Listen, we know you don’t want to go to the doctor—because, well, no one does. (Raise your hand if you’ve been personally victimized by the endless stream of yacht rock coming from the speakers.) It’s especially burdensome, though, for anyone living with overweight or obesity. Maybe you’re anxious to talk about or even know your weight, or you’re worried that you’ll be judged or dismissed.
Those are very real concerns, and they explain why having a higher body mass index is associated with avoiding medical appointments altogether. Still, everyone needs and deserves healthcare. This guide will help you navigate your visits with a little more confidence and ease, so you can get the best treatment possible.
Set an agenda
Every meeting should have an agenda, and doctor appointments are no different. Write down a list of the questions and concerns you want to cover ahead of time, says Dr. Alexa Mieses Malchuk, M.D., district medical director and primary care physician at One Medical in Cary, North Carolina. “You may not be able to cover every topic in one visit, so focus your list on your highest priorities.”
Part of the agenda should also include what you want the visit to accomplish. Do you want to learn more about your A1C? Check your cholesterol levels? Get a referral to a specialist? Remember: If you are living with overweight or obesity, that doesn’t mean it has to be the subject of every appointment. If you want to talk about seasonal allergies, you don’t need to talk about BMI too.
Be your own advocate
Everyone should feel empowered to speak up for themselves at a doctor’s appointment, and this is especially critical for people living with obesity and overweight. It’s easy to internalize weight stigma and bias from others, and buy into the false narrative that obesity is somehow the fault of the individual. (In reality, research shows it's a complex disease caused by multiple factors, none of which include willpower.) This can make it difficult to speak up in a medical setting. Follow the checklist below to best advocate for yourself:
Just say no
This may come as a revelation, but you don't have to say yes to your healthcare provider. If you’re asked to do something that makes you uncomfortable, like changing into a paper gown, you can simply decline, says Malchuk. This includes stepping on the scale. If the issue is about getting weighed in front of others, you can ask about recording your weight privately; if it’s that you don’t want to know the number, you can always ask your provider not to share it with you. Either way, don’t be afraid to voice your preference.
Keep your own records
Ideally, your medical care is part of a larger, centralized network—meaning, all of your healthcare practitioners have access to all of your healthcare records. If that’s not the case, it’s a good idea to keep a digital copy for yourself, along with a memo of your health history and current medications. “Most people just mention their prescribed medications,” says Malchuk, “but patients should include nutritional supplements and over-the-counter medications as well.”
Bring backup
If your agenda includes having a difficult conversation with your doctor—about your weight, your mental health, anything—consider inviting a friend or family member, says Malchuk. They can take notes as you listen, help you implement the advice afterwards, or simply be by your side. Not sure if your clinician’s office allows that? Just give them a quick call beforehand to check.
Collab with your provider
Your health plan shouldn’t be dictated by anyone—it should be a collaborative effort between you and your clinician, says Dr. Robert Kushner, M.D., a professor in the departments of medicine and medical education at Northwestern University Feinberg School of Medicine in Chicago. This shared decision making is “a process whereby healthcare providers take into account each person’s personal preferences, priorities, and goals before selecting a specific treatment plan.” If you feel like you're not an active participant in your care, tell your provider you want to be more involved. If you don’t feel like your provider allows you to be part of the decision-making process, find a provider who is more receptive.
Get more time
Do your appointments feel rushed? That might be…because they are. One study found that 56% of healthcare provider appointments were 16 minutes or less. To get the most from your visit, make sure you’re on time—a late arrival could result in a shortened or canceled appointment. You can also call the office ahead of time to ask for a longer visit. Sending your clinician your agenda before your visit can also help, as it gives them the opportunity to think through solutions before they’re in the exam room. If you don’t feel settled on a decision at the end of a visit, schedule a follow-up to give you and your healthcare provider more time to consider the options.
Always overshare
“There are no embarrassing topics,” says Dr. LaTasha Perkins, M.D., a family physician at MedStar Georgetown University Hospital in Washington, D.C. “A symptom you consider embarrassing may be connected to a serious issue, and we can't help you with something we don't know about.”
Case in point: bloody stool. It’s probably TMI on a first date, but not at the doctor’s office. It could signal a condition that requires treatment, like inflammatory bowel disease (IBD), says Perkins. “We're on your team. What you tell your doctor is confidential and will be protected, so feel confident that you can tell them anything when it comes to your health.”
So you want to talk to your doctor about weight-loss medication…
Although you can bring up your weight with your provider whenever you want, it’s best to do so during an appointment that is separate from, say, your annual physical, and dedicated exclusively to your weight goals. This way, your provider can take the necessary time to make a treatment plan with you—which may include prescription medication, if appropriate.
“You can also ask your healthcare provider for a referral to an obesity medicine specialist,” says Kushner. These are providers who are certified by the American Board of Obesity Medicine (ABOM), and who are “knowledgeable and experienced in the care of patients with obesity,” adds Kushner:
To prepare, write down your answers to the following questions, suggests Kushner.
- What is your main goal going in for this appointment?
- What has worked and not worked in the past to help you lose weight?
- What kinds of diet and physical activity challenges do you face?
- What kind of support do you have at home?
- What do you need before you leave today to be successful?
And if you don't feel like your provider is listening to your concerns or up-to-date on the latest advancements in treating obesity, consider talking to a provider at the new WeightWatchers Clinic. All providers are trained to give you compassionate care and personalized treatment plans, which may include weight-loss medications like GLP-1s.