How to Advocate for Yourself at the Doctor’s Office If You Have a Larger Body

Fact checked by Nick Blackmer

Key Takeaways

• If you’re someone with a higher weight, health check-ins and appointments can quickly turn to discussions of weight loss.

• You have the right to request not to be weighed, and you can ask for treatment options beyond diet, exercise, or weight loss.

• Consider bringing an advocate to help reinforce your boundaries with a doctor.

Weight measurement is as routine a healthcare practice as checking blood pressure, but it’s not always necessary. If getting weighed makes you feel uneasy, remember: you have the option to decline.

“It’s important for patients to know that it is completely within their right not to be weighed. And it doesn’t have to be a fight,” Lisa Erlanger, MD, a clinical professor of family medicine at the University of Washington School of Medicine, told Verywell.

Erlanger is one of many healthcare providers who offer weight-inclusive care. As opposed to a weight-centric approach, this holistic model promotes safe and equitable health care for everyone regardless of their body size.

Providers who adopt a traditional, weight-centric model often use a patient’s weight to determine their body mass index (BMI) and assess their health status. However, the American Medical Association advises against using BMI alone as a health measure since it doesn’t provide a reliable health assessment on an individual basis, and it was developed with data primarily from non-Hispanic White people.

The journey to getting appropriate health care at every size starts with choosing the right provider. Sometimes, doctors might ask people with a higher weight to lose weight regardless of the purpose of the visit.

We asked a few experts to offer guidance on how higher-weight individuals can navigate the healthcare system and better advocate for their needs.

Finding a Weight-Inclusive Provider

Databases from organizations such as the Association for Size Diversity and Health (ASDAH), Bare Health, and Health at Every Size (HAES) can help locate a weight-inclusive healthcare provider.

Erlanger suggests reviewing a provider’s profile and looking for terms like “weight inclusive,” “weight neutral,” and “Health at Every Size” while watching out for phrases like “weight management” or “obesity treatment.”

“The approach to higher body size as a disease that needs treatment is not fundamentally compatible with weight-inclusive care,” Erlanger said.

For those seeking a weight-inclusive dietitian, phrases like “intuitive eating” or “anti-diet” can indicate that they’re aligned with HAES principles.

“Unfortunately, most dietitians really work from more of a weight-centric model,” Kimmie Singh, RD, a registered dietitian based in New York City, told Verywell. “If they are working with someone in a higher weight, they oftentimes are checking their body weight, recommending weight loss, setting a goal weight for that person, and then doing an inventory of what they’re eating.”

Singh recommends setting clear boundaries with your dietitian regarding weight monitoring and being forthright if a particular diet doesn’t align with your goals.

“If you don’t feel like a provider’s a good fit, you don’t have to stay with that person,” Singh added.

Asking for Appropriate Medical Equipment

Consider asking a friend or family member to join you during the appointment to help advocate for a weight-inclusive approach.

The power dynamics of the doctor-patient relationship can be daunting for people with larger bodies, who might not feel comfortable advocating for themselves, said Jennifer L. Gaudiani, MD, an eating disorders expert physician at the Gaudiani Clinic in Denver.

At her fat-positive clinic, Gaudiani emphasizes the importance of creating an environment that counteracts weight stigma. This includes providing armless chairs in the waiting rooms, exam tables that are low to the ground, and appropriately sized robes and blood pressure cuffs.

However, not all clinics have equipment that can accommodate all body sizes, and it can feel embarrassing to ask for a larger robe or blood pressure cuff if these are not immediately provided.

Erlanger said bringing a friend or family can be helpful in these scenarios. They can help ask questions or make requests on behalf of you.

Tip: Having the right cuff size is essential for getting a correct blood pressure reading, and it’s well within your right to ask for the appropriate cuff size.

“We should decline to have our blood pressure taken in a cuff that doesn’t fit,” Erlanger said.

Using Self-Advocacy Cards

Self-advocacy cards on the HAES Health Sheets website can help you establish boundaries with a provider. These cards outline why you don’t want to be weighed, explain that you’re following a HAES lifestyle, or articulate why you might need a longer needle for vaccinations.

You can submit these cards with your intake documents or hand them directly to your doctor. While a doctor might still try to discuss weight during the appointment, you have the right to ask for a different approach.

“When the discussion is veering either to weight or to food and exercise, if that’s not where you want to go, you could say, ‘How would you treat this in someone in a smaller body?’” Erlanger said.

If someone wants to change their diet or exercise routine before trying a medication, that is a valid option, but it should be up to the patient’s decision and never be the only option offered by a provider, she added.

“If you want to alter food or exercise or even try to lose weight, that is your decision. But other treatments shouldn’t be withheld from you while you do that,” Erlanger said. “Withholding evidence-based care for a trial of weight loss is one of the things that leads larger-bodied people to have a higher burden of disease, and then it’s blamed on their bodies in a sort of twisted way—a vicious cycle.”

What This Means For You

Finding a weight-inclusive provider can take time. If you don’t feel comfortable with a provider or the available treatment options, consider looking for a new provider.

Read the original article on Verywell Health.