Does Your Child Need to Be Weighed at Doctor's Office?

A North Carolina mom has gone viral after asking her child’s pediatrician to not discuss her 9-year-old daughter’s weight — but is weight management a doctor’s job?

It can be, the National Institute of Health (NIH) says, as “extra weight may put people at risk for developing type 2 diabetes, heart disease, kidney disease, stroke, and certain cancers. Research shows that even a modest weight loss of 5 percent can result in health benefits.”

And obesity in childhood can be detrimental to a person’s overall health, the National Library of Medicine (NLM) reported, with almost 19 percent of children affected.

“Obesity is associated with a number of immediate and long-term physical and psychosocial health consequences including hypertension, type 2 diabetes, sleep apnea, anxiety, depression, and low self-esteem,” the NLM says. “Thus, to maximize health and quality of life, it is imperative to identify, prevent, and manage obesity during childhood.”

But parents like Caroline Hardin, who told her daughter’s pediatrician she wanted “a body neutral and body positive environment,” are often adverse to discussing weight.

“Many providers…worry that parents will react negatively to discussions about their child’s weight and indicated that parental opposition to discussions about weight were disruptive to obesity prevention efforts,” the NLM says.

And those parents have a reason to be concerned about weight discussions. "There are concerns that obesity prevention efforts may lead to the development of an ED [eating disorder]," the American Association of Pediatrics (AAP) says.

It adds: “Most adolescents who develop an ED did not have obesity previously, but some adolescents may misinterpret what 'healthy eating' is and engage in unhealthy behaviors."

But the AAP doesn’t tell pediatricians to avoid discussing a child’s weight — especially when it presents a health concern.

Instead, the organization advises that doctors use inclusive language, ”using the term ‘child with obesity,’ rather than ‘obese child’ ” as “pediatricians and other [primary health-care providers] PHCPs have been — and remain — a source of weight bias.”

The AAP also says doctors need to consider other socioeconomic and racial factors, and focus on “nutrition counseling” over “a structured diet.”

Adults can opt-out of being weighed at the doctor — although some medications (like birth control) — require a person’s weight for correct dosing.

The same is true for some children’s medication, as even Tylenol’s dosing is determined by weight. As Time Magazine pointed out, “Pediatricians need to know how much kids weigh, at least periodically. But that doesn’t mean they need to talk about it in ways that cause harm.”

"Given the anxiety that patients often go through when being weighed, having a full metabolic panel is often an acceptable substitute," Dr. David P. Selzer, an internal medicine doctor at NYU Langone, told Well + Good. 

"Rather than focusing on one data point, our top priority is to ensure that each patient is comfortable during their appointment," he said.

And if there comes a time to discuss a patient’s weight, the NIH recommends that physicians “open the discussion about weight in a respectful and nonjudgmental way. Patients may be more open if they feel respected.”

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