Scared of the Scale

I hated being weighed at the doctor’s office, so much so that for a long time I would avoid medical visits unless absolutely necessary. Once I learned that I could refuse being weighed, I was more comfortable making appointments. And, now I’m fine with it, although, as I have blogged previously, residual fear remains.

The fear of the doctor’s scale is apparently pervasive among women. According to research reported in the the NY Times’ article The Dreaded Weigh-In, “…women experienced high degrees of discomfort at the prospect of being weighed in the presence of others.”

” ‘Weighing concern may make these women, particularly those who are overweight and already at risk for certain ailments, less likely to visit a doctor,’ ” said lead author Andrew B. Geier, a doctoral candidate in the department of psychology in Penn’s School of Arts and Sciences.”

Mr. Geier suggests putting the scale in a private place, so that the numbers aren’t visible to every patient at the doctor’s office. That’s a good idea, but it doesn’t go far enough. I wasn’t just worried about other people seeing my weight; I was worried about seeing it myself. I didn’t want to be weighed at all. I felt I would be judged by the nurse weighing me and then by the doctor when she reviewed my chart.

Considering my lifestyle change, it’s clear that I now fully appreciate the benefits of maintaining a lower weight. But, I believe that in addition to scale privacy, giving patients the option to refuse being weighed is a better way to go. My recommendation is that patients are first asked if they’d like to be weighed. Then, if they say yes, they are taken to a private location to do it.

It’s more important that women go to the doctor than it is to record their weight. Docs can generally tell if a person’s too heavy by looking at them, so the conversation about health concerns related to weight can happen regardless of whether there’s a specific number to discuss.

Even more important, not focusing on a number opens the door to a broader conversation, covering topics such as exercise habits, work/home issues, and the actual food choices –fruits, veggies, whole grains, etc. – the person is making. After all, good health goes well beyond a person’s weight; it’s about the lifestyle practices that usually lead to the weight. Talking about those practices is much more likely to lead to a healthy patient than fixating on a number will ever be.

Even a Little Bit Helps

I’ve mentioned before how important exercise is for a healthy body.  So often, we think of it only in terms of being firm and toned, but there’s so much it does internally to improve our body’s functioning, keeping us living high-quality lives now and in our later years.

This is borne out by yet another study, which reveals that being moderately fit cuts stroke risk in both men and women.

The University of South Carolina’s Prevention Research Center in Columbia has released results of research on more than 61,000 adults at the Cooper Aerobics Center in Dallas. After taking a treadmill test, the participants periodically answered health surveys.  While participants were mostly white, well-educated and middle-income or higher, there was an unusually high proportion of women included; about a quarter of the participants were female.

Stroke is the third leading cause of death in the U.S., and up to now, most of the research on it focused on men.  But there’s good news for both genders.

“Being merely moderately fit — walking briskly half an hour a day — can lower the risk of having a stroke.”

“The study found that men in the most fit group had a 40 percent lower risk of stroke than the least fit men. The most fit women had a 43 percent reduction in their risk of stroke compared with women in the least fit group.”

“For moderate levels of fitness, the risk reduction ranged from 15 to 30 percent for men and 23 to 57 percent in women.”

We frequently create roadblocks to exercise by thinking that we don’t have enough time or money to do it any meaningful way.  This study shows that we can achieve significant health benefits just by walking at a brisk pace for about 30 minutes five days a week.  That’s not a lot of time, and walking doesn’t require any special equipment either, just a good pair of tennis shoes. 

The next time you start to talk yourself out of exercising, remember that even a little bit helps.

Weighty Conversations You’re Probably Not Having

In my last post, I discussed my phobia about getting on the scale with a new doc even though I’ve lost 114 pounds. That longstanding worry will probably abate over time as I adjust to the “new me” whose weight is within normal ranges.

There’s another issue related to weight and doctors, though, that was highlighted in the latest article from the LEAN PLATE CLUB. The thrust of the article is that doctors and patients have trouble talking about weight. It’s true. When I was fat, I rarely had a doctor talk to me directly about my weight, and when they did, they merely told me I needed to lose some. That was it.

I’m very disappointed about having to change doctors because my last one, Dr. Adams, really engaged with me about my lifestyle change. First, Dr. Adams was fit and healthy (at least outwardly) herself. Second, she actually talked to me about how I’d lost so much weight, what I did for exercise, what I ate. She discussed it with me in depth, even calling in her nursing assistant to tell her what I’d accomplished. She ordered additional tests for me so I could better gauge how healthy I was. She truly cared about what I’d done.

Maybe that doesn’t surprise you, but it sure surprised me. The doctor I had before Dr. Adams barely acknowledged what I’d done. She was a lovely lady and seemed to be more than competent. But, other than saying “good job” when she saw I’d lost a few pounds since the last visit, she never said anything else about my weight loss. She didn’t ask me what I was doing, didn’t check to make sure I was doing it safely and healthfully. She was just not that interested. In my experience, she is the rule; Dr. Adams is the exception.

Part of this is due to our health care system. Doctors are time-crunched before they even see their first patient. They have to maximize the ten minutes they have with us by focusing on critical issues.

Part of it, I suspect, is also due to the fact that so many people are overweight and out of shape. It’s frustrating for doctors. As the LEAN PLATE CLUB article relates, they “…can simply feel exasperated at the yo-yo dieting that is frequently the norm among their patients.” The doctor quoted in the article described “… how he lost his temper with a 39-year-old man. The man had shed 18 pounds — and normalized his blood pressure — only to regain all the weight a few months later.” This doctor sees several patients with weight-related complications, so it’s discouraging for him.

The result?  Some doctors just don’t talk about it. Others try a “tough love” approach that doesn’t seem to work either, at least according to members of the LEAN PLATE CLUB. Tough love probably wouldn’t have worked for me either. What would have worked? Well, as the article says, “… an honest discussion between doctor and patient that acknowledges the struggles — as well as the rewards — of shedding pounds” would have been great.

Now, though, that I’m not reluctant to talk about it, I’d like to find another doctor like Dr. Adams… one who lives what she preaches and can help me do even better with my lifestyle change. I’m still looking.