The Big Pushback

In the past few years I've read articles about how one could refuse to be weighed when viisting the doctor. I don't even know why they bother with it if they aren't going to take into account body composition or other health factors. I know, the number on the scale is a quick, easy to obtain metric and at the same time we hear, "Don't put too much emphasis on the number on the scale!" See also: Pay attention to what you're eating, how much exercise you're getting and how your clothes are fitting. And yet... the number on the scale matters.

When that number kept relentlessly going up, and old tactics -- eating everything I usually did, just a little bit less, going easier on the desserts, walking regularly -- failed, I was baffled. When my lab results finally crept into prediabetic range, I knew something was amiss. I drastically changed how I ate, eliminating sugar and creamer from my coffee (yes, I put both in there!), tracking my protein intake, and increasing how much water I drank. I joined (okay, re-joined) the gym and hired a personal trainer. I was not going down that genetic path to Destination Diabetiss. I thought, what if I adjusted my diet as if I already had it? Like so many other things in life, why did it have to take a crisis for someone to want to change?

In a year, I lost 15 pounds. The monthly photos show my incremental progress and slowly shrinking waistline. Despite the advice that it takes about three months following changes to lower your A1C count, it took me a year. My genes are stubborn.

When I went to my OB/GYN office earlier this week for one of my many check ups in a long list of check ups (that will only increase as I get older), I decided I was not going to step on their scale. I entered the office brewing for a fight. I filled out their forms and voiced a complaint that they had my information already, and I didn't understand why I was providing it yet again, or why I needed to provide my insurance card when I had the same insurance last year. "Yes, we just want to make sure nothing's changed." "Whatever you say, data miners," I said with a hefty eyeroll (just kidding, I didn't say that). On these forms, there used to be a section to share how many sexual partners you've had. I wondered about the relevance of that. Did they really need to know your number? Did that affect how you would receive medical treatment? Did you have to do some kind of exponential formula to account for the idea that not only have you slept with a certain number of people, but you've slept with who those people have slept with, and so on? It made no sense. In addition to that, you get asked your relationship status. Oh sorry, is this Facebook or the doctor's office? It's complicated. Last year, when I was seprated but not yet divorced, there was no "separated" option. I'd been in that status longer than someone who had spent in an undergraduate institution earning a bachelor's degree and I didn't get a checkbox? I remember filling out the form in all caps with my commentary about that. This year the form had been updated. You could check "separated," which was funny, because I'm legitimately divorced now. No more limbo here! Another option was "Unknown," which I checked.

By the time I completed my patient information, and HIPAA and agreement to sign away the deed for my house if I missed an appointmennt without providing at least 24 hours notice, I was shuffled back to the exam room. I got the spiel, and the medical assistant asked me to step on the scale. Ah-ha, I thought, game on. Let's see what happens when you refuse to comply with the status quo.

"I'm not getting on the scale."

"We need to weigh you."

"Why?"

"Well, you haven't been here in a year and we need your weight."

"I'm not getting on the scale. What, you're going to weigh me with jeans on?"

"Well, we subtract two to three pounds for clothes," she said. (which is it, two or three? Do they weigh the clothes after you strip naked and put on the sad little patient gown?)

"Do I not have the right to refuse to be weighed?"

There was a pause. Aha. Question authority, people, especially when it's not actually authority but a medical care provider bullying you so they can fill in the blanks on their form.

She did not say no. She said, "I'm not trying to be difficult." Which, as a woman, I hate that she felt the need to say that. We are not difficult just because we ask for things.

"I'm not either," I said. "I have to have agency as a patient and advocate for myself. I can give you the weight from my scale. I was 162."

"That was this morning?"

"Yes," I said, even though it had been from the morning of the day before. What, we go from subtracting two to three pounds for clothes to suddenly caring about how recent it was? Oh, no, not from this morning, but fifteen years ago. Introducing the new series "Catfish: Medical office weigh in edition." Do we want to get into when their scale was calibrated, or if they care if you've already taken your morning dump? If you want to be precise, be precise in all areas, please!

She took my blood pressure and asked if it was usually lower than what she measured. "Yes," I said. Did you miss that we just went through this exchange where I had to fight entirely too hard for myself over something incredibly basic? What's missed is the psychological effect of the weathering we go through. Logically, I know the number on the scale doesn't matter, but when you are at a point in life where you are fighting your own gentics, and it no longer takes a week to lose a pound, but instead closer to four months, even the doctor's office weigh in can get to you. You can logically know you have done the work to set yourself on the right trajectory but that scale number could set off another tape reel in your head telling you there's been a setback in your progress. We can know that's not true but it doesn't necessarily prevent the rollercoaster of feelings you will have to endure. Pushing back was my way of skipping that noise. When I explained this to my personal trainer, a person with the ideal physique who puts me through rigorous workouts twice a week, she completely understood. "I may be a trainer, but I'm still a female," she said.

The appointment itself went well. I was trying out the nurse practitioner because I generally find they have a much more congenial bedside manner and are more attentive, and you can call them by their first name. I chose well, and I usually have a positive experience with the actual care providers. It's that gauntlet of paperwork (well, digital forms) in the front office followed by the insistence on weighing in and recording blood pressure that sinks me, but not this time.