have every right as a patient to decline having your weight taken at most of medical appointments.
Here’s why:
Weight alone is not a vital sign. There is nothing about the number on the scale that tells us whether or not you are about to drop dead in the next 5-10 minutes. Blood pressure, pulse, temperature, and oxygen saturation on the other hand, when extreme, can absolutely indicate whether or not you need to go to the hospital or get in an ambulance right away! Keeping these bodily signs within normal ranges is vital to your survival!
And there are few reasons why your doctor actually needs to know your weight for your care. For example, if you’re having surgery and they need to ensure the proper amount of anesthesia or if you’re starting a new medication where the dosage is impacted by body weight or fluid retention. Those would be necessary reasons to step on the scale. But for the vast majority of appointments, it’s simply not necessary that you have your weight taken - especially if you know it often leaves you feeling frustrated and discouraged.
Here’s how you can advocate for yourself and protect your relationship with your body when asked to step on the scale:
Simply decline having your weight taken: When told to step on the scale, you can politely say, “I’d like to skip having my weight taken today,” and leave it at that. If the nurse presses you, give a rough estimate of where you think your weight is for them to write down.
Ask for a blind weight: If you do step on the scale, you can do a blind weight so that you don’t actually see or know your weight that day. You can do this by telling the nurse you don’t want to know your weight today (to help ensure they don’t say it out loud), step onto the scale backwards, avert your eyes from the scale, or ask someone else to cover the screen for you.
Tell your provider you don’t wish to discuss weight: No matter where you are in your journey with food and body, you deserve to protect the healing you’re doing in your relationship with your weight. To minimize the risk of enduring an ill-informed conversation about your weight, simply state, “I’d like to leave weight out of the conversation today,” or “I don’t wish to discuss weight today.” If your provider presses it, you can share with them that you’re working on taking a non-diet approach to your health and trying to take the focus off of the numbers while you work on healthy behaviors.
Don’t forget about the paperwork: If you’ve opted to stay off the scale, have a blind weight taken, or advocate for an appointment free of weight-talk, don’t forget to ask that your weight not be included on any paperwork the staff may send home with you. They can simply leave it off the paperwork or black it out with a permanent marker. You can even ask the nurse or your provider to remove your weight from your online health portal - it only takes them a few more clicks.
Advocating for yourself in weight-centric spaces can be hard and exhausting. But it’s worth it in the fight to cultivate a healthier relationship with your body and take the focus off of weight. Weight alone tells us very little about a person’s health. And the number on the scale simply isn’t vital to your immediate survival.
Now I will add, if you’re working with an eating disorder provider and they’ve asked you to have a blind weight taken at your next medical appointment for the purpose of monitoring weight trends during the health restoration/maintenance process, stick with what they’ve asked you to do.
While it’d be amazing to see our healthcare system embrace a weight-neutral approach to health that focuses less on weight and more on health-promoting behaviors for any and every body size… who knows how soon that’d truly happen. In the meantime, keep up the hard work of advocating for yourself and doing what it takes to protect the work you’ve put in to heal your relationship with your body.