You Have a Right to Refuse to be Weighed

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 By Dana Sturtevant, MS, RD & Rachel Sterry, ND

You have a right to refuse to be weighed.

This surprises people. And to some, it feels like a bold stance to take. But it is your right. And we believe it is an act of radical self-care.

By stating your needs around the weighing process you are taking a very real and potentially vulnerable step towards true self-care.

There may be times when it is medically necessary for you to be weighed- preoperatively, when ascertaining certain medication doses, or in the tracking of life threatening conditions like kidney failure and congestive heart failure. Most of the time, you are weighed because it is part of the “rooming” process for the medical assistant to collect some basic information before you see the doctor.

Many medical professionals are unaware of the potentially disastrous ripple effects that putting focus on your weight can cause. Because of this, you may find that your request to stand backward on the scale, or skip the weighing process all together comes as a surprise. You may even find that you are met with a little push back, but this doesn’t make your request wrong!

There is no need to justify or explain the emotions behind the scale. The fact is that you are in the doctor’s office to be cared for. It is the responsibility of those within the practice to ensure your experience does not trigger or cause any unnecessary harm.

We’ve had clients ask to step on the scale backwards and not to be told their weight, only to be given paperwork at the end of the visit that has their weight on it. When they see the number, it triggers thoughts about restriction, weight loss, and eating disordered behaviors like purging or compulsive exercise. Being told their weight has the potential to disrupt months, if not years, of progress to reclaim body trust and practice weight-neutral self-care.

Worksite health screenings are another place where people might experience body shame by a helping professional that just doesn’t know any better. We’ve had a few clients well into their recovery from an eating disorder be told at a one of these worksite events that they were slightly overweight according to their BMI and that they should “lose a few”. The people giving this feedback have very little health information about you (other than the stuff they can collect while you are there). Their feedback could be more harmful than helpful. Unfortunately, employees might be “dinged” for not participating. Talking to your supervisor or someone in human resources might help.

We have found that, however it happens, when a person becomes aware of their weight (or BMI), it sets them back in their efforts to practice radical, weight-neutral self-care. If you work in a medical office, we encourage you to talk to staff in your clinic about the reasons why someone may refuse to be weighed. If this is a larger bodied individual, they are often viewed as someone who wants to be in denial about their weight and are given their number as a “wake up” call. Assuming that people in larger bodies should feel concerned about their weight is an example of inherent bias and is a part of an iatrogenic practice that inappropriately reinforces body shame as somehow “motivating”. People of all shapes and sizes struggle with disordered eating, and part of healing their relationship with food and body means letting go of body checking behaviors, like monitoring weight. It is important to respect their request and do EVERYTHING we can to keep them from seeing their weight. This means making sure the information doesn’t end up in the paperwork they are given at the end of the visit.

People have a right to refuse to be weighed.

And by stating your needs around the weighing process you are taking a very real and potentially vulnerable step towards true self-care.

Only you know how you feel in your body, how your clothes fit, your joints move, your energy levels and vitality – none of which can be measured by a scale.

“You Have a Right to Refuse to be Weighed #bodytrust @BeNourished”
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Dana Sturtevant is a registered dietitian, certified yoga teacher, and self-proclaimed foodie. She especially enjoys blogging about mindfulness, yoga, Intuitive Eating, Health at Every Size®, and the Slow Food Movement. Learn more about Dana here.

 

 

 

 

 

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Dr. Rachel Sterry is a Naturopathic Physician. She is continually challenged, excited, and surprised by the breadth of her practice, the insights of her patients, and the possibilities that lie on the road ahead. Please visit her website www.drrachelsterry.com to learn more about her naturopathic medicine practice.

 

 

 


Comments

  1. Elizabeth says

    What a compassionate + helpful post. Thank you. I remember feeling nervous before my first time declining the weigh-in at a doctor visit (the visit was related to allergies and I knew my weight was not necessary information) and I wish I had had this to read then.

  2. kandy smith says

    I have medicare and have been told by the dr.’s office that if I refuse to be weighed medicare will not pay for my office visit. where can I find information on y rights so I can print it out and take it with me to the office visit?

    • Dana Sturtevant says

      Hi Kandy,
      My understanding is that they are paid by procedure, so a weight would increase what you are reimbursed for the visit, but a weight is not required for reimbursement (it is just another “procedure” that they can bill for). Patients have a right to refuse any and all medical advice, including medications, surgeries, procedures and testing, so I doubt weight is something that is mandated. I’ve also put a note out to a few list serves for other resources you might be able to bring with you to your appointment. I’ll let you know!
      Warmly,
      Dana

  3. Liz says

    I am so glad to see someone address the issue of doctors handing you paperwork with your weight printed on it! The last time I got in an argument with a medical assistant about not being weighed, she repeatedly told me I didn’t have to see the number. I’m not stupid. I’ve seen how THAT promise plays out virtually every time. There are so many opportunities for the number to get leaked to you once they have it. The most common is when they hand you an office summary. Another time, a doctor turned his computer toward me to show me some results, and tada, there was the number. Once, I had a friend in the room with me, so I especially didn’t want the number revealed. Three seconds later, the nurse blurted it out loud. Another thing is doctors now have online patient portals a lot of the time. I logged into one, and my weight was at the top of the first page that loaded. So, sure, I didn’t HAVE to see the number…unless I had to use the online system patients were expected to access.

    I recommend against the standing on the sale backward method. It sounds great in theory but is really risky in practice.

  4. Lane says

    I just came from my initial visit with my primary care provider. I waited 6 months for the appointment. I declined to be weighed by the medical assistant taking my vitals prior to meeting with the PCP. She said she understood completely and had left a doctor visit once because of the same issue. When I got in with the PCP she said she could not provide care for me if I refused to be weighed. This was a physical exam. I told her I keep track of my weight and that if their was a sudden loss or gain I would that I did not understand I would consult with her. I also said I have been heavy since childhood and now at age 57 I have decided not to subject myself to weigh ins that are not medically necessary. She said, “why don’t you let me help you with that.” I said, “I don’t want your help with that.” She said I could turn around so I don’t see the number, I said,” I know the number and keep track of it.” She said I would have to leave and could not be a patient at this practice because it was one of their rules and if they were audited (?) it would show that my weight had not been recorded. As she escorted me out she said, “let me know if you change your mind.” It certainly did not seem like I had the right to refuse being weighed when she then refused to treat me. How would you approach this?

    • Dana Sturtevant says

      Hello Lane,

      What a terrible, shaming experience.

      And, it’s true, not all doctors are going to love this. Doctors often do have the option of entering “N/A” and making a note to show that it had been considered but not collected for a specific reason. They could also add a note to show they explained what to do in case of unexpected weight changes. The auditors of different clinics may have more or less stringent reactions/ rules about this. With some changes due to the Affordable Care Act, we think a lot of clinics are confused about what they can and cannot do. We are still sorting out some of the details ourselves as we work on a Bill of Rights about weighing.

      Making you weigh because of “auditors” is NOT about your health or wellness. It’s about systems and filling in boxes. It’s about data collection, not good patient care. And even if you weigh backwards, patients often see the number on the after visit summary, and if, for instance, they are in recovery from an eating disorder, seeing their weight could disrupt months, if not years, of progress and trigger a relapse.

      The bottom line is you deserve compassionate care and you get to have a choice about medical interventions. This provider isn’t able to offer you the kind of care you deserve. We would encourage you to consider writing a letter to explain your frustrations and provide them with feedback. It is the only way to get them to re-think their policies and how they affect their ability to provide ethical care to the people they serve.

      • Dana Sturtevant says

        My colleague, Dr. Rachel Sterry, who co-wrote this article with me, also wanted to share her thoughts to your question:

        I second all that has been said and I would only add that the primary oath of a physician is to the patient and optimizing their health and wellness with the least amount of harm possible, not to an insurance company, or any other entity. It is absolutely within a patients rights to refuse to be weighed, or to refuse any treatment options offered and the doctor need only chart that the information was reviewed and the patient made an informed decision.

        There are many doctors out there who would be more than happy to conduct a yearly physical without the weigh in and I am so sorry that you was exposed to such an unkind healthcare provider.

        • Christina says

          You state “There are many doctors out there who would be more than happy to conduct a yearly physical without the weigh in”. Can you please send me a list?? I’m in long beach, CA and was on the HAES website and body positive website and couldn’t find one

      • Diane says

        I work in a dialysis clinic and constantly have to remind staff that, while we must monitor weight because that helps us monitor fluids, weighing is problematic for many of our patients. There are so many ways that our health care system takes away decisions from patients. We are required to “offer” a quality of life survey annually. Right on the form it says patients can refuse. However, if more than 20% refuse we get in trouble with our licensing agency. I know this because I’ve been told to get my response numbers up–even if I have to badger patients to complete them. Unethical but reality…

    • Diane says

      I recently changed my PCP. The “nurse” asked me to get on the scale to be weighed. I told her that I do not want to be weighed but she said it’s been a year since you been weighed. I repeated more sternly “I do not want to be weighed”. The nurse just stood their looking at my chart. I said “I have my rights as a patient!” She left the room and was gone for quite a while. Then the doctor came in we started the office visit with a weigh-in. The next time I go in I will tell the “nurse” before she even says “get on the scale” I do not want to be weighed”! and each time I go I will say the same statement “I do not want to be weighed” before she even asks. Usually the “nurse” stops asking me to be weighed after a while. I will not back down!

  5. Nervous says

    Can you suggest a simple sentence I can say when I refuse to be weighed? I don’t want to be weighed but coming up with the right words to say is making me nervous.

    • Rachel Sterry says

      Good question: I would recommend something to the effect of… I would like to decline being weighed today, it’s incredibly stressful for me and I find the information more harmful than helpful. Thank you.

      Rachel

    • Dana Sturtevant says

      In addition to what my colleague Rachel suggested, here are a couple of other options:

      “No thanks. I’m not going to be weighed today.”

      If they pressure you, I’d say:

      “No, I’m the patient and it is my right to refuse to be weighed. There are other, more meaningful ways for you to assess my health. If after seeing the doctor it is needed to dose a medication or something, I will consider it.”

      • Dee says

        Hello, just left a orthopedic surgeon’s office for a small avulsion fracture in my ankle. The office manager would not allow me to see the doctor unless I was weighed. He said that because, ‘you are on Medicare this office is not allowed to see you without your weight’. He said, ‘I must weigh you’. I refused nicely and asked for documents that referred to this requirement and I further told him I had never run into this before, moreover that no office had ever insisted, But he insisted and did not have any information readily available. So I said NO I do not want to be weighed, He still insisted while I sat there looking at my X-Rays in the other room waiting to be read. I was being pressured, but I could not do anything about it. I did not want to leave there with a broken ankle. So I submitted to be weighed. When I did get to see the doctor he did tell me I had a tear and put me in a brace. When I left the office the same office manager came over and handed me a piece of paper from CMS that outlined office procedures for Medicare but I saw nothing mandatory on there about weight, just a suggestion about how to proceed. I am still ill from being forced to be weighed against my will. I twisted my angle while walking and just wanted to know if it was alright. Now I do not want to go back to that office and I am on the hunt for another doctor who might treat my ankle, whose staff is not so disrespectful forceful.

  6. Barb says

    When I told my doctor I didn’t want to be weighed, she told me to find another doctor. I was shocked. I thought even without getting weighed they are supposed to see you.

  7. Susan Schiffhauer says

    I want to thank you for helping me decline being weighed for the first time after years of stress postponing and avoiding seeking care when needed. How freeing and what a relief!
    I am in my fiftys and my issues with the scale started hen I was fourteen years old. I was eating disordered and dieted and exercised obsessively. I weighed myself at least daily and throwing out the scale was a big part of my recovery.
    I am normal weight,I learned to maintain a healthy weight. I was a runner and competed in marathons,triathlon ,rowed crew and lots of other sports. I worked in the fitness industry for 25 years. None of this helped me step on that scale without extreme aniety,fear and loss of control.
    As a personal trainer I have always been sensitive to doing only testing and evaluation that will be positive ,meaningful and motivational for the individual stressing that it their appointment and always their choice! It’s about their health and goals!
    The emotions and negative impact of “mandatory” weigh ins can be so detrimental to our health!
    I wanted to comment because our feelings regarding body image are often alike regardless of weight and I don’t think everyone realizes this.
    Again thanks for giving me the courage and hopefully now I will take better care of myself. Not just self care ,but medical care when I need it.

  8. Roxanne says

    I have avoided seeing my primary doctor because of mandatory weigh ins, but now my doctor will not let me refill my prescriptions which are not expired unless I go in an see her and that means I have to be weighed in! I am so upset, I am being forced to be weighed in so I can get my refills on my medications. The whole experience makes me very sick. I end up having a panic attack. I have always stressed over my weight and starved myself. I have had issues with my weight for years. As a child I was bullied and would starve myself so being weighed is a big deal for me. I have tried an tried to explain this to my primary but all I get back from them is “this is office procedure”. I am going to refuse to be weighed in. I find it sad that I even have to argue with them over this , you would think they wouldnt bicker with me and have more compassion.

  9. Terri Ackerman says

    I just got back home from a doctor’s office where I did my usual–said I’d turn my back to the scale while being weighed. I always joke, “Let it be your little secret.” I’ve been doing this for years. I’m in my 50s and was diagnosed with anorexia in my 20s–I was anorexic in my thinking and behaviors but not in my actual weight. Anyway, I found that giving up the scale was scary but liberating, and have been functioning really well while focusing on my eating and exercise habits. At 52, I know I weigh more than I did in my 20s. I wear clothes of a different size, but I’ve being wearing these clothes for 12 years and they still fit. I’ve been weighed consistently once or twice a year over this time and no one has ever said I was an unhealthy weight, worst of all that I was obese. But according to the numbers I saw on my patient summary today, I would be classified as clinically obese if they are correct. So now I’m freaking out. Is it possible the scale was wrong or that I misread the numbers? I can’t ask because I can’t bear to have it confirmed. The weight doesn’t seem possible. If I were obese, wouldn’t someone have told me before? I don’t know if you can say anything to help, and I do see a counselor, who I will be seeing tomorrow, but this is the nightmare I never wanted to have happen.

  10. Terry says

    Thank you so much for this. I am at the doctor’s office right now dreading the conflict at the scale with some mousy little assistant emboldened by her position telling me that I HAVE TO get on the scale. I am not letting her win this time, as I have proof now of something I always knew in my heart….that I have the right NOT to be weighed.
    I also had the experience of a very controlling doctor telling me that because of Medicaid, which I don’t even get, that he HAD to get weights on everyone and that if I didn’t get weighed, he wouldn’t give me my medication. Really nice, huh?

  11. Dr Frankenstein says

    As a board certified family physician I can state it is vitally important to be weighed at every visit. If you don’t get weighed I won’t see you. You have the right to refuse, but so do i

    • Dana Sturtevant says

      Dear Dr. Frankenstein, thank you for your response. We are curious to know why you are so adamant that your patients must be weighed at every visit. It would certainly help us address the concerns you have about people refusing to be weighed.

      Without more information, it is hard for us to believe that this is medically necessary at every visit. We understand that there are some instances when it is needed, which are stated in the article (did you read the entire article?), but to say that it is vitally important is a bit misguided. We’ve all had times when we’ve seen a physician two weeks in a row – is it really necessary that I be weighed at each visit? Weight doesn’t change that significantly in one week’s time.

      You have a right to take your own stance, and we hear that you have clarity around your limits. We also hope you can respect that there are physicians who have absolute comfort in not weighing their patients, and patients for whom the experience can be far more destructive than helpful to their physical and emotional wellbeing. Health care providers are a commonly cited source of weight bias and stigma. Shame is not correlated with improved health or self-care.

      When the evidence that weight is a risk factor is incomplete and contradictory at best, and there is currently no evidence based treatment for high body weight (with data showing long-term maintenance of weight 2-5 years out), it is time for a new conversation about health and a more compassionate treatment model.

  12. Lynn says

    I found this after leaving a Dr’s office sobbing today. I had a severe eating disorder from 2010-2013. I was weighing myself 50 times per day, anorexic followed by bulimia when that failed. It took me so long to be able to eat food again and I did gain about 35lbs after going up to about 140 at 5’7. I don’t feel good about that and am trying to get back in a healthy way but it is so hard with triggers like the scale. I judge my weight now through my dresses. If they don’t fit or get too tight, I workout harder and cut back. But Dr’s offices are such trauma for me. Most have been ok when I refuse to be weighed, but today at the GYN she all but told me I was crazy for not wanting to be weighed. I am a size 6 and by no means obese. Even after I explained to her that I almost died from an eating disorder and it was a trigger she kept pushing and pushing. She said she can’t treat me properly without knowing the number and she wouldn’t show me (not true I can see my stat in my online chart). She then said WELL YOU NEED TO GET SOME HELP IF YOU CAN’T EVEN GET ON A SCALE. Yeah, I would love to but my insurance won’t even cover therapy. I have recovered all on my own. I left feeling so degraded and sad. Like non of my progress matters.

  13. Tara says

    I’m curious, do you have the right to refuse any/all vitals if the visit is just to meet a new doctor and you’re not suck or hurt in any way?…….I have severe Latrophobia and it’s tearing me up knowing I have to go in and be touched all over…..I don’t want to…..can i refuse but still be able to keep my doctor if i really-really need her?….

  14. Sandy says

    I too am experiencing this. I looked at my records on my doctor’s office “Patient Portal.” They have me down as “overweight” with a BMI of 25.0 to 25.9. On the date of that visit I weighed 122 pounds (clothed, mid-day), and I’m 5′ 5″. That’s a BMI of 20.3. In order to hit the BMI of 25 I would have to weigh 150 according to the NIH chart. I usually refuse to be weighed, but that day I went ahead because she pushed and pushed and told me the insurance requires me to be weighed. This is why we hate to be weighed. I was incredibly fit and proud of the achievement I had made.

  15. Julie says

    It all has to do with insurance companies. If the doctors office weighs you and determines that your BMI puts you in the “obese” catagory, then the insurance company can deny coverage and you even lose the ins. Company’s negotiated rate with that doctor. You get stuck paying the full non-discounted price for all proceedures. Doctors love it becsuse they get more money that way. Welcome to the world run by the Fat Police.

  16. Anna says

    While I respect your story, I want an explanation. By agreeing not to weigh, aren’t we going along with the mental disorder of a phobia of being weighed? If I have a recovering anorexic/other eating disorder, it is important that we weigh them in order to better help them. I do not give patients paperwork with their vitals on it, unless requested. I ask because I recently had a patient get extremely upset at me when I asked her to step on a scale, and even though I apologized multiple times, she went on and on about how cruel I was to ask her to weigh. (there was no flag in her chart to not weigh her) I feel there is a severe underlying reason, for this patient was by no means obese. I explained that knowing her vitals will help us better serve her(she was new to my dr), and that this is a requirement by meaningful use. Getting a weight does not reimburse us, and so that argument is invalid. I do agree with you on points in your article, and I have allowed patients not to weigh in certain situations. I guess I’m a little keyed up that I got yelled at for simply doing what I was told to do. I genuinely want to help people, which is why I would like your input on this.

    • Ruth says

      @Anna – what is mentally disordered about not wanting to be weighed? What medical reason is there for knowing one’s weight? There are far more effective markers of health than a set of scales, and far too much attention paid to the number on the machine than to the person’s actual “state” of being. “State, not weight” is a more accurate means of assessing someone’s health. And if you are concerned about someone’s health, then distressing them by insisting on an archaic and inaccurate procedure is not the way to ensure that they feel safe and listened to in your practice.

      “A mental disorder of a phobia of being weighed?” How about a refusal to allow unscientific weight bias to mediate the treatment I pay for as a patient, and to interfere with someone getting the attention they need, while discussing their options for improving their state of being without the advice they receive being shaped and channeled by that weight bias? It is appallingly common that people will get advice on “weight loss” without any attempt to assess the cause of their presented health issues.

      Weight loss is not a panacea to treat all ills, and people of and size can be healthy or unhealthy. Weighing is presumptive, in that it precedes a diagnosis, and allows room for implicit weight bias to take the place of evidence based treatment.

      Add to that the simple right to say “no”. That is an inviolable right for all.

      • Jen says

        I’ve had that happen to me. I personally don’t care about my weight so I’ve never thought twice about getting weighed at the doctor’s office, but my last doctor only seemed to care about the weight and completely ignored everything else I was telling her.

        I initially went in with abdominal pain and she did some tests and said that I was overweight so she thought it was a fatty liver (even though I had an ultrasound a few months earlier that showed my liver wasn’t fatty). She ignored everything I said and insisted it was the weight, and set me up with a followup visit a few months later.

        I was having a very stressful time of my life at that point, and I’ve been depressed for years and am a bit of an alcoholic, so I was in a bad state where I just wasn’t getting hungry due to the depression, I kept forgetting to eat, and I was drinking excessively. When I showed up at the followup visit a few months later I had lost over 30 pounds (I went from almost 160 pounds down to 125 pounds). The doctor didn’t even notice. She gave me the exact same spiel about how I was overweight and that’s what must be causing the pain and I should lose weight. I told her I had just lost over 30 pounds and she seemed surprised but restated that I still needed to lose more weight. I admitted to her that I had been very depressed, not eating much, and drinking excessively and could that possibly be the reason for the slightly elevated liver test that she did? And she said no, it must be the weight causing it, and that me losing weight was a “good trend” that I should continue. Seriously? After everything I told her, that’s her response?

        I can’t even imagine how someone must feel dealing with something like that if they have an eating disorder. I think a lot of doctors just use weight as an excuse to blame the patient for whatever’s wrong if they can’t figure out the real reason.

  17. Dotcom says

    Can you do this for an underage tween/teen? I think a lot of young girls (specifically ones without eating disorders) would actually benefit from skipping it—if not completely staying away from a scale in general until they are adults.

  18. Lisa says

    Here is my experience with refusing to be weighed. I went to urgent care for the flu. I’ve been there before, so they have my records (but its been a while.) Anyway, I felt irritable and unwell and when the nurse said, “hop up on the scale” I said Nope, and sat down on the table. She argued back about how they “needed to know” but I refused so she said, “can you give me an estimate then?” I told her to just go by whatever weight they had for me last time and she claimed there wasn’t one (LIAR!) So to get her off my back, I just said, “Okay fine, then why don’t you just put down 200 lbs then.” I chose that number because it is at least 25 lbs higher than what I really weigh which I thought would have been obvious. (I don’t know or want to know the exact number for my own personal reasons.) So she actually writes it down, while I glare at her, and when I was handed my paperwork it had 200 lbs (with a BMI of 36+ helpfully calculated for me in case I missed the point that I was fat.) I knew I wouldn’t be getting any prescription that would call for a dosage calculated on my exact weight, and there was no other reason for it. I felt bad enough from being sick, and didn’t want the added stress of seeing the number proclaiming my failure to control my weight on top of it. I don’t think I should have to explain all that to anyone, but it is one thing that keeps me from keeping doctors appointments many times. I know approximately how much I weigh, I work on it every day, but in my 50s it isn’t as easy to control as in the past. But anyway, its my issue and I’ll deal with it my way, the best I can.

  19. Savanna says

    Hello, thank you for writing this. I’ve needed to go to the doctor for years but haven’t wanted to because of the scale. I have a terrible relationship with food and my weight and the last time I went to the doctor, the first thing she said to me was that I should lose weight. There was no reason for her to say that; the reason i was there wasn’t at all weight related. Her saying that worsened my feelings towards food and my own body. I haven’t been back to see a doctor since then. Next time I go, I’ll refuse to get on the scale.

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