We know that going to the doctor is important for early detection and prevention of chronic disease. Unfortunately, following through on actually seeing your primary care physician is easier said than done when you are in a body that is not considered the “right” size.
Weight stigma, prejudiced, stereotyped, and discriminatory views and actions towards fat bodies, is not uncommon in the healthcare system, and is one of the leading causes of medical non-compliance, as well as avoidance of receiving care.
The language that providers use in appointments that is steeped in diet culture can lead to feelings of shame, inadequacy, and stress. The stress of feeling devalued due to body size has actually been shown to lead to greater occurrence of the diseases that are often blamed on being in a larger-sized body. This can include metabolic conditions like high blood pressure and type 2 diabetes, as well as psychological conditions like chronic anxiety, depression, and eating disorders.
We are here to tell you that your BMI does not have to rule your appointment, and that you deserve to receive the care that encompasses the whole you. It can be intimidating to advocate for yourself in the face of an authority figure, like a doctor, but the truth is that you are the authority on your body. You have the power to own the care you receive. The goal of this article is to give you the tools to feel confident in answering weight bias with a resounding “no.”
Don’t Weight Me
Many doctor’s offices want you to believe that the weigh-in is a mandatory part of your appointment. In short, it is not. There are rare instances where a weigh-in is medically necessary, such as when a child is failing to thrive, when medication dosage is influenced by weight, or with certain conditions, like cancer, but most of the time weight is not a necessary biometric to record. In fact, starting with a weigh-in can actually steer the appointment toward an unnecessary and irrelevant weight-loss conversation.
Here are some ways you can decline a weigh-in:
- Get right to the point: “Unless this is medically necessary, I do not want to step on the scale today.” Since this is your appointment, no further explanation is necessary when working with a healthcare provider who honors your body autonomy. If they keep pressing you, say something like “I would prefer that we focus on the reason for my visit, and not discuss weight or weight loss in this appointment.”
- Blind weigh-in: If the weigh-in is medically necessary, such as with determining medication dosage, it is ok to ask for a “blind” weigh-in. First ask, “is this absolutely medically necessary?” if the answer is “yes,” then say “Ok, I would prefer to not see the number, and please do not tell me what the number is.”
- Carry a “Don’t Weigh Me” card with you. It can be intimidating to say “no” to an authority figure, so it is ok to let a card do the work. Ginny Jones at MoreLove.org, has created “Don’t Weigh Me” cards that you can hand to the front desk when checking-in. You can find them here: https://more-love.org/resources/free-dont-weigh-me-cards/
Advocating for Weight-Neutral Care
Even with declining the weigh-in, you may still have to navigate diet-culture talk in the actual appointment. Weight-loss as a primary treatment is ingrained in the medical care field, and although it can be incredibly draining, it is up to us to change the narrative. To protect your energy, but still give direction, here are some respectful ways to shift the focus away from weight loss:
- Be Direct: “I would like to focus on treatments that do not involve weight loss.” Again, if the provider continues to push this topic, “Decades of research show that weight loss interventions are not only unsustainable, but can also be detrimental to overall health, especially psychological. It has not been effective for me personally. Let’s focus on non-scale ways to support my health.”
- Navigating Weight loss surgery/drugs: “Due to the lack of long-term research surrounding weight loss drugs, and the potentially harmful side effects, I do not want to talk about weight loss drugs or surgery. Please treat me without considering the size of my body.”
- Bring a friend: If you feel uncomfortable with confrontation, which is absolutely ok, please know that you can bring a friend or family member to help you advocate for weight-stigma-free care. You do not have to do this alone.
- More Resources: For more talking points, Ragen Chastain, a fat-acceptance activist and researcher, has created a couple of “What to Say at the Doctor’s Office,” cards that you can take with you to your appointment. You can print them out here: https://weightandhealthcare.substack.com/p/what-to-say-at-the-doctors-office
Build a Weight-Neutral Care Team
It is ok to walk away from a healthcare provider that you do not feel safe with. If weight-loss continues to be the only topic of discussion during your appointments, then you can ask for another provider. In fact, you do not even have to use any of the talking points above before making this decision. Ultimately, it is up to the healthcare provider to educate themselves.
If you are ready, and able, to find a weight-inclusive healthcare provider, here are some steps you can take to ensure you receive the care you need:
- Ask a friend, or current healthcare provider you feel safe with: Personal experience and word-of-mouth is one of the best testimonials to a doctor’s integrity and approach. If you are currently working with a Health At Every Size provider, then they probably have done the work to widdle down referrals to providers they are confident in. Friends and family who have a similar experience to yours may also have recommendations.
- Call Around: Asking the front desk of the doctor’s office if there are any Health At Every Size providers you can schedule can give you an idea for how weight-inclusive their clinic is. If they give you a couple of names right away, then it is likely they are actively practicing weight-inclusive care. If they do not know how to answer this question, that is a clear sign to move on to the next option.
You can even ask if they are ok with skipping the weigh-in during an appointment, or if they have larger-sized blood pressure cuffs, or if they have size-inclusive chairs in their waiting room. You deserve to have a comfortable experience from the moment you walk through their door.
If you do not feel comfortable asking these questions, you can try going into the office to inquire about an appointment. Take in the waiting room, check the vibe of the office staff. If you are not feeling it, you can leave.
- Check the Association For Size Diversity and Health Database: The Association For Size Diversity and Health (ASDAH) is building a Health At Every Size provider listing to make it easier to build your care team. Find the listing here: https://asdah.org/listing/
Have the Receipts
If you have the capacity to educate your healthcare provider, or you do not have the privilege of finding a new doctor, it can be helpful to have the research at hand when discussing the harmful impacts of weight-stigma. Here is a collection of the latest studies that point to the damage that weight-bias in the healthcare industry can do:
- Weight stigma and health behaviors: evidence from the Eating in America Study, Lee et al., 2021: https://pmc.ncbi.nlm.nih.gov/articles/PMC8236399/
- Overcoming Weight Bias in the Management of Patients With Diabetes and Ob*sity, Puhl, et al., 2016: https://diabetesjournals.org/clinical/article/34/1/44/31361/Overcoming-Weight-Bias-in-the-Management-of
- Stigma in Practice: Barriers to Health for Fat Women, Lee and Pausé, 2016: https://pmc.ncbi.nlm.nih.gov/articles/PMC5201160/
- Weight Discrimination and Risk of Mortality, Sutin et al, 2015 https://www.frontiersin.org/articles/10.3389/fpsyg.2016.02063/full
Final Thoughts:
Navigating weight stigma and diet culture in healthcare can be exhausting, but you deserve care that respects and supports your whole self—no matter your body size. You have the right to be heard, to ask questions, to set boundaries, and to receive evidence-based care that centers your well-being—not your weight. Advocating for yourself isn’t always easy, but it’s a powerful step toward reclaiming your health on your own terms. Remember: your body is not a problem to fix, and you are worthy of respectful, quality healthcare exactly as you are.
The providers here at Rooted Path Nutrition and Eating Disorders are all weight inclusive, non-diet and trained in the principles of Health at Every Size.
Reach out today – we’d love to support you on your health journey.