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You get weighed at the doctor's office. Then what?

It's one of the worst parts of any routine visit to the doctor's office: You take off your shoes and stand on the scale, usually out in a hallway, and wait for the bad news. (If you're like me, you always figure your clothes weigh at least 10 pounds, right?) The nurse scribbles the number down on your chart, maybe making note of your height, too.

And then what happens?

In most cases, apparently, nothing much.

Yesterday the STOP (for Strategies to Overcome and Prevent) Obesity Alliance released data from recent research. It showed that while the vast majority (89 percent) of the 290 primary-care physicians surveyed felt responsible for helping patients manage their weight, most (72 percent) say they lack the resources and training to effectively counsel their overweight and obese patients.

And while most of the 1,002 adults surveyed separately said they take responsibility for their own weight, most don't feel they receive adequate weight management guidance from their physicians. Of those with a BMI of 30 or above -- the standard cutoff for obesity -- only 39 percent said a health-care professional had ever told them they were obese. Of those who had been told they were obese, almost 90 percent were told they should lose weight, but only a third were offered guidance on how to do so.

The STOP Obesity Alliance also issued a "white paper" yesterday that spells out potential remedies to these and other problems in the primary care physician-obese patient relationship. The organization notes that it's important to get a handle on the problem, because nearly 34 percent of American adults are obese, and an additional 34 percent are overweight, according to the CDC.

But as this article makes plain, doctor-patient conversations about weight aren't always straightforward exchanges of information. They can be so weighed down by emotional baggage that they're painful for both parties.

I'd like to hear about how your physician addresses your weight -- if he or she does so at all. Have you had a painful -- or a positive -- experience discussing how much you weigh and what you should do about it? Weigh in with a comment -- and please take today's poll!


Let's tweet! The other Local Living writers and I are on Twitter at @wposthome/local-living. And keep track of my "Me Minus 10" effort to lose 10 pounds before I turn 50 at twitter.com/jhuget.

And join me and "Feed the Belly" author Frances Largeman-Roth for a chat Thursday at 1 p.m. ET on eating healthfully while pregnant.

By Jennifer LaRue Huget  |  March 17, 2010; 7:00 AM ET
Categories:  Me Minus 10 , Nutrition and Fitness , Obesity  
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Comments

My doctor once told me I was obese.

I said I wanted a second opinion.

He said: "Your ugly, too."

Posted by: lostinthemiddle | March 17, 2010 11:31 AM | Report abuse

While I have never been overweight, I have fluctuated within my healthy range on the high end of the spectrum. When I have been on the high end during a physical, my doctor has taken notice, and brought it to my attention (not that I hadn't noticed as well). He asked if there have been any changes to my lifestyle, and if there's anything that he should know, or can do to help.

I respect him for that, and have referred friends to him, especially overweight and obese friends. Many of these folks are oblivious or in denial regarding the amount of weight, and the detriment that it can have on their health.

I realize that people come in all shapes and sizes, but it's untrue when people use that as an excuse to sit on the couch and eat highly processed foods. I also realize that health issues can deter exercise. I believe that it is a physician's responsibility to discuss the ways in which less active and disabled folks can stay active and healthy.

Posted by: MzFitz | March 17, 2010 11:38 AM | Report abuse

I absolutely REFUSE to get weighed at the doctor's office. I only go to the doctor about once every five or six years for a "check up" and refuse all their stupid tests like blood or urinalysis, which I view as their way to make more money off me. The last time I went, because I'd been coughing and felt I may have had bronchitis, the doctor launched into a harangue about my refusal to do the tests, and kept saying "you need to have a colonscopy." I said, "really, will a colonscopy diagnose bronchitis?"

They also blame everything on my weight (I am 5'8" and weigh maybe 165, which I know is like 40 pounds too heavy, but I've not actually weighed myself in over 12 years. I wear a size 14, can run 2 miles in 24 minutes and have 108/60 blood pressure....)

So if I say, "I cannot hear out of my left ear," she says, "you need a cholesterol test, a colonscopy and to lose weight."

We are at loggerheads.

Posted by: khachiya1 | March 17, 2010 11:42 AM | Report abuse

This article (and doctor office weigh ins) are completely useless to me. I'm an athelete. BMI doesn't say squat about me because of my muscle density. Yes I have had one ignorant doctor bleat some crap to me. But the rest recognize that I am smaller (physically) then they are and that I do run 4 miles every day. sigh.......

Posted by: hmmmw | March 17, 2010 11:54 AM | Report abuse

As a child I was ill and overweight. My family doctor harangued me repeatedly about it saying things like "You'll never get a boyfriend if you don't lose weight." He did nothing whatsoever to help me, only made me more depressed and hopeless.

The constant weigh-ins made me so upset that now, as an adult, if I am asked to step on a scale at a new doctor's office, I say, politely, "please write on my chart--I am not to be weighed." No one has ever insisted.

I have friends who have gone to doctors who refuse to treat them, for illnesses unrelated to their weight, until they lose x number of pounds.

Given how little we really know about how to help people lose weight and stay a healthy weight, and given the newest discoveries about adenoviruses, the stress/cortisol/fat connection, and how certain foods rewire the brain to overeat, the medical establishment lags behind, repeating the "eat less and exercise more" mantra--good as far as it goes, but only a part of the picture. Doctors seem to have no trouble accepting that a thin person is "naturally thin" because of good genes or metabolism. But if a person is fat--it is naturally their own fault and they are to be scolded and shamed.

Posted by: Woodwose | March 17, 2010 12:43 PM | Report abuse

Is there no end to the nanny state?

How hard is for people to take some responsibility for their own lives. "No physician told them they were obese". Give me a break. Look at yourself in the mirror and get on a scale.

Want to lose weight- consume fewer calories then you expend. Which simply means exercising more and eating less. DOn't need a medical degree for that. What people are really hoping is that their physician will give them a magic pill that will allow them to eat as much as they want do no exercise and lose weight. Come to think of it that is exactly what people expect from the health care system.

Posted by: rds7481 | March 17, 2010 2:00 PM | Report abuse

Sadly, Woodwose, my experience with pediatricians and weight was similar. I have a disorder that caused early puberty: this means that I stopped growing early, and developed curves early. My parents were horrified, and tried to starve the genie back into the bottle - with the full approval of my pediatrician, who should have known better. He actually prescribed an extremely low calorie diet - below 800 calories a day. I was within the normal weight range for my age even at that point, and I exercised a huge amount (I ran a couple of miles every morning and participated in plenty of sports).

Needless to say, I ended up hospitalized and my metabolism was destroyed. I still have the hormonal disorder, but now I also have a legacy of not only overweight but also gross distrust of doctors. Not that any of them has ever made a practical suggestion regarding my weight, nor have any of them looked at what (outside of the usual) might be causing the problem. They just note the endocrine disorder, tell me I'm fat, and shove me out the door. Granted, I have none of the problems that they expect to see with fat: no cholesterol issues, no diabetes, no blood pressure issues. Which suggests that this might be the way I am, rather than a disease state. But good luck telling the doctor that.

Frankly, I think doctors may be the last people who should have a role in anything having to do with weight. They can't deal with the issue productively.

Posted by: BadMommy1 | March 17, 2010 2:12 PM | Report abuse

I was just out of college and weighed about 128, I am 5'4". My doctor took one look at the scale and told me I was too heavy. She said if you start carrying that much weight this early you are going to be sorry when you are older after having children, etc. I was about to respond but first took a good look at her and realized she spoke from experience. I am now in my 40's post kids and still weigh less than my 128 high water mark of 20+ years ago. That brief remark made the world of difference for me.

Posted by: SaintPaulMN | March 17, 2010 3:17 PM | Report abuse

Many medications are dosed based on weight.

Posted by: josephkenny77 | March 17, 2010 3:57 PM | Report abuse

As someone who generally eats well, exercises regularly and still struggles with weight, I welcomed it when my GP talked with me frankly about the dangers obesity and suggested ways to manage my weight. I knew I needed help to get healthy. The problem? My health insurance does not cover or contribute towards anything having to do with weight loss. My physician had referred me to nutritionist to help me manage my weight, but my weight had not yet lead to diabetes, heart disease or another similar chronic disease my insurance refused coverage. THAT seems to be the big disconnect to me. I'm still maintaining a healthy lifestyle and trying to loose weight, but imagine I would have better, more sustainable success with the help my doctor recommended.

Posted by: kDC3 | March 17, 2010 4:40 PM | Report abuse

I work as the health educator at a rural community clinic in West Virginia, where virtually all of our patients are obese and most are diabetic. Although our providers do offer the patients referrals to me for lifestyle counseling in hopes of improving their health outcomes, I'm lucky if one in ten accept the offer. Then I'm lucky if ten percent of those actually show up for their appointments. My best patient so far was a recent transplant from DC. We have serious cultural issues to overcome here.

I suspect that many practitioners have received so much pushback from their obese patients when they have tried to discuss the subject that that have simply given up trying--who has the time? Add the fact that most insurance companies provide no reimbursement for wellness education, and it's no wonder doctors don't bring it up.

Posted by: swmuva | March 17, 2010 7:50 PM | Report abuse

SaintPaulMN -- Your doctor told you that you weighed too much at 5'4" and 128? Hmm...That confuses me. I'm 5'4" and weigh about 125, and I think if I lost 10 pounds I'd be too thin. I'm not sure if it's a matter of body structure or ideas about what an ideal weight is. As for the original post, I was overweight in college and my doctor gave me positive feedback when I dropped from 160 to 130.

Posted by: shantybird | March 19, 2010 11:49 AM | Report abuse

I refuse to be weighed when I go to the doctor. I'm slim, but getting weighed is an issue for me. It would be nice if I weren't hung up about it, but I know too that I would avoid going to the doctor when I should if it meant I had to face the scale, so I accommodate my hang-up.

But I also believe the ritualistic weigh-in is pointless. It's obvious by sight if a person is overweight enough for it to be a health issue.

Regarding the comment that many medications are based on weight, most medication is one size fits all. Or the doctor will just adjust based on you being an exceptionally small or large person (again, obvious enough by appearance).

A few medications, like anesthesia require accurate weight for dosage, in which case, I'd get on the scale.

Posted by: Nutmeg2 | March 19, 2010 5:53 PM | Report abuse

In all seriousness, nutmeg, you seem to be missing the point of the weigh-in. What is obvious by sight at the time of the visit is not obvious to someone subsequently checking your records. The point is to have a history of your weight. When a medical practitioner can see you as part of a life-long continuum, it is easier to detect patterns, note anomolies, and just track the progress of your health. All of those things aid diagnosis and detection.
That knowledge is probably not going to be enough to overcome your "hang-up". I hope it is enough, though, to make it clear that the notion of the weigh-in as a pointless ritual is far from accurate.

btw, I'm in full agreement that it is better to go and not be weighed, than not to go at all.

Posted by: lostinthemiddle | March 20, 2010 11:22 AM | Report abuse

This is a timely post, given the current debate in Congress on healthcare reform.

I think that the current discussions about healthcare are shortsighted. They do not look to the future.

Healthcare initiatives to date have focussed on providing healthcare to the needy. This is good. But what about addressing the prevention of ill health. Poor personal health practices is responsible for creating the need to address healthcare at this time.

It is said that it is better to teach a starving man how to fish than it is to give him fish to eat.

Much has been written about the obesity epidemic. Obesity, of course, leads to ill health and exacerbates the need to address healthcare.

Why is noone talking about educating children in the subjects of fitness and nutrition in schools? Doing so would contribute to improved health in future generations and therefore diminishing pressure on the healthcare system in the future.

In the meantime, a way needs to be found to educate the current generation in these matters . Information similar to that which is contained in the following articles needs to be taught to the general population.

Fat Burning Nutrition

Fat Burning Diet

Fat Burning Exercise

Posted by: fatburninganswers | March 21, 2010 9:10 AM | Report abuse

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