I posed this this very question to dietitians across America. I received a variety of responses, but the general consensus was that those dietitians working with children and/or eating disorder patients do not weigh them. I get that. No one wants to further complicate the state of mind of someone who is working through body image issues. Most of the dietitians polled put the emphasis on making long-term, behavioral changes and not so much on the scale weight.
I look at the scale as a catch-22 scenario. It can work for you or against you. If you are one of those individuals who have been compliant and made positive changes, yet see no difference on the scale, it can alter your disposition. You may: (A) get frustrated and give up, (B) work a little harder, or (C) reward oneself and overindulge. You have to know yourself well enough to gauge your reaction to the results.
More so than the scale, the BMI (Body Mass Index) disturbs me. It’s a calculation based on height and weight, and it determines whether you are underweight, normal weight, overweight, or obese. Physicians use it as a tool to assess a patient’s weight (and health) status. The problem with BMI is if someone is physically fit and carries more muscle mass than fat, then it can falsely place them in the obese category. Let’s face it, there are many athletes with optimal health profiles who would be considered overweight because of their BMI.
I suspect “waist circumference” will be replacing BMI soon. Visceral fat (aka abdominal fat) surrounds internal organs and research is finding it is closely associated with developing heart disease. The less harmful kind of fat, subcutaneous fat, lies under the skin and has less of a negative impact on health. You may be more likely to get health problems from this kind of belly fat. Measurements greater than 40 inches for men, or 35 inches for women are considered high-risk ranges.
Back to the scale! I can usually tell if a person doesn’t want to be weighed when they step in my office, but I always ask them, anyway. Some will tell me that they want to wait until the next visit, and I respect that. Often times, we end up chatting on why they don’t want to weigh in; once it’s out in the open, they end up wanting to get weighed. Just talking about it begins the emotional processing and something that they would have kept bottled up inside (to fester) gets cleared up. Most recently, a patient felt she had indulged through the holidays and was very upset with herself. We chatted and when she agreed to get weighed, come to find out - she had lost three pounds.
I also see weighing oneself as a checks and balance system-it helps you to keep an eye on your weight. Up a few pounds? You might think differently about grabbing those chips or maybe lacing up your sneakers.
One of the things I never agree on is when someone in their 50’s tells me they want to weigh what they did in high school. That’s hardly ever going to happen again for the majority of people. Body composition and metabolism change as we age. It’s a lot harder to manage. Having unrealistic expectations can sometimes set you up for failure. Slow and steady is always the best course.
As practitioners, we all agree that once you start to eat healthy and to exercise “how you feel” is an important gauge to success. How your clothes fit is another good measurement. It’s really more about the journey you take to eat healthy, change bad behaviors, get fit, and gradually lose weight that will help you to succeed in the long run. Your weight is just a number-it’s how you choose to let it play out in your head that matters.