Weighing our children

At the Kartini Clinic we tell our parents (over and over again) “Please don’t let anyone one, even another doctor’s office, weigh your child while they are in treatment here.”

Why not? Well let me tell you why not:

I walked into the exam room to see my patient, a young boy who had had a very rocky road to remission. He was barely stable physically and just had one toe in psychological recovery. He had struggled.

“I had a bad week” he told me in a quiet, shamed voice, “I had a melt-down in my pediatrician’s office. I cried. I yelled.”

“Why was that?”

“Because they weighed me.” He saw the expression on my face and hurried to add, “I told them not to, I begged them not to, but my parents were there and they said I had to let them.”

I was shocked. We have told all of our parents to defend their child’s right to refuse to be weighed outside of their treatment setting here.

You see, although pediatric medications are dosed by weight and if a four year old comes into the emergency room they will have to know approximately what he or she weighs in order to dose them properly, a teenager would simply get an adult dose. This boy was a normal sized, slender teenager. They did not need to know his weight. Someone just wanted to “fill in the blank” on an office form.

I looked at the father. “Don’t you remember how we ask that you help your child tell their other providers not to weight them? Kids need our help saying no to another adult who may not understand what they have been through.”

“Well, they wanted to know,” the father said, “and, besides, they made an effort to do it just right. They weighed him in a gown with his back to the scale and they didn’t tell him. They just wrote it down and then told us.”

Before I could respond, the boy said: “I was so embarrassed. I was really ashamed. I knew I weighed more than I had before I got treatment and I knew they were thinking about how much weight I had gained.”

There is literally no reason for a general pediatrician, or even a non-eating disorder sub-specialist to have to know a person’s weight. They can see at a glance if it is a major problem either way, and, if they still feel they must have the number for their records, they can call us after the child has left. That way the child is spared the humiliation of everyone knowing their weight in a setting where this is not the norm and spared the anxiety that being weighed ceremoniously in front of many adults can engender.

But the boy went on: “And now I know I’m fat! I’m fat! I now know how much I weigh and I’m going to lose it all!” He grabbed his imaginary roll of stomach.

“How do you know how much you weigh?” I asked, confused, “I thought they didn’t tell you.”

He hung his head, “They didn’t. After they weighed me they all left the room so I could get dressed, but they left the scales in the room and so I just jumped on them.”

Of course.

This little vignette does not do justice to how distressed our patient felt, or how angry and frustrated I felt. How can we convey to people the importance of limiting exposure to weigh-ins outside of the clinic? This caution goes for weigh-ins at school, in PE class, on sports teams, in physician’s offices, dietician’s offices, therapist’s offices and ?above all—at home.

Remember, for the sake of the kids:

No one weighs me but my Kartini doctor. No one.