Why "Just Change Your Weight" isn't Always the Answer.
Hi Friend,
Picture this... The medical assistant (MA) calls your name, you walk down the stark white hallway and are greeted by a scale. "Step up, please" instructs the lady in scrubs standing next to you. You wince at the thought of someone else seeing the numbers that will tell you your current weight. Will it have changed since the last time you looked at it, are you within normal limits? Is she going to judge you?
You grin and bear it and are quickly shuffled into a room to your left. You hoist yourself onto the krinkle papered exam table while answering the MA's intake questions absent-mindently, since your focus is still back at the number on the scale. She closes the door behind her and leaves you to wait for the practitioner.
Your appointment progresses smoothly until the doctor brings up your lab work. She shares with you some findings and gives you a new diagnosis. Her only recommendation is to lose weight.
You ask if there is anything else you could do to help improve your health considering your new diagnosis but the doctor shakes her head and just says, "you need to lose some weight."
You leave feeling a little overwhelmed and confused, having no idea how to follow the doctor's recommendation.
While this is a condensed and oversimplified example of how a doctor's visit might go, it does happen to people. While I am fully aware that some patients do need to lose weight, there is work to be done by the healthcare community when it comes to weight loss recommendations.
A simple "lose/gain weight" recommendation does not address how to go about the process in a healthy and sustainable way; what is an appropriate rate at which to lose/gain weight; are there issues related to body image or relationship with food that may greatly impact a person's ability to successfully lose/gain weight? what is the history there?
If you happen to be that patient who receives a weight change recommendation, whether it be to lose weight or to gain weight, I recommend you ask your practitioner a few questions, which are discussed below. I've also included a few questions to ask yourself to help you determine the best course of action for you.
Questions to ask your provider:
It's important to remember that the average medical school curriculum provides around 20 hours of nutrition education. That isn't a lot when you think about the amount of training a physician receives overall.
Questions #1: "Can I get a referral?"
If a practitioner recommends a weight change for you, I highly recommend that you ask for a dietitian referral to get specialized support on your journey. There is a plethora of contradictory information on nutrition on the internet and a lot of untrained people providing recommendations. This makes it extremely difficult to zero in on evidence-based information on your own.
Question #2: "Would you please take a blind weight?"
Many clinics don't think to offer to take a blind weight, where the patient steps on the scale facing away from it. However if you have an eating disorder it is important to take a blind weight. Seeing your weight can be triggering, discouraging, or promote eating disorder behaviors. Even if you don't have an eating disorder, blind weights can be an option if seeing the numbers distresses you.
Questions to ask yourself:
I highly recommend spending some time in personal reflection prior to implementing measures to change your weight. Aim for a bigger picture view of your lifestyle that will then allow you to identify where your focus should be to reach your optimal health. The questions below can help you uncover and gain a better understanding of underlying issues that may need to addressed.
- "Have I been feeling overly stressed lately?"
- "Is it appropriate for me to regularly and consistently move my body? If it is, have I been moving enough?"
- "Have I had my hormones checked?"
- "Have any of my medications changed?"
- "What are my thoughts around food? Am I experiencing associated confusion, shame, or overwhelm?"
- "What have I been taught about which foods are going to fuel me properly?"
- "Do I have the culinary skills I need in order to adequately prepare nourishing food for myself?"
- "Is there someone in my life who might help keep me accountable to gain/lose the appropriate amount of weight?"
- "Do I know if I have insurance coverage to see a dietitian for Medical Nutrition Therapy?"
Overall, it's important to note that weight changes should really be recommended for health purposes. Every body is different with a unique shape and size. No two people are going to look exactly the same at a healthy weight for them. Whenever you seek to change the numbers on the scale, just remember you really don't have direct control over whether they go up or down. You do have control over your behaviors. Focusing on behavior change is always the key for long term change.