When loved ones express concern about their weight, especially if they have tried and failed at diets in the past, they are often expressing frustration and hopelessness.  Thus, begin by validating their feelings instead of immediately jumping to provide them with a solution. Consider saying things like “I know that it must be frustrating to think about tackling your weight again” or “I see how upset you are that you were not able to stick with your healthy living plan.” Do not disagree with their feelings or tell them not to feel the way that they do.  Having their feelings heard and understood will help them to feel less defensive and help them see that the other person genuinely wants to help.

Next, it would be helpful to ask why they are trying to lose weight, as this will be the thing that motivates them.  For instance, are they losing weight for a special event, for the summer or were they were told to lose weight by their doctor? All of these reasons suggest a specific goal that once met stops motivating continued weight loss or maintenance of the new weight.  Therefore, it would be helpful to shift the discussion to health and wanting to make life style changes that will lead to the loved one being healthier.  In this way, weight loss becomes part of the larger ongoing plan.

Since the person likely feels judged on the success of their weight loss, help them see that this is about their well-being and not about a specific number.  Consider saying, “I know you really want to lose 10 pounds, but let’s figure out how you can feel healthier in general and not be so focused on the number” or “I am confident that you can lose the 10 pounds that you want, but wouldn’t it be great if we focused on helping you feel healthier rather than on getting to a specific number.”  Try to help them establish goals that do not include reference to weight.  For example, “I want to be able to walk for thirty minutes three times per week” or “I want to reduce the number of medications that I take.” After these goals are established, ask about progress towards these goals or about activity level, do not ask about the weight loss itself since it brings the conversation back to the magical number on the scale.

Because sustained weight loss can occur only in the context of a life style change, this is not something that can happen to only one person in the household.  If talking to a loved one in the home, talk about ways that you as a family can reach your health goals.  For example, consider saying, “For my part in our health plan, I will take on the responsibility of buying the fruits and vegetables, so that we always have healthy snack options in the house. What task do you want?”  Approaching things as partners will also decrease the judgment and help the person feel supported. However, the person initiating this conversation has to be actually willing to make the changes themselves.

Start with specific manageable goals, such as “Let’s cook one more meal at home than we usually do” or “Let’s go out for a 15 minute walk every night”  instead of “Let’s only eat salad from now on.”  Once these small goals have been successfully met, new ones can be established.  This gradual process allows the person to have a positive experience with getting healthy instead of a negative and punitive one that they might have had in the past.

If the idea of weight loss was not brought up by the person who needs to lose the weight, then it becomes even more critical to make this a family effort. Instead of saying, “You should lose weight this year” consider saying “I would like us to start the new year being more healthy,” and then proceed to describe what the person will do as discussed above.

While there may not be a way to make these conversations pleasant, they can be positive and productive if there is a willingness to support and make actual difficult changes in the household.

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