Structure House, a North Carolina-based weight-management facility, offers an online refer-a-friend program in which an e-card with details about Structure House’s offerings arrives in your pal’s inbox, with a note reading, “I saw this program online and thought I would share it with you.”
Experts are divided on whether this is an effective — or especially friendly — way to tackle the topic. But it speaks to the fact that weight loss is an extremely sensitive issue that leaves many at a loss for ways to broach it.
“For people who are trying to lose weight, it can be very helpful to have a support person in their life,” says Rebecca Puhl, director of research and weight stigma initiatives at Yale University’s Rudd Center for Food Policy and Obesity. “But that person needs to be supportive without stigmatizing, and that can be a fine balance.”
Complicating matters, Puhl says, is the reality that the vast majority of people struggling with their weight are well aware of their size — and the attendant health complications.
“They may have attempted weight loss many times before, and we need to assume their lack of success has much to do with the ineffective treatment options available to them and the biology of the human body,” says Puhl.
The last thing they need from their friends, in other words, is piling on. But that doesn’t mean you should avoid the topic altogether.
“If you saw a loved one with a sore on their arm that could be a melanoma, you would ask, ‘Have you had that checked?’” says Lynn Grefe, president and CEO of the National Eating Disorders Association. “If you think their health is at risk, it’s not a judgment, it’s a concern. If you saw someone with a gun to their head, you would try to take the gun away. If the person is at risk for diabetes, they could lose their sight, they could lose their legs. The person, in a way, has a gun to their head. They may not know what to do.”
Starting the conversation
A critical first step is keeping the conversation centered around health.
Grefe suggests asking your friend if she or he has had a recent physical. Offer to help locate a doctor and attend the appointment.
“Let’s see where they are on the map,” Grefe says. “See if they have high blood pressure. See if there’s undetected diabetes. Keep the approach on health.”
Puhl counsels health care providers on how to approach weight loss with patients and says the terminology can make or break the conversation. “Would it be OK if we talk about your weight today? How are you feeling about your weight right now?” she suggests to providers.
For friends, she says, “It’s really about making yourself available and approachable to the person and letting them know you’re there if they ever want to talk about it. More important than letting them know this is an issue is telling them you’re there to be supportive.”
You may not even need to raise the issue of weight specifically, says Liz Josefsberg, director of advocacy at Weight Watchers International.
“It can just be crafting open-ended questions, ‘Hey, how are you feeling about things right now?’” Josefsberg says. “If somebody has gained a lot of weight, usually something started that. It could be as simple as a move or a new job, but it could be the breakdown of a relationship. If you’re a good listener, you can help them process out what the issue is.”
Grefe concurs. “People don’t choose to be overweight. Something deeper is going on and you need to reach out and say, ‘I’m concerned.’”
No tough love
Tough love, despite what you might see on “The Biggest Loser,” is not in order here, say experts.
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