Should You Talk to Your Friend About His/Her Weight?

Posted By elissa on Apr 26, 2011 | 4 comments

This author of this Chicago Tribune article, “Broaching a Weighty Subject,” thinks so.

But I don’t. Especially when it’s done like this…

With a few key strokes and the click of a mouse, you can anonymously tell a loved one that he or she might want to consider losing some weight, and hey, you know just the place to help.

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.”

The author concedes that “experts are divided on whether this is an effective…way to tackle the topic.” Do tell.

But the rest of the expert “advice” in the article is just as questionable. Try this on for “size”:

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.”

Suffice it to say, I don’t agree with this assessment. Not everyone will link something seemingly innocuous like a sore to a life-threatening disease; but they’d have to be blind, deaf and dumb to miss the message that obesity is linked to increased risk of diabetes, CVD, etc.

Be that as it may, “increased risk” does not imply inevitability… so acting as if your friend has a gun to his/her head is a perfect way to turn them into an ex-friend. The relationship between obesity and health is more complicated than the author apparently understands. For example, she seems totally unaware that a significant minority (25% – 30%) of obese people are – in fact – metabolically healthy.

So there’s a lot of FAIL built into this approach:

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.”

In other words, treat your friend like a dim-witted child. I’m sure s/he will be touched.

…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.'”

This is even worse. No, people generally don’t choose to be overweight. But if I were obese, I’d resent well-intentioned but tone-deaf attempts by my friends to play amateur psychologist! 

Seriously: you can’t assume simply by looking at someone’s waistline that “something deeper is going on” – that’s ridiculous.  And an offer to help with a doctor’s appointment could easily backfire: all too many overweight/obese patients have had negative experiences with their docs. So if your friend hasn’t seen a doc in a while, there may be a reason beyond helplessness, self-neglect or indifference.

For the record, I’ve had discussions with overweight friends and acquaintances about losing weight and getting into shape. But this is because they brought the subject up with me. And why not? They know that I “walk the walk” and am fairly knowledgeable about fitness and nutrition. And when asked, I offer solid, practical information, not generic, poorly-informed, anime-eyed expressions of “concern” for their health.

And that brings up a point completely missing from this article… just how entitled to talk are the “yous” this article is aimed at?

IMHO, before approaching a friend with “concerns” over his/her perceived unhealthy habits, you ought have your own under control. 

To put it another way: people in glass houses shouldn’t throw stones.

If you’re a thin person, good for you.  But you can’t blithely assume that you’re healthy – let alone healthier than your overweight friend – just because you’re thin. Fat people who are fit (according to treadmill testing) may actually be healthier than those who are thin-but-sedentary. 

In short: if you have an overweight friend you’re concerned about, you should lead by example and STFU until asked. If you’re physically fit and have healthy eating habits, these things will be noted… and will almost certainly come up in conversation. Ditto if you see your doc for regular checkups, maintain a healthy blood pressure, etc. Your friend will either inquire further or change the subject – either way you’ll know where s/he stands on the issue of his/her weight… without resorting to melodramatic conversation-killers like this:

“How can I help?” Grefe reinforces. “I love you too much to lose you. I want you to be around a long time.

Spare me…