You Can Decline to Be Weighed

Did you know that you can choose to not step on the scale at the doctor’s office?

I had no idea until a few years ago when I saw it on social media.

I was baffled—but that’s what they tell you to do first! They never said I had an option!

Plus, I get serious White Coat Anxiety when I’m in any kind of western medicine practice and I tend to regress into an almost childlike obedience.

But learning that being weighed is optional at your appointments was groundbreaking to me…even though I wish it hadn’t been that big of a shock, because the thing that I wish we all could hold fast to is that we have the right to decline literally anything at these appointments.

That’s hard to remember though.

So, last year was the first time I declined to be weighed.

I felt incredibly nervous, and I said “Oh I’m not doing that today” in a voice that was more meek than I’d hoped.

But the medical assistant was pretty chill about it, said “Oh, ok,” and then brought me back to the room.

I’d done it! I was so glad!

Cut to this week, at my physical.

I was brought to the scale, more prepared this time to say a polite and firm “No thank you.”

Unfortunately, this time wasn’t as easy as last time.

The assistant paused for several beats, and in a voice that sounded confused asked me if I had weighed myself recently.

I said I hadn’t.

She again paused, with more confusion, and then asked if she could take my height, to which I said yes.

Once I was in the room, waiting for the nurse practitioner to see me, I heard them talking about it on the other side of the door: the medical assistant told the NP that I refused to be weighed, and the NP’s response was a baffled and irritated “but it’s a physical.”

My heart started racing as I listened in on this conversation, because I knew it was going to be more of a fight than it should be.

A little bit into the appointment, the NP asked why I declined to be weighed.

I said, “Well I know it’s optional.”

She then proceeded to tell me that at some appointments it’s optional, but at physicals it isn’t, because they need to track BMI.

Here’s the first huge problem: For a patient to ever be told that something isn’t optional is categorically not ok.

Everything is optional.

It might be against medical advice, but that doesn’t make it not optional.

She then asked me if I could estimate how much I weigh, so I gave her a number, which she put in my chart.

She told me my BMI. I told her I didn’t know what that number meant. She told me it meant I was “normal.”

She then said, “I hope you don’t think that you’re fat at this weight!”

I said that, no, I did not, but that I have put a lot of effort into focusing not on a number but on how I feel in my body.

I wish I had said more (and I wish there had been any kind of acknowledgement that I’m actually able to be a much healthier person by using a more embodied approach rather than bowing to the Scale Gods), but I honestly wasn’t prepared for it to be this big of a deal.

Though, in retrospect, I guess it makes sense—there is a pigeon-holed focus that so much of medicine has on weight.

But here’s the thing: weight is not necessarily any indication of health or disease.

The BMI is deeply flawed and is also not at all an indication of health or disease.

And—and this is the thing I wish I’d had the words to say but didn’t at the time—my weight had nothing to do with why I was there, what my concerns were, related to any prescribing of medications, nothing.

Here’s the slight caveat about refusing to be weighed—some medications require weight for prescribing purposes, so that practitioners know how much to dose.

But that’s it.

And even then, I’ve heard from others that practitioners have misused that reason to weigh patients.

Some of my personal reasons I choose to not be weighed are:

• I have a history of disordered eating and it’s triggering for me

• Related to the first point, I’ve worked really hard for the number on the scale to not mean anything and to focus on how my body feels, but once I see a number it takes mental energy to recalibrate, and I don’t feel like doing that if I don’t have to

• I have thin-privilege and it’s important for me to decline to be weighed so that medical professionals are more used to hearing the refusal…if I’m getting pushback, then people in bigger bodies are definitely getting even more of that.

And again, weight is not as tied into health as a lot of practitioners think, and can often be so focused on that other actual medical problems get missed or dismissed.

After this most recent experience I had, I gained some comfort from some Reddit forums where people shared their experiences of declining to be weighed…some positive, some negative, some mixed.

I’m not alone, and that helped to soothe the ick I felt after having to push back against a narrative that is categorically false—that certain measures are required and that patients do not have the autonomy to decline certain things.

Whatever your reasons for not wanting to be weighed, you don’t have to justify them unless you want to.

You can simply refuse, and if they push back, you can ask that if they need to, they simply document that you refused.

This is your care. You are the consumer. Even though you’re not the practitioner, that doesn’t remove your agency.

And if you need any support along the way, I’m here.