But it’s really smart and pragmatic. Getting overweight people into the office is the first step. This approach doesn’t deny that obesity is a serious health crisis, it just changes things slightly to better reach these patients.

I read medical records for a living.

Recorded weight at an exam has been hit and miss for quite awhile now. At the end of the day, your health is in your hands. If you want to improve your health, you allow your physician to work with you. It's not their responsibility, it's your responsibility. You want to improve your blood pressure, you need to take it to track it. You want to improve your weight, (which impacts quite a few other aspects of your health), you need to take it to track it. You can opt out of quite a few tests/measurements. You're just left with fewer things to understand. You'll never know you're diabetic if you opt out of testing until you're in the ER,

As they say in business, "You can't manage what you don't measure."

Weight is a fundamental fact of one's health. It's a metric like height or age. For a physician to not record a patient's weight sounds like it borders on malpractice as one's weight has significant effects on one's overall health.

When Trump's so-called doctor reported his weight as 230 lbs., we all scoffed because we can see with our own eyes that Trump is closer to 275+ lbs. But it made Trump feel good to know he wasn't officially obese.

So, if doctors are trying to make their patients feel "better" by not recording their weight, the patient is not really serious about their health. I mean, it's like if you refused to allow blood to be drawn or to provide a urine sample. How is the doctor to evaluate one's health without fundamental metrics?

Too many Americans are overweight but won't admit it. As we've heard in other circumstance, fuck their feelings.

Doctors rethinking taking a patient's weight is not about some sort of "coddling" as you imply. As someone who suffered from a severe eating disorder, in my case anorexia, I understand how focusing too much on a number like weight can be counterproductive depending on the person.

For example, what if a person adds an exercise program to their routine, gets their blood pressure down, and blood sugar down, but their weight isn't going down as much as they'd want? To constantly be reminded of their weight as a number, versus focusing on health indicators of improvement, is counterproductive.

My husband got his A1C from 13 to 6 by making himself walk 5 miles a day. His cholesterol is also back to a normal range. Guess what didn't go down? His weight.

So there are other ways to approach the subject, less confrontationally.

I have never been overweight and I have always had a sweet tooth.

Last edited Tue Dec 31, 2024, 03:45 PM - Edit history (1)

So at age 67 I went on the ketogenic diet (low carb, high fat) and lost 40 pounds, keeping it off for 4 years when I decided to go on the carnivore dietary life style. After a few months I had gained 15 pounds but oddly my belt size had not changed. That's because I had put on muscle mass which is what any 71 year old wants to do to prevent falls. My doctor is delighted and happy with my labs. When I started on this journey I had trouble doing 10 pushups now I can do 100 pushups--in a row.
I'm happy and weigh what I did when I graduated high school pre-SAD.

carbs, sugar, insulin resistance. When I think back to the things we were told, nutritionally. Trans fats were GOOD for you, they prevented heart attacks! Lard was bad bad BAD. Sugar substitutes were salvation! I mean sucaryl, aspartame, saccharin - let it snow! Meanwhile they added all the stretchers - carageenan, emulsifiers, Guar gum. You can eat anything healthy as long as no fat!!

We was lied to.

Not your opinions on someone’s weight.

I went on a keto diet and dropped weight amazingly, worked out at the gym and was really really fit and down to my high school weight - my doc was concerned and advised that I put on 10 pounds.

Then Covid, then back surgery, then more back problems....the weight gain started again. The issue with Keto is finding a vehicle to put other foods on. Using lettuce wraps just doesn't cut it and Keto "bread" is vile.
There's also an issue with cholesterol. I also like veggies like beets and carrots which are no no's on Keto.

that works too

and I've only been cautioned once in my life about it by my cardiologist. I was edging toward being overweight, but not quite yet there.

This year I've been to the ER twice. Once for a respiratory infection where I had difficulty breathing, and once for what ended up to be pulmonary embolisms. Both times my weight was not taken, nor mentioned. Somehow they managed to diagnose and treat me without weighing me.

I have BDD, so I can't gauge myself.

I applaud this doctor.

Knowing what I weighed didn't do a damn thing to stop the bleeding. Our "healthcare" system is so fucking idiotic.

The didn't need to know my weight in order to give me a local anesthetic. I didn't get any pain meds, or anything other than a tetanus shot, which is a standard adult dose. There is ZERO need to weigh someone in order to stitch up their goddamn finger.

For most meds, the dosages are adult/child. For some it is weight-based (ursodiol, for example). If a weight-based dosage needs to be administered, the weight can be taken at that time. (And, in my experience, it is based on reported weight - not measured weight.)

starving myself trying to get my weight down for my weigh in at my 6 month PCP appointment today. After I got home I had a stack of buckwheats.

Yeah, I’m a little intimidated by the process. I take my 5 pounds of shoes off before I get on the damn scale too. My doc is all over me whenever I have a weight gain from the previous visit. I guess my HBP and diabetes have something to do with that. Being on Lyrica all the time doesn’t help with weight control either.

I have got to remember to reschedule these visits so they don’t always come the week after Christmas.

from taking Lyrica, that I can not take off! It helped my nerve pain tremendously, but then my ankles swelled
up to the size of softballs - so was taken off. Now I have the weight plus the pain that hinders my exercise.

I hate to be on a constant "diet" and watch my husband eat quarts of ice cream at a time and not gain.
Life is not fair.

I have to take it for my nerve pain too. The side effects are awful. Swollen hands, ankles and all. But I naven’t found anything else that will help lower my nerve pain other than the Lyrica + Lorazapam. I have to take diclofenac sodium to control the swelling from the Lyrica. What a mess.

I have slowly gained way too much weight and have been trying to lose it for more than a year with only mild success. Of all things I dread the weigh in and shut down my sensory faculties while it’s being done. At least I’m going in the right direction but way too slowly which happens at my age. Shit.

"BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers."

https://www.nhlbi.nih.gov/health/educational/lose_wt/risk.htm#:~:text=BMI%20is%20an%20estimate%20of,breathing%20problems%2C%20and%20certain%20cancers.

one.

Risk than being in the “normal” category.

https://www.nature.com/articles/d41586-023-02243-y

And the article notes that BMI was intended for measuring populations not for giving individually based advice, as other factors should be taken into consideration for each individual.

There is also research suggesting that the “ideal weight range” is different for older versus younger people.

It doesn’t factor in muscle mass. A number of athletes have obese level BMIs, despite having very low body fat.

Having a thicker neck than the average woman, like I do, makes me obese, although I am not obese.

Also, menopause isn't factored in.

BMI shows nothing. I have been insanely fit and had bad bmi. Why? Because I have a thicker neck for a woman and a larger frame for my height. Didn't matter i wasnt an punce overweight. Women rugby players are also obese by bmi standards. So is Simone Biles.

It is obsolete and inaccurate .

Visiting my father in 3 different nursing homes after he broke his hip I could not but notice all the people over 85 were thin, this was over 3 years and seeing literally 1,000's of residents.

No one likes to take care of heavy people. I believe they are more likely to be neglected.

I definitely avoided my doctor in the past because of discussions about weight. Dread going back this year because I have gained some more weight. I am healthy in all other ways but making the whole appointment all about weight is not helpful. I am only a little overweight as compared to many people and very aware of it and trying to lose so its not helpful to me to bring it up. I have no objection to them takinh the measurement but ignoring all other good test results is not helpful to me.

Been dealing with weight issues since I was six. All I ever got was lectures on how I should "pull myself away from the table." Yeah, I'm fat. No shit, Sherlock. What are you going to do to help me with this? I mean, besides basically calling me a liar when I tell you that I spend 2 hours a day in the gym, and still gain weight if I eat more than 1200 calories a day. And, then tell me I need to eat less and move more.

I haven't been to a doctor in well over a decade. A large part of it is financial, but I also really don't want to have to deal with the shit they give me over my weight. I'm one of those people they're driving away....

but tends to focus on the reason for the visit, not weight.
I stopped trying to lose weight way back in the 1980's after being frustrated time and again with being on the weight loss yoyo. Read a book called "Diets don't work" by Bob Schwartz (first published 1982). In the years since, plenty of research has backed up what was in his book. That's when I started attempting to eat better. Still working on it, lol.

and then IF necessary to address the findings, physicians or PAs/NPs can broach the issue. That said, unless the patient needs to be on one of the drugs dosed on LEAN BODY WEIGHT (there are a few meds and anesthetic agents for which that is necessary to avoid complications or overdose), the other indicators of physical health outside absolute weight are adequate. That doesn't mean obesity doesn't need to be addressed--especially if it is associated with the reason for the visit or identified issues, but it need not be first and foremost.

Perhaps medical care should be priced by the pound, the less you weigh, the less you pay!

That might entice people to watch their weight a little better.

That’s one of the dumbest things I’ve ever heard.

Or are you just trolling?

Last edited Tue Dec 31, 2024, 10:03 AM - Edit history (1)

they shouldn't go to a doctor.

As to the comment about with being charged by the pound, it was just tongue in cheek. Should have been obvious.

But since you're clutching your pearls, how about the doctor going, "Hey, we're having a sale on checkups this week, only $1.99 a lb. for a limited time only!"

I haven't replaced it in years.

But I know. The belt says so.

One of my favorite sayings
-Airplane

They'll refer you to a nutritionist rather than learn anything about diet that they can teach you. Them telling you to "get more exercise" is almost useless. How much? What kind? When?

Don't get me started on doctors and BMI. Useless numbers in most of their hands.

This is all my opinion, based on personal experience and knowledge. Doctors not knowing shit about nutrition and fitness is long a pet peeve of mine.

feel the same way, but I am underweight and I have two doctors that hound me over it. I have been underweight practically my whole adult life and sometimes I feel like telling them to shut the hell up.

anxious. I tell them ahead of time and not tell me the reading and then take it later after my initial anxiety goes down. Then it drops. However, I still must take b.p. meds.

Many people have higher BP readings at the Doctor office because of what you describe.

confirmed for me. I had asked her if she could do the bp thing below the elbow (as a friend had told me her primary did) because when my former PA (aka misogynist asshole) had done it, I nearly blacked out, and my arm was bruised and very sore for several days each time. She told me that strapping the cuff that tight and really pumping up the pressure does result in higher readings. Not so surprisingly, when she did it, mine was fairly normal, white coat syndrome and all. Which probably also explained why my at-home readings were different than those with the PA (misogynist asshole), and aligned closely with her reading.

always lower than when the doc takes it.
Finally got my Orthostatic Hypertension under control. Every time I got up I got dizzy. My Cardiologist that installed my pacemaker put me on strong BP meds and I quit taking them. Had all kinds of stress test and zero Afib. He didn’t buy it until I told how much I jog. Then he agreed. Lots of my meds I take half the dose.
The poison is in the dose.
Have a healthy BMI, but still take my shoes and jacket off when I step on the scale

But he doesn't usually say anything about it. He's more concerned with my bloodwork.

One less harangue, at least.

With your own doctor about your health is the right thing to do nowadays. If there is one place where you should be open about discussing it, it's at your doctor office.
Many people struggle with weight, doctors are able to help you. If your doctor is not willing or able in a manner that is approachable to you,with respect and understanding then he may not be the right one for you.

seems like a very progressive position.

Seems along the same lines as trying to control people's reproductive healthcare.

But in the past, any time a woman was a patient of a male doctor she got told one of two things, no matter what the complaint.

1. It’s all in your head
2. Lose weight

doctors can estimate weight pretty accurately. At least accurately enough to order the appropriate tests. Hell I can estimate weight pretty well and I am just a schmo.

excited to share it with my doctor.

(She's kind of awesome. In my checkup after the Covid quarantining, she weighed me and in a dismayed voice said, "Scrivener7, you gained 7 pounds!" Then she shook her head and said, "Oh, whatever. So did I." )

it's needed as part of the calculation for plateletpheresis

if there's a specific medical indication.

they need to know if you have gained or lost weight

tell them you just don't think a weigh-in is necessary

And in that case, it matters. But I have dodged going to a doctor for years because I don't want to get weighed (among other things, that they weigh my shoes and coat along with me sometimes, doesn't help). I am not seriously overweight and I am generally healthy but I simply don't want to deal with it.

Last edited Tue Dec 31, 2024, 12:48 AM - Edit history (1)

I'm glad I stepped on that scale. I had no idea. I knew I had gained some weight. But I'm only 5 ft and 20 pounds is a lot. My BP is also elevated. Now I'm "watching my weight".

They didn't weigh me when I went to the minor emergency clinic a few months ago. They asked me my weight. I was off, but it was no big deal because antibiotic doses are prescribed over fairly large weight ranges. For instance, every adult gets the same "Z pack". I guess if I weighed over 300 pounds or under 80 pounds, maybe the Z pack dosage could be an issue.

The woman in the article complained about weight being discussed in conjunction with antibiotics and sciatica. So there shouldn't be an issue with antibiotics and weight. However, there is a correlation between sciatica and weight. Not much details are given, but sciatica is such a broad topic. Has she been to PT? Is she exercising for it? Can she exercise? Does she have a severe case? Does she have previous surgery? How overweight is she? 20 pounds or so? (Probably not an issue) 100 pounds? (Yes) The list is endless and probably too broad to address in the article. However, there is a correlation between weight and back pain. However, there is also a very strong correlation with exercise, but exercise and weight can go hand in hand. No info given on the sciatica issue.

No matter what I weigh. I remember feeling like a cow when I hit 110 pds. I’ve been up and down, but one thing remains constant - doctor’s patronizing attitude. Why do they feel like it’s a revelation to you that you’ve put on weight? Do they think we haven’t noticed? And the advice is always the same: eat less and exercise - like we couldn’t figure that out. Unless there are clear indications that your weight is negatively impacting your health, it should be left out of the discussion.

in a doctors office once a year. Its an indicator of health, and if its not written down there is no record. And if you end up in a serious accident and can't speak, at least its available.

The first clue something wasn’t right was my weight loss

This way there are no surprises at the doctors' office, and it is their job to track your weight, IMHO.

Every body is different but obesity is a gateway to so many medical issues that it's surprising how little is done in our system to address it.

Type 2 diabetes is treated as an illness, being "pre-diabetic" is, as well, but a lifetime of overweight just isn't given the attention it could be in America.

Full disclosure, I am technically obese, I wish to lose 20 pounds but am right now 25 pounds lighter than I was four years ago.

My opinion is, why weigh myself in their office, in the summer in wearing shorts and a golf shirt, in the winter I'm wearing pants, shirt, heavy sweater and boots, probably 5 pounds difference just in clothes.

My last visit the aid gave me a bunch of shit about it.

I am really glad that some of you don't have to worry about this or have the steely discipline needed, especially in what most consider stressful times, to control it. Things like COVID, work from home, stress, general aging, all contribute to weight gain and being shamed for it doesn't help.

And here I thought ageism was the last acceptable prejudice on DU.

seriously

if they don't know the patient's body weight?

I think people should be weighed, but sometimes it just isn't necessary. For instance: A follow up visit for something that isn't related to weight at all.

The woman complained about two things: Antibiotics and sciatica. These are two very different things. Sciatica can have a weight component and there wasn't an elaboration on that. And it gets me to: What was being done about her sciatica? That's a huge, huge, huge can of worms.

The article brings up an issue, but I don't think having doctors not weigh people is the solution.

is a sign of disease. Docs want to be able to spot check and see if a patient has gained 50lbs in two months or lost 50lbs in two months.... I don't get the problem here.

It didn’t even matter what the scale said—almost every damned patient from the ER to specialists’ offices was declared “obese” or “morbidly obese.” A woman 5’ 7” and 135 lb? Obese. Someone 5’ 10” and 160? Morbidly obese.

This was especially bad before HIPAA because they had pages and pages of “funny” abbreviations and acronyms to describe patients, especially in the ER, which is deadly dull much of the time. 4F was popular—fair, fat, 40, and female), BMW (bitch, moan, and whine), CTD (circling the drain), DBI (dirt bag index: # of tattoos x # of missing teeth = # of days since last bath), etc.

Now, that’s all history—at least on paper. Can’t give legal ammunition for a lawsuit now that patients can demand to see their medical records.

Except that the concept of obesity is still something most docs just can’t wrap their head around. It’s no wonder people avoid appointments to avoid the scale.

Of course, that’s changing now that GLP-1 drugs are becoming popular to lose weight without trying (note: the effects don’t last when you stop these very pricey drugs, and you lose as much muscle mass as fat). Now, it seems that every damned one wants a script for these overpriced miracle drugs, so they are running to their PCPs like crazy—and demanding a diabetes diagnosis so their insurance will pay for them. *eyeroll*

many of us avoid doctors except in dire circumstances.

deal with our health care our own way.

I don't weigh at the doctor's office. If there is a reason: pregnancy, anesthesia, (not likely to be happening at a checkup). They have bloodwork to talk to me about and their "how are you feeling" stuff.

Aside from an occasional sinus infection, I've been in great health for years (most of my life) even being fat enough that most of you would hate me on sight without knowing anything about me.

And yet, I still deserve to be treated like a human being, not a number on the scale. When I weigh, it becomes the only thing the doctor is willing to talk about (well, not a doctor, a PA, we don't get actual MDs in rural clinics).

The point is, if you are cool with being weighed at the doctor, say "yes" when they ask you to get on the scale. If you don't feel like it, then say "no" and everyone can move on with their day.

It doesn't affect anyone but me when I say "no". It's my choice, my body, my health.

…and had a more enlightened & educated point of view regarding weight gain, on the whole.

You won’t hear me moan about “fat-shaming” on DU, nor will I take it personally if someone mocks Trump. But I have written about my experience with medication that causes weight gain, and how every doc saw the scale and no doc ever bothered to read the list of my medications.

I have written about the incredible difference between group class photos of kids in the 1950s (in my class, exactly one child was overweight) and those a few generations later — are the judgmental folks of the opinion that all those 10 year olds in 2020 have simply lost their minds regarding food? Or maybe someone needs to start reading labels and ask: when did high fructose corn syrup get added to everything in the American grocery store?

I’d thank you for your kind attention, but I doubt anyone is paying attention or will change their minds.

What's next, blood pressure, pulse and temperature??

She was chunky even as a little kid. She ate the same thing as we did, in similar portions, with similar activity. She just always had that extra layer.

With her first baby she weighed less at birth than she did when she got pregnant - including the boy. By the time the 2nd one came she was 20 lb overweight. From that point on she gained about 5 -10 lb a year until she topped out at 270 at 5'1" around age 50. She was fairly active. She earned a living on her feet all day, and we could walk MILES. She kept up. Plus there was the farm. My sister was never a sitter.

A few trips to the doc for various things, she faced the bias. They didn't take her seriously. They discounted everything to fat. The assumption was she was lazy, stupid and lying about her eating. As her knees deteriorated she fought harder in the kitchen to keep her weight from getting any higher. She'd been on 400 calories a day for 5 months when she had her heart attack. She'd managed to take off a mere 15 pounds.

The cardiologist in the hospital that put the stents in told her she should have come in when chest pain first started years before.... well she did. Nobody listened.

Fast forward another 8 years. She was managing to maintain but was practically starving herself. She kept complaining about stomach pain but discounted it to hunger, which she endured because "fatties need extra willpower" (her quote). She could just cry with "hunger pain". We begged her to see the doctor. She wouldn't. "What's the use?".

She fainted at church and didn't come to until she was in the ER for several hours. Turned out she had cancer. Too far advanced to do much of anything to save her. She died less than a year after the diagnosis.

The issue of weight and medical attention is VERY personal to me. What we are doing now DOESN'T work. If skipping the scale helps even one person be willing to go to a doctor and ask for help, then it will be worth it. Let someone out there not lose a sibling or parent or child because of embarrassment, shame, and demoralization.

and I've heard similar stories over and over.

If you're fat, you're worth less than nothing to our society.

Thanks for your story. It's very moving and I hope people in this thread who are being a bit holier than thou read it.

Obviously weight can be a factor in health issues, but there is no reason for doctors (in most cases) to stick you on a scale. Those of us who need to lose a few pounds are well aware of it.

I don't think doctors need to know to the pound how much we weigh and doctors' scales are also not always accurate. The last time I was weighed at a doctor's office it was so far over what my home scale said it wasn't even close and I complained to the doctor. (I don't mean five pounds - it was off by 25 pounds and at the time I was playing softball and running miles every week).

I have not had a routine checkup since then. It's too stressful to be weighed.

If someone doesn't want to get on the scale, they don't *deserve* medical attention.

I'm sorry about your sister, and I'm sorry about the kinds of social attitudes that are so prevalent, even here.

severely broken, extremely sexist, medical system go on and on.

One of the leading causes of blindness in the world

I deal with it on a daily basis as Native Americans get it

I have seen it in every phase. At the last CE I attended, I had to correct the lecturer on a couple of things

But, I say but, when some diabetics get to the point where it’s in their eyes, some of them get a coming to Jesus moment. They get with the program, diet, exercise, take their meds. The risk of blindness scares them.

They come back and the retinopathy has completely cleared up! Nothing I did It’s all on them. I love to see it too

They look better too, no more gut, no sweaty and wan complexion. They are happier too

The one fella, his phone kept ringing during our visit. I’m like dude , what the heck?

Doc he says, I can’t help it. Ever since I lost all this weight, the women, they just won’t leave me alone!

I tell this story to DM patients a lot.