How often should you jump on the scale?
For many years, I never recommended to patients to weigh themselves daily (first thing in the morning). The prevailing medical opinion was that weighing oneself triggered anxieties that might end in eating disorders like anorexia and bulimia.
Contrary to what I said to my patients, however, I have weighed myself my whole life (nearly) every morning – and have kept the same weight since age twelve. Except for pregnancies, gaining twenty pounds with my daughter, forty with my son. The difference? In both cases, relentless morning sickness. With my daughter, eating or even thinking of food made me throw up; with my son, eating calmed the sickness. During pregnancy, I did not care what I weighed and how I looked; all I cared was the baby I was expecting. So I followed my body’s whims and cravings. Including the incredible craving for a lobster at a very inconvenient time…
My body feels well only within a very tight margin: Two pounds less, and faintness grips me. Two pounds more, and stuffiness prevents me bending forward.
My personal weight story made me absolutely unacceptable for several overweight patients who stated that I had never been in their shoes and could therefore not advise them. I respect that view. But it would also mean that one can’t be a good doctor for a cancer patient if one didn’t have experience with the dreaded disease. Or could couldn’t treat a heart attack because … you are getting the idea. (On the other hand, the notion that better doctors come from personal experience with serious illness, is worth spinning out. The A+ nerds who populate our medical schools – half of them should be replaced with compassionate, common-sensical young men and women).
A study showed that people who weigh themselves more often also lost more weight. That takes this discussion beyond my personal story – and here it becomes interesting.
French women supposedly don't gain weight as they age. Which means if the scale tells them they have gained a pound or two, they take action. And responsibility. That might be part of the French Paradox - that the French live longer but eat more fat. Might be they eat fat - and then put in a salad day.
A scale is a reality check. If you want to avoid looking the facts in the face – your decision. I like to confront bad situations – weight gain, disease, divorce, death (why do nearly all adverse events start with a "d"?). That led me one time to lie down in a casket and pull the lid shut, just to see how it was. It was surprisingly peaceful. What I found out in the coffin: It was nothing to fear.
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