Navigating Healthcare in a Weight-Centric World
Walking into a medical office can feel like a gauntlet of anxiety and frustration when you live in a body that the mainstream medical system has deemed problematic. For many people in North Carolina, the simple act of seeking care for a sinus infection or a twisted ankle turns into an unsolicited lecture on weight. This focus on body size often breeds distrust and a lack of safety in medical interactions, leading many people to avoid going to the doctor. It is common to feel as though you are not being heard or that you are receiving insufficient help because of a provider’s weight bias.
At Lutz & Alexander Nutrition Therapy, we believe your body is your most powerful ally in creating your best health. We want to equip you with the tools to shift the conversation from your weight to your actual health concerns and goals.
You Can Decline Being Weighed
The scale is often the very first stop after you are called back to the exam room. It feels mandatory, but for many, it is a significant trigger for body image distress, a relapse into disordered eating habits, and/or a catalyst for the visit being focused on weight. You have the right to decline being weighed. There are a few situations when monitoring someone’s weight is medically necessary, such as for specific medication dosing, anesthesia, during pregnancy, and during eating disorder treatment.
Script for Refusing the Scale:
- “I prefer not to be weighed today. I am happy to discuss any health concerns I have without that data point.”
- “Unless it is strictly necessary for a medication dosage, I decline the scale. Please make a note in my chart that I am practicing weight-inclusive care.”
- “I decline being weighed.” (You may have to repeat this several times.)
Another option is a “blind weigh-in,” where you stand on the scale backward and request that the number not be shared with you or discussed during the visit. However, it’s worth noting that, often, post-appointment printed information includes the weight measured during the appointment. So, if you weigh blindly, you may still see the measurement printed or in your patient portal.
Addressing the “Weight Loss” Prescription
It is frustrating to go to a doctor for a specific symptom only to be told that “losing weight” is the solution. This is a very common experience in the Raleigh and Charlotte medical systems, where the weight-normative approach dominates. This approach places an unhealthy emphasis on weight and weight loss when defining health, often at the expense of recognizing the multifaceted nature of well-being. Furthermore, there is no research supporting the sustainability of long-term weight loss, and intentional weight loss is not without significant health risks. When medical providers prescribe weight loss as a medical intervention, they are not practicing evidence-based medicine. There is a lot of physical and emotional harm caused by our medical system prescribing weight loss as a solution.
Script for Redirecting the Conversation:
- “What treatment would you recommend for a person in a smaller body presenting with these exact same symptoms?”
- “I am not interested in weight loss as a clinical intervention. Can we focus on behaviors or treatments that address my symptoms directly?”
Finding Weight-Neutral/Weight-Inclusive Doctors in NC
Advocacy is easier when you have a provider who already understands the Health at Every Size® (HAES) framework. We encourage our clients to seek out providers who practice with a weight-inclusive approach, which views health as multifaceted rather than just a number on a scale.
It can be difficult to find providers who work from a weight-inclusive perspective. Advocating for yourself at your doctor’s office can be a step toward ensuring your care is weight-inclusive. We all deserve the same standard of evidence-based care, regardless of body size.