Are you tired of your weight being a constant topic during doctor visits? Many people feel frustrated when their health is often reduced to just one number — the body mass index, or BMI. Despite its popularity, there’s a growing sentiment that BMI isn’t very useful for assessing overall health. So, what should you and your doctor focus on instead?
It’s not uncommon for doctors to bring up weight, but it can feel pretty disheartening. As a health professional who promotes body positivity, I often hear stories from patients who feel judged based on their size rather than treated as individuals. One such patient, Jessi Rice Greenlow, recalled that her childhood doctor visits revolved around her weight. Her experience shaped how she viewed herself and her relationship with food.
Fortunately, there are better ways to evaluate health than BMI. Evidence-based measurements like blood pressure, glucose levels, physical mobility, and mental well-being offer more comprehensive insights. So, let’s explore how you can guide these discussions next time you’re at the clinic.
Recognize the Limitations of BMI
A report released in 2025 highlighted that BMI doesn’t provide a complete picture of an individual’s health. Though it may be helpful in analyzing trends across larger populations, it often fails to capture the nuances of personal health. Recent resolutions from the American Medical Association also stress the limitations of BMI in clinical settings.
In my clinic, it’s a regular occurrence to treat patients who are categorized as “healthy” by their BMI yet suffer from serious health problems, while others may be labeled as obese yet maintain robust health. Sometimes, weight changes can even indicate health issues, like weight loss during cancer treatment.
Feel Free to Decline Weigh-Ins
It’s perfectly acceptable to tell your doctor that you prefer not to be weighed at every appointment. While some conditions do require accurate weight for treatment, you have the right to prioritize your comfort. If it’s necessary but distressing for you, consider discussing the reasoning behind it or requesting privacy regarding the number.
Direct the Conversation
If a conversation about weight feels unwelcome, have some phrases ready to steer the discussion towards what really matters to you in terms of health. You might say, “I’m not comfortable discussing my weight every time,” or “Can we discuss other health metrics instead?” Most doctors will likely appreciate your effort to broaden the topic.
Focus on Your Health Goals Rather than Size
When I meet with patients, I like to begin by asking what their health goals are. The perception of health varies greatly from person to person, and it’s important to find out what a fulfilling life looks like for them. For instance, some may want to eat more vegetables, while others, such as those recovering from eating disorders, might need to shift their focus away from food altogether.
Your health objectives can evolve over time; for example, caregiving might take priority over exercise, but later, maintaining fitness to prevent bone loss could become essential.
Patients like Greenlow are now seeing doctors who focus on their overall well-being rather than merely pushing them to lose weight.
Key Metrics to Monitor
When assessing health, address mental health first. A positive mood is foundational for overall well-being, so don’t hesitate to ask your doctor about mental health screenings or treatments. Additionally, regular physical activity offers numerous benefits, and it can be integrated into your day without needing to hit the gym.
Sleep is another critical area. Quality sleep plays a vital role in both mental and physical health. If you’re struggling with sleep, bring it up with your doctor; they might suggest helpful strategies like cognitive behavioral therapy for insomnia.
Consider Glucose Tolerance
I often screen my patients for glucose intolerance, which could potentially lead to diabetes. The Hemoglobin A1C test is usually my preferred option because it doesn’t require fasting and provides useful insights into blood sugar levels over time. If you have an elevated A1C yet aren’t at the diabetes level, regular exercise can help manage this without necessitating weight loss.
Assess Cardiovascular Risk
Understanding your cardiovascular health risk is vital. Traditional methods have used calculators to assess risk for heart disease, but there’s now a newer tool called the PREVENT calculator, designed to improve accuracy and even accommodate younger patients. If your doctor suggests medication based on a risk assessment, inquire about the specific calculations and factors involved.
Stay Current with Cancer Screenings
Make sure you’re up-to-date on recommended cancer screenings appropriate for your age and personal history. Essential screenings often include those for cervical, breast, and colon cancers.
