If You’re Concerned For Your Fat Loved One’s Health

Concerned puppy is very concernedThis is a question I get a lot, and I got it five times yesterday so it seems like it’s time to blog about it. It goes something like this: “We love our fat [loved one], but we’re concerned about their health. We think they need to lose [insert number of pounds.]  How do we tell them that we love them as they are but we are afraid for their health and we want them to be around for a long time?”

I know that most of these people have the best of intentions, and I know that they are living in a society that encourages them to do this. Still, I think it’s something to think over very, very carefully.

First, consider that there is not a single study of any weight loss method where more than a tiny fraction of people actually lose weight, and the weight they lose is typically a few pounds. The odds of actually losing a lot of weight and maintaining that are basically lottery odds, gaining back the weight is a near certainty, and a majority of people gain back more than they lost, so even if you buy into the idea that thinner is healthier, suggesting that they attempt weight loss would actually the worst possible advice that you could give.

To take that a step farther, I would suggest that everyone who wants to be involved in this intervention ask themselves the following: why do I think that this adult isn’t capable of making decisions for their own health?  Have they asked that folks comment on their body size/health/choices? Do I think they haven’t heard the (highly questionable) messages that thinner is better? Do I feel that I have some accurate expert information that they haven’t heard before? (Hint:  The answer to this last question is almost certainly “no.” If you’re planning to quote Dr. Oz, you’re making a horrible mistake.)

How are you going to bring this up?  Say your intended script out loud – have someone say it to you. I think you’ll find that there is really no way to say “We think you’re going to die if you don’t do something that nobody has proven is possible for a reason that nobody has proven is valid,and that would really be a bummer for us” that isn’t offensive or hurtful.

If you are still thinking about speaking with with this person, I would think long and hard about what information/options you think you can actually offer that they haven’t already heard, and if  your unsolicited advice in this matter is really likely to do anything other than rack them with guilt and shame that may be with them for the rest of their lives, or lead them to do something truly dangerous (and possibly deadly) like drugs, stomach amputation surgery, or medical contraptions, or worse. If your discussion drives this person to dangerous or self-harming behaviors, how will you feel about that?

Are you really prepared to accept the consequences, and your responsibility for them? Remember that you can’t take this conversation back. Once you tell someone that you have a problem with their size (even if it’s “just about their health”) you’ve let them know that you are judging them for the body they live in 100% of the time and for what you perceive their habits, behaviors, and health to be. It’s possible that, no matter how good your intentions, this may drive a wedge between you as they now assume that every time they see you,  you are judging their body/health/behaviors, and it may create a situation where they are no longer comfortable being around you. That’s a completely valid response on their part to you choosing to share your judgment, unsolicited opinions, and inexpert advice with them.

Be aware that you may ruin your relationship with this person, and if that happens it’s on you for busting out the unsolicited, unwanted judgment and advice.  From a personal perspective, I am “Type 3 – Super Obese” It’s as fat as you can get on the BMI chart, a category above “Morbidly Obese” and if my family members came at me to tell me that they had made up a number of pounds they thought I needed to lose to be healthy so I didn’t bum them out by dying, suggesting the same things that I’ve heard and tried already, I would be pissed off, and it might ruin those relationships completely.

I know that there is nothing wrong with being fat, but even if I was still buying into the sizeism and healthism that our culture encourages, I would still assume that if someone actually wants my opinion about their size, health, habits, or anything else, I will be among the very first people to know. Until then, I don’t make it my business.

No amount of time is ever guaranteed with any loved one, I would recommend enjoying the time you have with someone, and not jeopardizing your relationship for a conversation that’s not likely to have any benefit, and could do some serious harm.


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33 thoughts on “If You’re Concerned For Your Fat Loved One’s Health

  1. I love everything about this post. Everything.
    I had a similar conversation with my mother recently, over my stepdad’s “health”. Turns out, after strategic questioning and pointing out the facts and realities of his life as we know them to be, her “concern” was really annoyance and exasperation over his constant complaining about his health status. This is a 74-year-old man who has had a heart valve replacement, diabetes, macular degeneration, and she constantly nags at him for eating sweets or having honey in his tea. I calmly told her that at this point in his life, if he chooses to enjoy sweets and honey in his tea, after all he’s been through with his various medical issues, he’s doing pretty well, all things considered. She agreed and said she’s mostly aggravated by how often he complains about his many maladies. I said yes, but he partly complains because he has little control over the myriad side effects from being on so many medications, and also because complaining is part of his personality. He reminds me of my late grandmother, who wasn’t happy unless she was griping about some ache or pain. My mom agreed and said he is exactly like my grandmother. So then, if the “problem” is his constant complaining, and most of what he complains about cannot be controlled, and “control” at this point in his life is pretty pointless because let’s face it – if you’re lucky enough to make it to 74 and still live independently and eat mostly what you want and live how you like, then isn’t THAT more important than nagging at someone who just wants to enjoy his tea with honey?

    Honestly, every time I read your blog, I have more practical tools to deal with my family’s many isms. Thank you!!

  2. I comment mostly on your other blog because we both share the love of triathlon, but this one really hit home.

    I love my daughter’s wife dearly and enjoy the time we spend together, however my wife and I can count the minutes every time we see her that there will be a discussion on how “concerned” she is for our health. It makes us so uncomfortable.

    She has an answer for everything too.

    “Read this study, it will change your mind” (please read this study that shows only a small fraction of people can lose weight long term, and this study that says health is not an obligation or an indicator of worthiness)

    “We have a man on the floor who is so addicted to food, that he bribes janitors to bring him things from the vending machine, Dennis, when I see you eating at 2AM you remind me of him.” (This was a great one from last summer–but she did not care that the food she and my daughter prepare is not very filling and I had a training run in the morning.)

    “Join me for parkour…it’s a how your body was meant to move! Not just be a consumer of everything” (you managed to disinterest me and insult me at the same time)”

    I will always love her and the happiness she brings our daughter but I would love it if she just backed off once in a while. We see her twice a year…is it worth it?

    1. Yeesh. I’m so sorry you have to deal with her. I snort-laughed at “addicted to food”, though. Yes. We all are. It’s called “being alive”. I’m glad your daughter is happy, but this lady sounds like a nightmare. You seem to be handling her so gracefully. Good for you! How do you not tell her to explore self-love?

      1. That’s a great question; she’s a nurse practitioner with a pHd in psychology, a certified parkour coach and she runs a paleo nutrition blog, so anything that doesn’t meet her standards of “scientific proof” is not worth discussing. I think her answer would be that “self love” is being as healthy as possible at all times. We just don’t agree that I and my wife think self love is being healthy is doing runs, triathlons and walking the dogs but also enjoying a good dessert with most meals. But that being healthy is NEVER an obligation to anyone ever and that love should be unconditional love, not love of choices.

        She really is a great person and I do love her, she brought us our wonderful (step) grandchildren and she’s been a huge boost to our daughter’s self worth but it’s just so hard when someone can’t admit they are wrong even though there is mountains of evidence that doesn’t support their cherished notions.

        1. How can anyone with a PhD in psychology be so adamant in denying the vital importance of mental healthy, and self acceptance to happiness, and even SURVIVAL?

          Has she EVER studied suicidal ideation? At all? Or self-harm? How about that poor man in the famous starvation experiment, who literally cut off his own fingers, and couldn’t even say why he did it? And he had been checked out as psychologically sound, before the diet. And really, that’s all the starvation experiment was – a diet. We fat people are expected to consume EVEN FEWER calories than those study participants did. And we get yelled at all the time, if we consume more, or even the same amount of calories as they did. In fact, even if we’re chomping on peeled celery, we get yelled for consuming ANYTHING, while still being fat. And we consider all kinds of self-harm, just to stop that pain.

          And does she really think that people with chronic illnesses or injuries (who cannot be called “as healthy as possible at all times) cannot love themselves? Because they’re not physically healthy, and that’s all that matters?

          What sort of damage does she do to her patients, if that’s what she really believes?

          She scares me.

        2. After your thoughtful response, I’m a bit embarrassed to say this, but I actually meant “explore self-love” as a euphemism for “go *&^%^ herself”. 😀 It sounds like she has been a good partner to your daughter. I understand that you value that and wouldn’t want to hurt their relationship. It also sounds like she has other great qualities. It’s truly hard to negotiate having such different opinions on health and dieting with important people in your life. It’s good that you and your wife have each other for support during these visits. I bet that helps.

          Sometimes I think people adopt a very strident, almost religious belief about certain diets (Paleo is one of those to me). I have no idea how she is reconciling her expertise in science with that. Fortunately, it’s none of my business what she eats and why. I only wish she would apply the same respect to your choices. I completely agree with your idea of what self love entails. I wish you luck and sanity in continuing to negotiate this difficult relationship. Thank goodness your visits are only a few times a year!

      2. You should have heard what my boyfriend said in the kitchen a few days ago. He claimed that unhealthy food — or food addiction, I cannot remember which — kills more people than drugs like heroin.

        When we were talking about other health-related stuff before then, I asked him where he got his information, and to please cite his sources. He pretty much said that he read a bunch of articles on the subject and they all said the same thing. He didn’t know what confirmation bias was when I explained it to him in another little chit chat.

        Gr…the fact that you read, say, 10 different articles, and they all said the same thing doesn’t make your claim true, you nincompoop!

        I swear to all imaginary gods that critical thinking skills are something that most people lack.

  3. THIS. I can’t say how much it hurts that my mother constantly judges and disapproves of my size. As a middle aged adult, I know it shouldn’t bother me, but once I’m under her roof, I feel like that little fat girl again, and everything I put in my mouth is subject for comment or the silent stink-eye, which is worse. The wedge that this has driven between her, my sisters and I has prevented us from becoming close, and I never feel safe in my childhood home. All I can do is love them, mostly from afar, knowing this will never change. To anyone who is thinking about saying, “I love you, but ____,” PLEASE DON’T.

  4. I have a good and well-meaning friend who, twenty years ago, unexpectedly busted out with something along the lines of, “You are beautiful, and voluptuous, and the only thing that bothers me about your weight is that you will die sooner.”

    I had been complaining about my weight, which I know better than anymore, but I felt like I had been slapped.

    You’ll notice I have not forgotten it. I’ve also gotten a good bit heavier since then, so it didn’t “work”– and as Ragen points out, the pounds I’ve put on are very likely in large part because of my attempts to lose in the first place.

    I have never told her that her taste in men stinks, and that she needs to settle down with someone of a type that doesn’t attract her if she wants any stability, because it won’t do any good and will hurt her feelings. So I learned something.

  5. While it should go without saying that fat-shaming is NEVER OKAY, I think it might be somewhat useful to consider one of the places this kind of comment may come from. Yes, often it’s about the speaker reassuring themself that s/he is “better than you are” (aka concern trolling), but sometimes they’re speaking out of fear. (This in no way excuses them being asshats.) So what are they afraid of? (Spoiler: it isn’t of losing your wonderful company!) While the people speaking from their fear are unlikely to ever see this post (or this comment!), it might make a good starting place for some social jiu-jitsu. People who say dumb/malicious things are not thinking of the person who hears them. They’re thinking of themselves. So: what are they thinking?

  6. If you care about someone who is fat, you should respond the same way you would for anyone else you cared about! Call them, invite them over, listen to them, do fun things with them, let them know what you like/appreciate about them, and be there for them when they’re having bad days. BE A DECENT HUMAN BEING. It’s pretty simple.

  7. I was recently diagnosed with type 2 diabetes, and when the doctor started on his predictable speech about how the “only real cure” was for me to lose weight, I mentally rolled my eyes and thought, well, I know that slimmer people can also get these diabetes, so this cannot be true. I did not have the energy to confront the doctor that day, but instead I listened politely and every time he said “lose weight” I replaced it in my head with “exercise more and eat healthier.”

    I am SO GRATEFUL that I’ve been reading this blog for years and knew what was going on and how to reinterpret this man’s advice in a way that would actually help me. I’m glad I know what the research says about healthy behaviours. I was able to stay positive instead of getting depressed and anxious like I would have in the past if faced with this diagnosis. I realized I actually know a lot more about what is going on with me and my health than this doctor seemed to. Ragen, thank you so much for all you do. You have made a huge impact on my health — especially my mental health and self-esteem.

    For anyone who is concerned about a loved one’s health, I would say the best thing you can do for them is make sure they know you love them unconditionally. That there is nothing they can do that would stop you from loving them. Tell them about things you like and admire about them. Spend time with them. Show them how much you value them. These are ways you can actually improve their lives.

    1. And weightloss doesn’t even treat or cure diabetes. I did a back of envelope calculation of diabetes and weight categories last year, and discovered that: 3% of humans develop diabetes, is split 50-50 between fat and thin. Taking 67% of the world as fat, results in 2.2% of fat people developing diabetes, and 4.5% of thin people. So thin people have double the rates, but no one tells them to gain weight and reduce their risk!

      Also a congenital disease that only women develop, called lipedema, affects about 15% of people (taking the upper level of 30% of women, and divide in half to get the total for all humans), which means there is 5 times as much lipedema in the world as diabetes, but there is no funding, and less than 50 surgeons worldwide to treat it (before 2014 only Germany had surgeons to help).

      Some twisted priorities there.

      1. I’m not questioning your science or your math, but where do you get that 50% of people that get/have diabetes are thin? I would love to have some proof for that to throw in with arguments, because that is a great arguing point.

          1. well I saw a test comment and this one. It’s frustrating when technology fights us.
            I know it’s not simply based on weight or eating habits, because my husband (who until 6 months ago STILL thought he was healthier than me, even with the diabetes and the smoking and excessive [diet] soda drinking and red meat eating, thought he was healthier than me because he weighs less than me, it took me showing him all my blood test results and trying to gently explain to him that weight and health are not the same thing) has diabetes and, while not thin, he is not nearly as fat as I am and he walks a small to moderate amount depending on how much his heel spurs bother him, before he was diagnosed he ate less sweets than me (aside from the soda) and less junk food in general, and suddenly his sugar was 444 when he was in the ER for a kidney stone. So I know it isn’t just a fat person thing, I was just wondering if there was some kind of proof to help me in future discussions 🙂

      2. Mich, are you able to try posting again? Your test messages came through fine. I, too, would love to have a link to these statistics, such as those that indicate that thin people get diabetes just as much as fat people and that only 3% of people get diabetes.

  8. I am saving the email I received for this post, because I know I will need it. Due to me actually eating more than the bare minimum of calories a day and not being able to exercise due to health issues such as persistent dizziness and chronic fatigue, I have gained (back) quite a bit of weight. I am expecting my father to have something to say about this since growing up I received the “You have such a pretty face!” and other non-compliments. There are other reasons I’m sure I’ll hear…things that I don’t want to get into, but THIS, this right here is absolutely perfect. I’m dreading hearing the start of that conversation, but you’ve given me the ammunition to combat it. I can just pull out my phone, pull up the email/post and either give him the phone or read it myself. I’m not sure which one would be more appropriate…I’m leaning towards reading it myself. That seems more empowering.

    Thank you for all that you do. I often find myself stricken with l’esprit d’escalier where I”ll think of a clever response later. I’m also extremely sensitive and have both anxiety and depression, so it’s often a nerve wracking decision between saying what I feel needs to be said or not because I know I can’t handle the fight. People like you are wonderful so I thank you again.

  9. Yeah, you only get to express concern for someone’s health if they actually tell you they are dealing with ‘x’ health issue. And then that concern damned well better take the form of ‘How are you doing? Do you have a treatment plan? Can I help with anything?’ You know, actual concern.

  10. I absolutely love this! I have been fat all my life. I’m 59 now. In my late 40’s, my mother asked me if I’d considered gastric bypass—as she was handing me a piece of cake. I was not happy with the discussion and refused the cake. Then, she got all hurt that I didn’t eat the cake!

    I am so glad I found your blog! You make so much sense! BTW, I do have joint and back problems, but looking at my relatives, the thin ones have the same problems, so my weight does not have as much to do with it as heredity.

  11. Before you have “the conversation” with someone you love, please consider that obsessing over your food intake has been proven to lead to mental illness, and that being told you aren’t good enough, and not worthy of love or respect has also led a great many people to take their own lives.

    Add mental illness to self-hatred (because when the very people who claim to love you pile hate on you, it’s very rare NOT to wind up hating yourself), and you have a perfect storm.

    I wanted to kill myself, well, not so much kill myself, but just stop living with all the pain and hatred. That stopped, as soon as I stopped dieting.

    So, you want your loved ones to live with you for a long time? Then DON’T tell them to diet! DON’T tell them to do this or that “food plan” or “lifestyle” or the like. DON’T tell them they need to change to be worthy of basic human dignity. DON’T stand idly by, when others are piling hatred on them. DON’T parrot the hatred, in the hopes that you can “hate them thin,” because it doesn’t work, and frequently backfires. DON’T let them hear or see you make fat-hatred comments about other people, INCLUDING yourself, even if you say, “But not YOU. I love YOU just the way you are.” DON’T say “no one will love you until you” unless they lose weight. DON’T worry about numbers on a scale, a chart, or a tape-measure.

    DO encourage healthy behaviors, such as stress management (lower cortisol levels correlate with lower instances of the dreaded “fat diseases,” such as heart conditions and diabetes. Go figure). Likewise, exercise and healthy eating are healthy, regardless of whether or not a person who exercises and eats healthy actually loses weight, at all. In fact, someone who is fat may actually GAIN weight with a healthy change in diet and exercise, because muscles weigh more than fat.

    DO tell them that they are worthy.

    DO tell them that others like them are worthy.

    DO speak up when you see fat-hatred.

    DO speak up, and ask for kindness, in general, and positive representation of fat people in media.

    DO include positive representation of fat people in any media you control, such as blogs or newsletters.

    DO speak up about how “glorifying obesity” is not really a thing.

    DO speak up about personal preferences, and that there is no universal standard of beauty, and lots of people DO find fat people lovable and desirable.

    DO realize that illness, accidents, and just plain mayhem happen every day, and that even healthy people can die suddenly. Remembering that, focus on enjoying the time you have NOW, because no matter how small a person may become, there is no guarantee they’ll live past today, anyway.

    DO realize that quality of life trumps quantity, especially if that quantity is only maintained by the misery of self-hatred, and hatred of society, in general, forcing you to literally torture yourself every day, in an attempt to become a socially acceptable size.

  12. Trying again.

    Linda Ramos said it in a comment to one of Marilyn Wan’s posts on fb. Before that I had no idea that it was equally spread between fat and thin.

    Also a friend on fb, who is definitely in a lower weight class, and comes from a long family history of diabetes, and even their doctors prescribe weightloss for these walking skeletons (not based on their eating habits) as a cure-all.

    1. It’s like that’s all doctors know. They drive me crazy.
      Dr: “Durrr….. Diabetes? I know: Lose weight! What? Yer already a ‘healthy’ BMI? Well try it anyways. I hear they’re going to fix BMI again, and then you’ll fall into the overweight category…”

      1. Seems like that is what they’re doing. I know they want to redefine overweight status to BMI 22, but only for Chinese, since they get diabetes at lower weights than everyone else.

    2. Oh, I just saw this post; you can ignore my previous reply asking for a link. I’ll try asking Linda Ramos herself, and if I get an answer, I’ll post it here.

      1. I wasn’t able to find Linda Ramos’s post, but I did find some interesting statistics on the web that show that, while the population of China has less than one third the rate of so-called “obesity” of the U.S.,The number of people who have diabetes or early signs of the disease in China is greater than the entire population of the U.S. http://blogs.wsj.com/chinarealtime/2013/09/04/diabetes-cases-are-on-rise-in-china/ This is something to tell concern trolls who imply that high weight is the cause of diabetes.

  13. My Dr. Fat shames me all the time. She’s pushing me towards gastric surgery. I dont really want to. I’m 29yrs old and 370lbs I can walk great distances, i stand for 12+hrs a day. All well adding a 35lb duty belt and 9lb bullet proof vest. At work I can handle myself in a fight and even chase and take down offenders. I wear 125lbs of medieval armor and sword fight in that armor. I work out at the gym and i swim. How can she as my Dr. Say im unhealthy when i do things many my size can’t. It’s so frustrating. My family has the same view as my Dr. And theyve already done gastric without good results.

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