How to you tell someone they need to lose weight?

apullum

In my experience, doctors never gave me useful advice about losing weight. What they told me ranged from somewhat helpful to straight up myth. Eat fewer white carbs. Shop around the edges of the grocery store and avoid processed food. Don't drink sugary sodas. Fill half your plate with vegetables. Eat several small meals a day, do snack, don't snack, don't eat after a certain time, always eat breakfast no matter what. Sometimes I was just handed a set of printed flyers about what to eat and not eat.

Not one of those things will cause you to lose weight. You can gain weight just as easily eating only unprocessed food as you can eating frozen dinners every night. You can also lose weight the same way. Losing weight requires a calorie deficit, not avoidance of a particular type of food or eating on a certain schedule. So doctors were not doing me any favors when they told me that the solution was to eat this and not eat that. I learned that their advice didn't work, and that weight loss was a big mystery. Further, I had absolutely no interest in giving up foods I liked. So I wrote off weight loss as something that I'd like to do in the future, but that would probably never happen.

No one gave me practical advice about how to start an exercise program without feeling overwhelmed or ashamed of my body. No one told me how to fit exercise into my day. No one ever mentioned that I could eat what I wanted as long as I was burning more calories than I consumed.

I started Couch to 5k because a friend inspired me to do it. She was older than me and not an athlete, but if she could do it, I could too. I started tracking on MFP because it was easy. There were no gimmicks about magic foods that promote or hinder weight loss. It was just numbers. It broke weight loss down into basic math.

My doctors ask me how I did it, and here's what I tell them: it's about building a healthy routine that works for you. You do not have to give up chocolate or cheese or bread. You have to budget your calories for those things if you want them. You have to track your calories even if you think you know what you're eating. There is no magic food group. You have to schedule time for exercise and prioritize it if you want to do it, and you need a routine that is beginner-friendly. I recommend C25K specifically because it's so accessible. I was morbidly obese and had never run a step in my life beyond gym class; now I'm training for my third half marathon and am 7 pounds from my goal weight. My gynecologist started running again after seeing my progress.

I hope they tell those things to the patients who ask. I hope they don't offer it unsolicited to those who aren't interested, because the biggest thing I tell them is that you have to want to do it. Being lectured or shamed does not make anyone want to do it. Having their medical concerns not taken seriously because they're overweight does not make anyone want to do it. Pointing to weight loss as the answer to all of their problems does not make anyone want to do it. What does make you want to do it is specific to you, but you need a goal that involves losing weight, and a sustainable routine that you're willing to keep up for the long haul. The motivation to lose weight has to come from you and you alone, because no one will keep up a routine for years if they're only doing it because someone else told them to. You can give your patients *factual* information about their weight (not the myths and trite slogans I was told). If they're interested, you can give them practical advice about how to do it. But you can't make it happen.

Therealobi1

My nurse was the one who told me I was obese. She told me to control my portions and get in 30 mins of exercise a day just by walking, She told me many of issues I was experiencing would go if I lost weight
I really didn't pay much attention to her, I thought I was just stressed and overworked
Along came group holiday and I decided to lose weight for that. Now I am less tired, blood pressure fine, no daily heart burn...
She was right I just wasn't listening to her.

Azdak

There are different stages of readiness for change. If someone is in one of the early changes, there is not much you can do except try to move them down the path a little.

Since this is kind of my job, I try to take a practical approach. First of all, I always treat people with respect and I try to assess where they are in terms of both readiness for change and having the knowledge/tools to effect change.

I have one advantage in that I am not some 20-something athlete who has always been 10%-15% body fat. I know exactly what it is like to struggle with job stress, busy schedules, physical issues, stress eating, you name it. So I can give them practical tips and tools, based on both research and personal experience.

I never talk down to people. They know they are overweight, and they often know in general what they need to do. So I talk to them with empathy and support. I acknowledge their challenges and struggles. Even if I know they are probably not ready to fully commit, I give them straight, matter-of-fact reasons why losing weight can improve their health, backed by research and presented in a way that emphasizes the practical benefits for them individually.

I do hit the exercise component hard. I do that because, even if they cannot lose a substantial amount of weight right now, they can improve their fitness. I know that with almost 100% certainty. And regular exercise will improve their overall health, regardless of whether they lose any weight. Sometimes the increased self confidence and self esteem that comes with feeling more fit can be just the catalyst to push them to take their diet more seriously.