If a loved one is overweight, you may be concerned and want to intervene. After all, having a high body mass index (BMI) is associated with a higher risk for health issues like type 2 diabetes, heart disease, and cancer, as well as a low quality of life, as the Centers for Disease Control and Prevention (CDC) notes.
But not so fast, experts say. Weight loss is a sensitive topic and a personal choice. If you wish to talk to your friend or family member about it, taking a mindful approach can help you get your message across, if it is welcome, without hurting your loved one’s feelings.
“Talking to a loved one about weight and weight loss can be extremely triggering for that individual,” says Ariela Vasserman, PsyD, a psychologist at NYU Langone Health in New York City. “Timing and empathy are two key factors when attempting to have a conversation. Most attempts from others tend to elicit intense feelings of shame and humiliation, which likely promote more avoidance of the discussion.”
As with many difficult topics, when it comes to discussions of weight loss, it’s not just what you say but how you say it that matters.
“It is a really sensitive topic and words are everything when discussing it with loved ones,” says Vijaya Surampudi, MD, an assistant professor of medicine in the division of human nutrition at UCLA Health in Los Angeles.
1. Do Ask for Permission
If you’re concerned about the effect your loved one's weight may be having on their health, start by asking them for permission to discuss it, says Kasey Goodpaster, PhD, a clinical psychologist and director of behavioral services with Cleveland Clinic’s Bariatric and Metabolic Institute in Ohio. “If they don’t want to talk about it, respect their decision and let them know you are available if they change their mind,” she says. “You might say, ‘I’m here for you if or when you would like some support.’”
Better yet, wait for your loved one to broach the subject. “My recommendation would be to wait until the loved one makes a comment about their weight or eating habits,” says Vasserman. “When they do so, I would recommend listening, empathizing, and validating their experience rather than trying to come up with a solution for them to change.”
With permission, you may share helpful information. “If they have a weight-related problem like osteoarthritis and they are volunteering information about their knee pain, you can use it as an opportunity to start the conversation,” says Dr. Surampudi. “For example, you can say, ‘Did you hear that if you lose 5 pounds that is like 20 pounds off your knees and ankles?’”
If the person has expressed that they do not want to talk about their weight, listen and respect this desire. ”Do not continue to bring up the topic of someone’s weight if they have already expressed they don’t want to talk about it,” Goodpaster says. “Trust that they will come to you if it becomes something they would like to address.”
2. Don't Say, 'You Should Go on a Diet'
Avoid accusatory words like “you need to” or “you should,” advises Surampudi. This can come off as critical and may make your loved one feel judged.
Offering simplistic advice like “why don’t you eat less and exercise more” is also just plain unhelpful, says Goodpaster. “Such advice sends the message that weight management is easy when it is actually highly difficult and complex,” she says. It’s also likely something your loved one has heard before, she notes. “Assume the person with extra weight has tried many diets before, and treat them as the expert in their own bodies,” Goodpaster says. “If they are ready to make a change, you might ask, ‘What have you already tried? What worked best for you?’”
3. Do Come From a Place of Love
Because overweight and obesity increase the risk for a host of health problems, including the ones mentioned above, you may want to have a frank conversation with your loved one about their overall health. “It is important to emphasize the concern around health as opposed to weight or looks per se,” says Vasserman.
Articulate that your concerns are because you care. “Send the message that you are coming from a place of love rather than criticism,” says Goodpaster. “For example, ‘I will always love you regardless of your body size, but because I love you so much, I want to make sure we live a long, healthy life together.’”
You can also invite them to share their perspective in a loving way. “For example, you might say, ‘I feel concerned about your health because of your family history of diabetes. Can you tell me how you’re feeling about your weight gain?’” Goodpaster suggests.
4. Don't Say, ‘You're Going to Eat All of That?’
Before being critical, realize that picking on your loved one isn’t likely to produce positive changes. “Do not ‘food police’ or make critical comments about what the person is eating, even if they have expressed that they are trying to lose weight,” advises Goodpaster. “Food policing usually triggers guilt and shame, which in turn can trigger emotional eating.”
Research also finds making negative comments to a loved one can be harmful. A study published in June 2016 in the journal Eating and Weight Disorders found that women who remembered their parents commenting about their weight during childhood had greater dissatisfaction with their weight as an adult.
Additionally, shaming a person is not an effective way to get them to do something. “Keep in mind that lasting change will never occur from being pressured or guilted into change by others,” Goodpaster says. “The person needs to be self-motivated to lose weight in order to engage in the many difficult behavior changes needed long term.”
5. Do Say, 'How Can I Help?'
If you’re talking to someone who is thinking about weight loss but seems overwhelmed, remember that sometimes all people need is a supportive ear. “The most important feedback, in my professional opinion, would be to suggest to the loved one that you are there for them and will be supportive along the way,” says Vasserman. “Asking how you could be helpful or supportive can open up fruitful conversations, as opposed to making concrete suggestions around how to lose weight.”
Additionally, rather than placing the focus solely on a specific person who has extra weight, it’s helpful to make healthy behavior changes together as a family, says Goodpaster. “For example, the whole family might help with grocery shopping and meal prep, go on walks together, or engage in other enjoyable forms of physical activity,” she says.
Scientific research supports a joint effort approach for effective weight loss, as well. For example, a study published in February 2018 in the Journal of Health Communication found that people who participated in a 15-week online weight loss program with a buddy lost more weight than those who did the program alone.
6. Don't Automatically Compliment a Loved One’s Weight Loss
Unless your loved one has specifically asked for it, refrain from commenting about their weight loss. “Some people appreciate compliments when they begin losing weight because they have difficulty recognizing change in themselves, and others feel uncomfortable and ‘under the microscope’ when any comments are made about their bodies,” Goodpaster says. If you’re unsure what the person wants, ask.
Goodpaster advises not automatically complimenting someone’s weight loss, unless they have expressed they would like this kind of feedback and you know that weight loss has resulted from healthy behavior change. “You can never assume that weight loss is a good thing, as sometimes it is unintentional due to illness, or the result of unhealthy weight control practices,” Goodpaster says.
7. Do Pay Attention to the Timing of These Conversations
As mentioned, timing is crucial. “I would most certainly not discuss one’s weight around others, as this will likely be humiliating,” Vasserman says. “Additionally, I would avoid any conversation about health and weight if you or your loved one are in an emotionally vulnerable state, such as during a heated argument.”
Surampudi agrees. “Timing is everything,” she says. “If you know your loved one is very sensitive or not ready to even think about making changes, wait. If a person is going through a rough time, a divorce, say, or some setback, that may not be the right moment to address a weight problem and set a challenge.”