Every Friday, our clinicians meet (and I tag along) to discuss the families they met with over the past week. They discuss successes, challenges, and plans moving forward. These meetings are very enlightening and have led us to conduct several quality improvement projects over the years; they’ve also led us to consider and challenge assumptions that all of us can have about obesity and weight management. One recent example: self-weighing.
The premise underlying regular self-weighing is that it gives a person objective feedback about any lifestyle changes made or not made, which may or may not correspond to changes in weight. A few systematic reviews have concluded that, when added as part of a comprehensive program, regular self-weighing helps adults with obesity to manage their weight (see abstracts here and here and here), although findings are not universally positive (see here).
However, from a clinical perspective, regular self-weighing is not something our team encourages very often (if at all) among our families. Typically, clinical conversations with families about weight get redirected – away from the number on the scale and toward the areas we emphasize – helping children and families be as healthy as possible (physically, mentally, and socially).
Our clinicians have described the process of weighing children, and then discussing it with families in a productive, non-judgmental manner as a challenging task because it can conjure up long-standing emotions and feelings of frustration, guilt, shame, and blame; it can also detract from the bigger picture focus to support children’s physical, mental, and social health. These clinical experiences are reinforced by epidemiological research that questions the (1) value of self-weighing as an effective weight management strategy and (2) impact of this behaviour in individuals who are more vulnerable to adverse psychosocial consequences (adolescent girls, for instance). Overall, it seems there’s a need for more robust evidence to reveal how self-weighing impacts the health and well-being of children with obesity (and their families) and how this behavior should (if at all) be included in a comprehensive plan for pediatric weight management.