Last week on Marie Anelle’s post about parenting and children’s weight, Harpy reader mischiefmanager and I got into a discussion about routine weight-monitoring at doctor’s offices. She suggested the topic really deserved a thread all of its own, so blog goddess that I am I’ve gone and created one!
Here’s a slightly edited version of our thread conversation, followed by my own more coherent argument for why routinely weighing folks as part of appointment intake proceedure can have a negative effect on peoples’ access to healthcare. I shall then open up the floor (or rather, the comment thread) for (respectful please!) debate about the role monitoring body mass plays in healthcare.
I just had a conversation with my mother last month about fat shaming and automatic weight checking at the doctor’s office. She was resistant to thinking it would be better best practice to forgo the automatic weigh-in for more holistic assessment of someone’s health, but after a few weeks of thinking she emailed me to say she’s starting to understand my perspective. It was a heartening conversation.
I think it’s SO HARD for us to see the way that discussion about body weight in our culture implicitly invokes shame and moral judgment because of all the powerful cultural narratives that link body size with moral fitness. We’re so used to that it’s invisible to us. So when us contrarians are like, “talking about obesity as THE public health crisis of the century is totally shaming,” folks are like, “what?! but it’s health!??!” without understanding how “health” stands in for judging someone’s moral fitness…mischiefmanager says:@Anna: You can’t not weigh people. That piece of data, like blood pressure, can be indicative of a problem, and especially since we’re all so sensitive on the topic, a recent unexplained gain or loss is something the patient might not choose to raise. The problem isn’t the weighing, it’s the toxic attitudes our culture has about body shape and size.annajcook says:@mischiefmanager mmm. I think the weighing conversation might be a more involved one than this comment thread should be asked to sustain, but I would argue this: that there’s a difference between routine weighing as part of intake at virtually every doctor’s appointments (even specialists do it) and tracking the body mass of someone with whom you are working in a holistic manner and have decided (together) that tracking weight is part of your plan to better health. Routine taking of a person’s weight often just causes feelings of shame and has driven a number of women I know personally away from seeking medical care for any number of conditions (and I know from reading fat activist blogs this is not uncommon). So, from the perspective of a doctor who is seeking to reach patients who are not getting care it might be worth considering how de-emphasizing weight as part of the intake procedure might actually facilitate better outcomes for patients at the heavier end of the spectrum.mischiefmanager says:@Anna: I see your point. Still, though, docs collect all kinds of data that we as patients find uncomfortable to discuss-what our eating and exercise habits are, for example. They wouldn’t be doing their jobs thoroughly if they didn’t. So I wonder how we can balance the externally imposed shame that many people feel about many aspects of their health with the doctor’s responsibility to be upfront with the patient.