Stepping on the scale is an inherent part of the American healthcare experience. But does it have to be? Healthcare professionals and patients say not necessarily.
For patients struggling with mental health, eating disorders, or other body-related concerns, being forced to step on the scale may cause significant distress. Because of this, the ‘don’t weigh me’ card has become increasingly popular. Born from the desire to make a trip to the doctor a more inclusive, less stressful experience, the cards sit in waiting rooms across the country and allow patients to discreetly make a choice: would I like to be weighed today? Similar in size and shape to a business card, patients may grab a card and hand it to the provider before the start of the appointment, indicating the patient should not be weighed and that any discussion around weight should only occur if permission is given.
According to Rebecca Shenkman MPH, RDN, LDN, Director, MacDonald Center for Obesity Prevention and Education at Villanova University, “to be effective and emphatic providers, it is important to ensure a safe and comfortable environment and for the patient to feel seen and heard – and one such way is asking permission to be weighed (if the medical situation does not require a weight). This shows patients that their provider respects their voice and choice” Shenkman says. “'Don’t’ weigh me’ cards are a tool that providers should recognize as a good ‘pause button’ that allows them to re-center patient care on the individual and not have a conversation guided by a scale number or attribute certain symptoms or conditions to weight.”
Healthcare providers may express weight biases that prevent patients from receiving effective care. The provider may correctly or incorrectly attribute a patient’s health concerns to weight and overlook additional factors not correlated with obesity. And while obesity is certainly a chronic and progressive medical disease that should not be ignored, there is more to a patient than a number on a scale. “A barrier to effective healthcare utilization is the prevalence of weight bias towards individuals with obesity. A first step to reducing bias is to acknowledge the issue exists and to recognize one’s own biases which may intentionally or unintentionally result in unfavorable behaviors and attitudes towards individuals with obesity,” says Shenkman. While communication about weight-related health is important and many times necessary, to center the dialogue on weight alone means missing out on other potential issues.
“By letting patients lead the conversation, having an open dialogue and practicing shared decision making, and approaching the discussion around eating habits and weight-related behaviors within the broader context of health, patients are likely to be more receptive to medical advice given and seek future care.” When patients are allowed to choose to be weighed they are empowered to make their own decisions surrounding their care. ‘Don’t weigh me’ cards help provide peace of mind and a comfortable environment for all people, allowing providers to act more effectively and patients to seek out effective care more often.
To speak with Shenkman, email firstname.lastname@example.org.
Rebecca Shenkman Director of the MacDonald Center for Obesity Prevention and Education | M. Louise Fitzpatrick College of Nursing
Rebecca Shenkman, MPH, RD, LDN, is an expert in nutrition, weight management, and using food to help prevent and control disease