Healthcare series: First blind weigh-in experience

Many are opting out of doctor's office weigh-ins as awareness spreads that health can in fact coexist with all body sizes. Some opt-out due to anti-"diet culture" and Health at Every Size (HAES) movement solidarity.

"Diet culture" is the trendy commoditization of unattainable body standards. It's understandable many fear fatness and obesity amidst such marketing messages. Those fears are further fueled by unscientific beliefs that wrongly equate body mass index (BMI) with health.

BMI was not created by a doctor or health expert. It was founded by a mid-19th century Belgian astrologer, Lambert Adolphe Jacques Quetelet. In 1812, he wrote A Treatise on Man and the Development of His Faculties about the perfect weight-to-height ratio for a white European man.

But the book is about man, not woman or all people. This exclusionary system designed by a non-health expert is the foundation of the BMI used by professionals today, two centuries later.

Ultimately BMI enables stigma and unequitable healthcare barriers. High BMIs tend to cause fewer health complications for Black people compared to white, but Black women experience the highest obesity rates. Weight bias perpetuates racism against this group as fat, unhealthy, and lazy. In reality, Black women are none of those things. They disproportionately live near poor water systems and polluted air, and their consistently lower socioeconomic status, which prevents their access to decent healthcare.

I'm not a white European man from the sixteenth century, so that alone will probably mean the BMI scale cannot work for me. Add in that I'm an athlete, and muscle weighs more than fat, and there's a recipe for BMI disaster. So I don't want to get weighed at the doctor's office anymore.

That's not an uncommon decision anymore. Starting in 2021, a body positivity nonprofit in California created free “Don't Weigh Me” cards for patients to give to their medical professionals to forgo the weigh-in altogether.

Skipping the weigh-in isn't practical for everyone. Some, like myself, have health conditions requiring a doctor to monitor their weight.

Blind weigh-ins offer an anti-BMI compromise. The patient intentionally turns their back on the scale so they do not know the number.

A 2020 study concluded blind weigh-ins "significantly reduced" anxiety in patients with eating disorders, and as an anorexia nervosa survivor I was optimistic it could work for me as well. I was anxious too--worrying the nurse would judge me for requesting to be weighed blind. (Disclaimer: The nurses get all kinds of requests, and the last thing on their mind is judging me. And if they did, their opinion of me is not my business).

I reminded myself the ignorant bliss of not knowing the number would outweigh the temporary discomfort of asking the nurse. I didn't want my weight to impact or quantify my self esteem that day or in the coming weeks. My weight, no matter the number, never quite feels “just right” for me. I was proud when it was over. I'd done it.

Actively rejecting "diet culture" and its ideals takes time.

Blind weighing is a small rebellion against weight norms and societal expectations. Other rebellions include: Not indulging others' "indulgent" comments while eating (a.k.a fuelling), and reminding myself that health is not necessarily the same as the media’s portrayal of beauty.

TLDR: The online bill came through the portal, which housed my weight front and center on the home page. Self criticism abounded.

The lesson: My optimistic intentions cannot eradicate anxious spirals and disappointing results. Especially when I'm acting within a healthcare system that is not built to validate or support my mental health needs.

The takeaway: My first blind weigh-in experience wasn't just disappointing or just affirming of my personal bias to distrust the healthcare system at large.

Life is more complicated than just one takeaway or feeling. I learned in therapy that multiple feelings can be true and valid at once.

I can be simultaneously disenfranchised with a flawed healthcare system and uplifted by the individual professionals who have treated me with compassion. I can use this to prepare me for future visits, by asking a loved one to log into the portal for me, or paying the bill in person. If it sounds like blind weighing may be for you, then you can be prepared now too.