Stepping on the scale at the doctor’s office is no one’s idea of a good time. People take a deep breath, look away, crack jokes, take off their shoes and socks — all to try to be lighter. We’re obsessed with weight. But weight and health are related far less clearly than we pretend, and it’s time to do better.
We weigh people at most visits because weight is easy to measure, not because it’s a good marker for health. The American Medical Association recently called for doctors to stop leaning on BMI as a key health measure — a significant pivot for a slow-moving, conservative organization, and a good sign the evidence is undeniable.
BMI was built to study population-level trends, not individual health, and it was never properly validated across diverse populations. It lacks sensitivity to race, sex, gender, and age — “normal” was defined in a homogeneous, predominantly white population, and everyone else gets screwed. A body builder gets classified as obese. The science doesn’t even support a clear link between BMI and mortality for individuals.
“Walk ten more minutes a day” beats “lose ten pounds” every time.
Weight bias is deeply ingrained in medicine anyway, affecting how people are treated, what treatments they’re offered, and how they see themselves. And weight itself tells you nothing about body composition — where fat is located and what it’s doing (visceral vs. subcutaneous) matters far more than the number on the scale.
We measure weight because it’s easy. But body fat percentage, waist circumference, lipids, and blood pressure are just as fast to check and tell a much fuller story — as do behaviors we can actually act on.