What to Do When Your Doctor Tells You to Lose Weight

Navigating conversations about weight loss

When you visit the doctor, conversations about health can quickly shift to weight – even when it has nothing to do with the reason for your visit. If this sounds familiar, you’ve likely experienced weight stigma. Suggesting weight loss as a catch-all solution for everything from fatigue to joint pain does more harm than good. It can overshadow real concerns, lead to misdiagnosis or nontreatment of other conditions, and even discourage people from seeking are.

Your health is so much more than a number on a scale, and you deserve care that acknowledges the full picture. If your doctor brings up weight loss, it can be frustrating and disheartening, but knowing how to navigate those conversations can help.

Here are some tips to keep the focus on your overall wellness.

1. Don’t be afraid to ask questions

When a doctor suggests losing weight, it’s perfectly okay to ask for more information. Find out why your doctor is recommending weight loss and whether other factors are at play. Is the recommendation based on specific health markers, like high blood pressure or cholesterol levels? Or is it a general suggestion based on outdated body mass index (BMI) charts?

Meredith Nisbet-Croes, MS, LMFT, CEDS-C, national clinical response manager at Eating Recovery Center (ERC), encourages asking, “Is this the same advice you would give to someone in a smaller body with the same medical concerns?”

Questions like this can empower you to understand what’s really going on. That way you can determine whether there are more effective ways to improve your well-being that don’t rely on arbitrary weight goals.

2. Be cautious if you’re in eating disorder recovery

If you’re recovering from an eating disorder, weight loss recommendations can be particularly triggering. Here are a few ways Nisbet-Croes recommends working with your doctor to explore safer options:

• Let your doctor know about your eating disorder history so they can take it into account and tailor recommendations with your recovery in mind.
• Request alternative options that address your health concerns while protecting your progress in recovery.
• Lean on your treatment team and support people if weight loss or specific food behaviors are legitimately recommended for your health.

“We want folks to consider holistic health,” Nisbet-Croes notes. “Intentional weight loss can be harmful to anyone and jeopardize their relationship with food and their body, regardless of whether they have a history of an eating disorder. It’s also important not to overlook critical health needs if there’s a genuine medical necessity.”

3. Advocate for yourself or your loved one

Your health matters, and you deserve thoughtful care.

As Nisbet-Croes suggests, “Share that you know there are many ways to pursue health, and let your doctor know you’d like to explore other options before jumping into something risky and not lasting like weight loss.”

Here are a few ways to stand up for yourself, depending on your situation.

Redirect the conversation

It can be hard to respond to weight-focused advice on the spot, but you can guide the discussion toward your overall health based on what feels right for you:

• If you want to avoid confrontation, ask your doctor to share all treatment options available.
• If you’re in the mood to educate, point out that research shows most people who lose weight quickly gain it back in the long term ^[1]. 
• If you’d like to set boundaries, remind your doctor that you’d like to focus on the reason for your visit rather than weight loss ^[1].

If you’re living in a larger body

If you’ve tried standing up for yourself and still feel like your concerns or conditions aren’t taken seriously, it can be incredibly frustrating. This can be especially damaging if you have an eating disorder, including atypical anorexia. In moments like these, it may help to ask other members of your treatment team to advocate on your behalf. As Nisbet-Croes explains:

“Your therapist or dietitian connecting with your primary care doctor can do a world of good in getting the treatment you’re seeking in a way that’s not harmful.”

If you don’t have a treatment team, consider bringing a friend or family member to your appointment. Nisbet-Croes advises:

“Having a support person with you to help advocate and regulate as needed can make a big difference.”

Stand up for your child

If you want to avoid discussing certain topics in front of your child, it’s best to address this before the appointment.

“Asking the doctor not to discuss food or weight in front of your child and instead speak with you privately can help filter what is shared with your child,”  says Nisbet-Croes.

If something is mentioned during the appointment in front of your child, it can be turned into a learning opportunity. On the way home, you can assert your family boundaries or reeducate them in a more neutral or positive way.

5. Prepare ahead of time

It’s always helpful to go into an appointment with a plan. As Nisbet-Croes advises, “Knowing what questions you’d like to ask, what boundaries you need to assert up front and how you’ll handle any boundary crossing by the provider or their staff can help determine the quality of your care.”

If you need a place to start, this quick reference health card can help you set boundaries at the doctor’s office by allowing you to:

• Let your doctor know if you don’t want to be weighed, or if you prefer a blind weigh-in
• Share your pronouns and who you’re comfortable seeing for your care
• Ask for things like gowns, chairs and blood pressure cuffs that fit your body
• Mention if you have a history of eating disorders, trauma or other mental health issues
• Request help with things like filling out forms or needing a translator

6. Consider a second opinion

If you don’t feel heard or comfortable with what your doctor is recommending, it’s perfectly fine to get a second opinion . While some medical conditions might involve weight loss as part of treatment, it’s always a good idea to explore all your options first.

Want to find a provider who practices weight-inclusive care? Nisbet-Croes recommends the following:

• Check the Health at Every Size (HAES) provider directory.
• Look through Reddit and Instagram threads for source providers who practice weight neutrality.
• Call the doctor’s office and ask about their approach.

And remember, if you’re starting with a new provider, using the quick reference health card mentioned above is a great way to set the tone for your care.

You deserve weight-inclusive care

It’s important to feel understood and respected in every conversation about your care. Whether you’re setting boundaries with your current provider or seeking a second opinion, it’s about finding someone who listens to your needs. Trust your instincts, look for providers who understand and don’t be afraid to stand up for what you deserve.

If you are looking to improve your relationship with food, ERC offers weight-inclusive eating disorder treatment tailored to your needs. Reach out today to start the conversation. One call is all it takes to get started.

Read more on this topic:

• Fat in a Thin World: A Weight-Inclusive Podcast
• 5 Self-Advocacy Tips for Fat Folks with Eating Disorders
• Ozempic and Eating Disorders: The Risks of Weight Loss Drugs
• Traveling While Fat: 11 Essential Tips
• Vegan Diets and Eating Disorders: Is There a Link?