Let’s Go To The Doctor! Part Two: On being weighed.

I don’t do scales, spoken cheerfully, brightly. With a smile.

This is my automatic, comfortable response, these days, when I visit a doctor’s office. There are really only four reasons I typically find myself at the doctor’s office, and they are, in order of frequency: because I need a new copy of the prescription for my allergy meds; because it’s that time of year when I’m having basic preventative maintenance; because I have a question; or because I have the flu. I haven’t had the flu since 2007 — touch wood — so the primary reasons are scrip refills, annual physicals, or random questions. Nevertheless, I get asked to step on the scale almost every time I come in. You’d think a cursory perusal of my chart would indicate, hey, there are NO WEIGHTS written down here! Going back years and years! But no. They still ask. I assume it’s just kneejerk, like taking your pulse and temperature. It’s what they do.

Fortunately, I’m okay with being asked, now. It took me awhile to be okay, and the process began when somebody told me, many years ago, that you can refuse to be weighed. It’s true. You can say no. For someone like me, who’d spent her life with a mortal terror of doctors and scales, and who’d nonetheless been intimately acquainted with their use — often weighing myself multiple times a day during my dieting childhood — this was a revelation. What? I don’t have to do something the physician’s assistant asks of me? I have a choice? Incredible. Particularly considering that my scale-phobia had historically kept me from going to the doctor for many issues I really should have seen to much earlier. I could force myself there for an annual physical; I was good about that. But once a year was my limit, and even then I was prone to withholding symptoms out of fear that the doctor would blame my weight. For example: I only discovered I had undiagnosed asthma when an attack landed me in the emergency room in my mid twenties. I thought the occasional wheezing and gasping for breath was… normal? It was mild enough, and seemed to go away eventually. Certainly nothing worth facing a scale over. Until the morning came when I couldn’t breathe at all.

Even in the ambulance on the way to the hospital, oxygen mask strapped to my face, feeling disoriented and frightened, looking out the back windows at the parted traffic left in my wake, I vividly remember thinking, Well, at least they probably won’t try to weigh me first in the ER.

True story.

Hence, discovering I was allowed to refuse the scale was a big deal. It meant I could go to the doctor with only moderate anxiety, instead of the debilitating, paralyzing anxiety I had done battle with for as long as I could remember. It gave me some small degree of control over my engagement with the medical world, even if it was primarily symbolic. It made me recognize that I had rights, as a patient, and those rights deserved to be respected. Oh, I had my failures. My first year of scale-refusal attempts (almost all of which took place at Planned Parenthood, as that was my cheapest option for getting checked out and purchasing birth control pills in a time when cheapness was important) were a string of dismal defeats. They went like this.

Nurse: “Okay, please hop up on the scale.”

Me: (twitching & terrified, as though I’m watching a speeding bus bearing down on me, and speaking in a voice audible only to dogs) “Um, no.”

Nurse: (confused) “Excuse me?”

Me: “Okay.” (gets on scale)

This happened again and again, for two years. It was so very disheartening.

Right about now, some of you are starting to wonder: hey Lesley, why don’t you want to be weighed? It’s true that not all fatties have problems with the scale; indeed, it’d be inaccurate even to suggest that all size-acceptance activists have problems with the scale, as I personally know many who don’t.

But I ain’t one of them.

The fact is I have scale-related trauma going back to some of my earliest memories. Not just at the doctor’s office, but at Weight Watchers, Jenny Craig, and every other diet plan I’d ever participated in. To start with, my experience has always been that in receiving medical care, every appointment can be divided up into the time before the scale and the time after. Before the scale, medical professionals tend to respond positively to my cheery doctor’s-office demeanor. We chat and joke. After the scale, their response invariably changes. They get quiet, less responsive, even somber. I won’t argue that this is true of every fat person, or every doctor’s office, but it has happened repeatedly throughout my doctor-visiting life. As if once they see how very fat I actually am, expressed in triple digits, something changes. And it’s really, really distressing to be on the other end of that. Not being weighed means I am typically treated like a three-dimensional human the entire visit, and not like some pathologically ill chunk of meat.

I have also many more personal reasons for refusing to be weighed. I’m not going to get explicit about my personal reasons here, because, to be frank, I don’t fucking have to explain myself unless I choose to do so. Neither do you. That’s the beauty of privacy. It will have to suffice to say that the inevitable and persistent mental and emotional damage, often lasting for weeks or months after the fact, that is done to me by getting on a scale — and yes, it happens even if I am facing away from the numbers — far outpaces any possible benefit a medical professional can gain by knowing the exact number of pounds I weigh on any random doctor’s office visit. I am weighed when there is a clear and measurable need for it: to prescribe the proper doseage of a certain medicine, for example. But I am not weighed as a matter of course, because, simply put, that does far more harm than good.

Finally, it was on my very first visit to my current doctor — this would have been circa 2000 — that I decided I was going to stand my ground. I went in for my first appointment and was met by a friendly young man who led me down the labrynthine halls toward the assigned examination room. I clenched my fists, breathed deeply; I could do this. He stopped suddenly outside a small room with a scale near the door. “The room we’re going to be in doesn’t have a scale,” he explained, “so if you could just–”

“No.”

He paused, cocked his head at me, perplexed.

“No.” I said it louder. I knew it sounded desperate. I was shaking. My heart pounded like a earthquake through my whole body. I felt nauseous from the fear. And I suddenly realized the patently obvious fact that he could not force me to get on the scale. For one thing, he was a lot smaller than me. And even if he wasn’t, I suspected that the employment of bodily force to weigh someone was frowned upon in most doctor’s offices. In that moment I experienced one of the more radical epiphanies of my life, when I discovered that all I really had to do was simply stand still. I’d spent years trying to devise explanations and excuses that would convince medical folks to somehow understand or withdraw their scale-related requests, but I didn’t actually need them to do either. All I had to do was resist the (admittedly nigh-overwhelming) urge to follow instructions. All I had to do was not move.

He began to say something, “I don’t–”

“I’m not getting on the scale.” I planted my feet and willed gravity’s prodigious effects to keep me fast. We both just stood there for an instant, considering the situation. I’d like to say we faced off like two well-matched gladiators on the bloodstreaked floor of the Roman coliseum but in reality he just looked bewildered and uncertain and I was near-hyperventilating and visibly trembling from head to foot.

After a moment’s thought, he made a gesture that was half shrug, half nod, said, “Okay,” and then he led me to my exam room without another word on the subject. My immediate reaction was to shout “I HAVE TRIUMPHED!” and skip gaily out of the office right then and there, but I still had an appointment to keep. After finally managing to say no and keep my word, that first conversation about fat with my current doctor (a conversation I’d had with many other doctors in the past, with varying degrees of success) was a piece of cake. I explained that I was fine with being weighed for specific situations in which it was necessary, but that I did not want to be weighed every time I came in. I explained why. I explained that as a person who did a lot of sewing (and, uh, shopping) I am constantly aware of my body measurements — the act of being measured doesn’t affect me in the way that being weighed does — and asked him to trust that if I noticed any sudden and unexplained changes in my size, I would report them. And finally, I said, you know, it’s not like you need a scale to tell you that I’m fat. My doctor was understandably reluctant to agree to my conditions, but I can be quite persuasive, and in the end we reached an accommodation under the terms I’d suggested. I was lucky; not all doctors would accept a patient’s need to manage the weighing process. And I know it; this is why I have stuck with that doctor for nearly ten years, in all that time never once having been weighed in his office. Ten years of saying to various nurses and physician’s assistants — cheerfully, brightly, standing firm, “I don’t do scales.” Smile.

I am quite aware that this post will make people angry. Oh, it will make them so very angry. It’s about control. Just get on the scale, fatty! No. You don’t get to police my healthcare practices any more than you get to police the size and shape of my body or the things I choose to do with it or the food I feed myself. You don’t get to draw lines; I do. I made a decision based on knowing myself, and knowing what the experience of being weighed recalls, and what happens inside my head as a result. No one else can make that decision for me. If scales don’t bother you, then be weighed! Be weighed! Numbers are okay. Numbers shouldn’t be secrets. Numbers shouldn’t be shameful. And indeed, I have no problem with numbers — pounds or inches — themselves, in isolation of the weighing process. But we should all have the opportunity to create boundaries. And we should all have our boundaries respected. Even if they seem irrational to others. Even if they seem foolish.

No, I don’t do scales. Cheerfully, brightly. Smile.

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