How to talk to someone about obesity

With almost half of Brits now deemed overweight or obese, it’s likely that more and more people are gearing themselves up to have cringe-inducing conversations with obese partners, friends, even employees about their weight.

But just how do we go about being helpful rather than harmful? And where is the line between genuine concern for someone’s wellbeing and simply fat shaming?

A study of 3,000 people published in the Obesity Journal showed that those individuals who were criticised about their weight were six times more likely to put on weight. They’re also more likely to comfort eat and avoid exercise.

The perils of the ‘O’ word

Jenny, 46, a solicitor from Birmingham, knows all too well the danger of risking a friendship when talking about obesity.

She was increasingly worried about her friend Anna’s escalating weight. But she knew Anna had recently been through a painful and prolonged divorce and that any kind of feedback about her weight might crush her already fragile self-confidence.

In the end, Jenny took the plunge. “I’ve always been a fairly direct person and I was worried about Anna’s health. She went from a size 16 to plus 20 within a few months and I saw her weight gain as symptom of her unhappiness. I wanted to help.

“I could see she was comfort eating. Plus, every time we met up Anna would be drinking glass after glass of Chardonnay while talking about the issues with her ex.”

“Rather than just plunge in I gently asked Anna if she minded me talking about her weight. But the moment I broached the subject she reacted with hostility. Anna said: ‘I know I’ve put on weight but frankly, I’ve been under a lot of stress and the last thing on my mind is how I look.’ ”

It's best to tread carefully.

Dr Kelly Johnston

Obesity scientist Dr Kelly Johnston advises great caution when it comes to talking to the obese about their weight.

“It’s best to tread carefully.  If your friend, or whomever it is you may feel concerned about, feels  you are criticising them, it may simply serve to batter their confidence further,” says Dr Johnston.

“In many cases, they are even more likely to seek comfort and escape by way of increased eating.  Weight stigma is highly pervasive, and somewhat of a “vicious cycle” – a positive feedback loop in which weight stigma begets weight gain through increased eating behaviour.”

How GPs approach the issue

Dr Matt Capehorn, who runs the Rotherham Institute of Obesity (RIO) says that GPs like himself are trained to take a very specific approach to the issue.

“The way that a clinician would address the issue of weight might be slightly different from the way a friend or relative would,” says Dr Capehorn.

“Rather than upsetting the patient by saying ‘You’re obese, do you want to join the weight loss clinic?’ we might say at the end of a general consultation, “Do you have any concerns about your health?” inviting them to volunteer any concerns about their family history of disease such as diabetes or their underlying fear of bowel cancer.

“This can lead to an opportunity to link this concern to weight, by saying something like, ‘When you are ready we could talk about helping you get to a healthy weight to reduce your personal risks.’ This is a very basic example of Motivational Interviewing, a technique we use a lot.”

If your loved one does not want to discuss their weight with you, let the issue go.

Jennifer Kromberg, psychologist

Psychologist Jennifer Kromberg blogs on this topic in greater depth in her article ‘How to Talk to a Loved One About Their Weight.’

She says concern about obesity must always be approached in a compassionate way, particularly if it involves a partner or family member.

“Shame may make your loved one eat healthy (or restrict their intake) in front of you, but it doesn’t create long-term change,” she explains. “In fact, shame is likely to promote exactly the behaviours you hope to help your loved one avoid. Examples of shaming statements are ‘I’m not attracted to you anymore,’ or, ‘You can’t even fit into your clothes’.

She adds: “If your loved one does not want to discuss their weight with you, let the issue go.  Discussing one’s weight is an extremely personal and sensitive matter. It might need to be done slowly over time. And remember – just because your loved one does not want to talk about their weight with you, does not mean they aren’t thinking about it or talking about it elsewhere.”

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