How to you tell someone they need to lose weight?

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.