Please note, this blog post is not to excuse the behavior or treatment of providers toward fat people, but to help remove the power difference between fat people and their providers. If you can better understand where a medical provider is coming from, you can better advocate for yourself during a medical visit.
So, why do medical providers weigh you?
(Other than recording your BMI and counseling you on weight loss.)
Weight is not reflective of just body fat***, but total body water. BIG ASTERISK HERE because BMI and weight are not good measures of actual body fat because they don’t directly assess body fat. Muscle and bone are denser than fat, so BMI & weight can overestimate body fat in people with high bone density and muscle mass or underestimate it in people who have low bone density and muscle mass. So, keep that in mind.
But, when doctors weigh you and tell you weight is a “vital sign” what they mean is they want to measure the water in your body and see if there are any sudden fluctuations. Sometimes weight fluctuation is the first sign of a developing condition. Now, this is not just the normal fluctuations of a few pounds (it is normal for your weight to fluctuate a few pounds daily depending on what you eat or drink), but larger fluctuations. Your provider should know the difference between a sudden change and normal fluctuation, but in order to really see that, they need to know what your “normal weight range” is. Providers also need weight to determine some medication dosages (technically that's why it is on your ID, but how accurate is that?). If that is what they need, providers will probably vocalize that.
BIG HOWEVER, if you are in a larger body and your weight suddenly fluctuates down (dropping weight) your provider might just assume you are pursuing weight loss and advocate for more weight loss instead of checking for another medical issue. If you are having symptoms, push for testing! Annnnnnnnnd if you are in recovery from an eating disorder, weight gain is a normal part of recovery, so a sudden increase in weight is probably just healthy weight gain. So, be sure to inform your provider of your recovery if they don’t already know about it.
While it is important to understand where providers are coming from, know that weight fluctuations are not the only way to detect these medical conditions. So, if being weighed will escalate disordered behaviors, you don't have to be weighed. You can refuse. You can also choose to do a "blind weighing." Blind weighing is the practice of allowing a medical professional to weigh you, but you don’t see the weight. Step on the scale backward, so you are facing away from the number. You can ask your medical provider to omit/remove your weight from your visit notes too!
Keep your eye out for my upcoming Free PDF about weight refusal.