How to Approach a Loved One About Obesity

By Eric L. Zielinski

We all know the U.S. is currently experiencing an obesity epidemic. According to the Centers for Disease Control and Prevention (CDC), more than one-third of U.S. adults (35.7%) are obese, and the numbers are rising. Texas is ranked in the top 10 obese states, with 31% of all Texas adults categorized as obese. Digging a little deeper, Texas cities like McAllen, Edinburg and Mission frequently fill the top 25 list of most overweight cities in America, with Houston topping the charts several times since 2000. In fact, Houston received national recognition for this problem when Men’s Fitness Magazine ranked it as the “fattest city in the United States” in 2012.

A Behavioral Risk Factor Surveillance System (BRFSS) report from the Texas Department of State Health Services reveals that 66% of Houston-area adults were overweight or obese in 2009, compared to 61% in 2002. Among youth, the Youth Risk Behavior Surveillance System (YRBSS) reports show 34.4% of students in grades 9-12 in Houston schools were overweight or obese in 2007, compared to 29.4% in 1999. Houston high school students are also heavier than students in the general population: 34.4% in Houston compared to 28.8% in the U.S. population.

Why Houston?

Tracey Ledoux, Assistant Professor at the University of Houston Department of Health and Human Performance, helped answer this question during an exclusive HFM interview. Ledoux, a licensed psychologist and registered dietician who researches overeating, shared that, even though there is “… no definitive answer, characteristics congruent to higher obesity rates are prevalent in Houston.” For example, “… typical southern cuisine high in fatty meats and higher in carbs; lots of fast food, which is high in salt and fat; and no public transportation” all contribute to Houston’s obesity epidemic. Ledoux called out the elephant in the room when she stated that, “The temperature doesn’t bode well to lots of activity outside for three to four months out of the year,” which contributes to significant weight gain.

Obesity: What is it really?

It is vital to recognize that this is not simply an aesthetic “I don’t look good” issue. Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. In fact, according to a 2009 study published in the medical journal PLoS, obesity ranks as the second cause of preventable death in the U.S., responsible for an estimated 216,000 deaths– second only to tobacco use.

Clearly, this is a critical issue that needs to be addressed, especially for Houstonians. Yet, as parents, spouses, or even children of older parents, what can be done to help our loved ones who fall into these data sets? First of all, let’s understand what obesity is. In its 2012 report, the National Institute of Health (NIH) defines obesity as “an energy imbalance.” The basic idea is that “The body needs a certain amount of energy (calories) from food to keep up basic life functions,” and when the intake of calories exceeds the body’s metabolic ability to consume this energy, fat starts to accumulate in the body. “Many factors can lead to energy imbalance and weight gain,” the NIH states. “They include genes, eating habits, how and where people live, attitudes and emotions, life habits, and income.” It is very important to recognize that this is not an issue about being a glutton or not having self-control. Biochemical individuality determines, to a significant level, how we metabolize excess calories.

How to approach a loved-one who’s dealing with obesity:

Like many other disorders or illnesses, approaching a loved one who is obese is not a simple matter of laying out the facts; many emotions come into play.  Saying the wrong thing can end up backfiring and shutting down all future opportunities for helping with the problem.

Interestingly, there is a debate within obesity research circles on how to approach a loved one who’s dealing with obesity. According to American-based Medi Weight Loss Clinics, the first thing to realize is that most people who are overweight or obese already know this. This approach seems to have been adopted globally, as we see in Virtual Medical Centre, Australia’s leading medical information website. Both organizations argue that you should not take the approach that you are providing a great insight. Overweight people, they contend, often already have low self-esteem, and the last thing they need is a friend or loved one telling them they are overweight and must lose weight. However, Ledoux contends that this isn’t always the case. When considering that over 65% of all Houstonians are overweight, Ledoux argues that being overweight may be the “new normal.”

So, when considering whether or not to approach a loved one who is obese, keep in mind that they may not realize that there’s a problem. If you do decide to tackle this challenge, however, Ledoux advises us to consider that “obesity is a topic not without value or judgment.” According to Ledoux, while most forms of discrimination are banned, weight bias largely isn’t. For example, it is still socially acceptable to make rude comments about obese individuals, as often times heard in movies and television sit-coms. Obese people are forced to purchase two seats on commercial airplanes, and research has shown that overweight workers make less than their colleagues.

Interestingly, weight discrimination in the workplace has often been ignored, but it’s a serious issue and one that’s been in the news recently after a Texas hospital said it would require new employees to have a body mass index of less than 35. (That’s about 245 lb. for a man of 5 ft. 10 in., and 195 lb. for a 5-ft. 2-in. woman). According to the Texas Tribune, the Citizens Medical Center in Victoria, Texas, instituted a new policy requiring that an employee’s physique “should fit with a representational image or specific mental projection of the job of a health care professional.” Interestingly, according to the Minnesota Department of Human Rights, only six cities and one state (Michigan) have specifically outlawed weight discrimination at work.  But everywhere else, employers are off the hook if they have a legitimate business reason to deny an overweight employee a job.

With all this in mind, Ledoux points out that entertaining the concept that you or your child is obese calls up a lot of baggage. When doing so, Ledoux recommends the following:

1. Approach your loved one from a place of true warmth, care, and nurturing.
2. If your relationship is estranged or you’ve been in contention over some of life’s other issues, your intervention may be viewed as “nagging;” the existing problems in your relationship may render you unable to provide meaningful help.
3. Take the position of being legitimately concerned for their health.
4. Own your personal feelings. Use phrases like, “I’m concerned for your health.” “I’m worried about losing you.”
5. Remember to not offer unsolicited advice. We cannot control others’ behavior, and forcing our mores on other people is manipulation in an attempt to control or change them.
6. If they are not receptive, let it go.
7. If they are receptive, suggest that they first go to their primary care provider (PCP). PCPs can rule out other medical complications and help your loved one discover his or her baseline levels. Determination of cholesterol, glucose, and blood pressure levels can often help to identify the next step.

Seven approaches to consider when trying to help a loved-one who is obese:

Of course, we all want to help those we love in any way we can, but helping people deal with or overcome obesity is a particularly challenging task. Try these seven approaches:

1. Walk the talk: The only way to help someone see the need the change is to become the change you want them to see. Take strides toward a balanced, proper diet and let them experience your growth first-hand. Chances are, they will make some of the changes with you without even being asked because they see how your life is changing.
2. Don’t tempt: Be especially careful when you’re with your loved one to not eat or drink things around them that are their known Achilles heels. This could be a tipping point for them. Be disciplined and cognizant of what you’re doing all the time (see Tip #1).
3. Don’t judge: Realizing that not everyone is created equal in every way can do wonders toward helping us see we’re all under construction and have room for growth. People know that they’re being judged by our actions, not just our words. Don’t kid yourself: if you’re thinking it, it’s evident in your behavior.
4. Look between the lines: If you don’t know your loved ones well enough to answer why they are in the position they are in, take some time to get to know them better. There may be some deep-seated issues that need to be addressed with a professional before they can really change or even want to change.
5. Praise baby steps: The same psychology applies to adults as it does to children: We all need praise! When people are discouraged, overcoming adversity and reaching their goals become an insurmountable task and often times it’s easier for them to simply give up than to push through.
6. Be patient: Remember, we’re all under construction. Healing and transformation takes time. Let them know that you love them and will support them at whatever pace they tackle their obesity dilemma.
7. Love them: Love doesn’t fail, so don’t give up on your loved one. Even though they might give up themselves, don’t let up. Be a pillar of strength for them and keep on practicing these seven tips. You’ll be surprised who those late bloomers are, regardless of their age. Remember, this is a life or death issue, literally, and they need your support!

Eric L. Zielinski is a father of three and a peer-reviewed researcher studying toward his Doctor of Chiropractic degree. With a passion to help reverse the world’s health crisis, Eric is also working toward his MPH/PhD in Public Health.