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HomeHealthOverweight? Doctors putting less emphasis on the scale

Overweight? Doctors putting less emphasis on the scale



There’s been a shift in the approach of some healthcare providers when it comes to addressing (supposed) overweight patients.

Traditionally, doctors have often used weight, as measured by body mass index (BMI), as a primary indicator of health. However, recent research and experiences of patients have highlighted the potential harm of focusing solely on weight.


“Providers sometimes miss major health problems — in both people with larger bodies and those with smaller ones — when they’re too laser focused on a patient’s weight,” said Dr. Lisa Erlanger, who practices weight-neutral medicine and is a clinical professor at UW Medicine in Seattle, via PESI.

“There’s so many horrible stories … of diagnoses that were missed because the focus was on weight,” Erlanger exclaimed.

Here are key points as they relate to a patient’s weight and doctors’ advice:

The Impact of Weight-Centric Care: When healthcare providers overly focus on a patient’s weight, it can lead to misdiagnoses, delayed care, and emotional distress for patients. Some patients report feeling that their health concerns are dismissed, and they are advised to lose weight without addressing their specific medical issues.

Weight-Inclusive or Weight-Neutral Care: Some healthcare providers are adopting a weight-inclusive or weight-neutral approach to patient care.

This approach considers factors beyond weight, such as genetics, blood sugar levels, and overall health, when assessing a patient’s well-being.

Health at Every Size” Principles: Practitioners of weight-neutral care often subscribe to the principles of “Health at Every Size.” They emphasize that healthcare should be consistent regardless of a patient’s weight, and they do not recommend weight loss as a primary treatment for medical conditions.

Promoting Healthy Habits: Instead of focusing on weight loss, weight-neutral providers encourage patients to engage in exercise and consume nutritious food for the overall well-being of their bodies. They emphasize sustainable and joyful lifestyle changes.

The Challenges of Weight Loss: Weight-neutral providers point out that long-term weight loss is often difficult to achieve, with many individuals regaining lost weight over time due to hormonal changes that increase appetite and slow metabolism.

Individualized Approach: While weight-neutral care is gaining traction, some healthcare professionals in the field of obesity medicine believe that weight loss can still be appropriate in certain cases, such as for managing conditions like diabetes. They stress the importance of discussing weight loss as a treatment option in a sensitive and nonjudgmental manner.

Weight Loss Drugs: Some healthcare providers are using weight loss drugs, such as Wegovy, as a tool to help patients manage their weight when lifestyle changes alone prove challenging. Critics, however, highlight limitations like cost, availability, and long-term effects of these drugs.

Balancing Care: Regardless of the approach, healthcare providers should aim to ensure that patients with larger bodies feel heard, respected, and have their primary health concerns addressed in a sensitive and supportive manner.

Overall, some healthcare providers shifting away from a solely weight-centric approach to a more holistic and patient-centered model of care.

My unprofessional opinion: How do you feel? Bottomline.

Can you walk long distances and up the stairs without getting winded or having pain in your legs and feet? Do you amass an average of over 5,000 steps per day with ease? Can you keep up with your much thinner friends and family members when walking on the boardwalk or when you’re at the mall?

Although it would behoove most of us to lose 10 pounds, if you’re well over your BMI but don’t have pre-existing issues such as diabetes or high blood pressure, your size probably isn’t a health issue.

Again, that’s my unprofessional opinion. But, I’m obese according to my BMI and easily jogged a nice and steady 6 miles several days ago – all while still recovering from a sinus infection.

How many doctors can do that?

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