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Let's Talk About Health, Not Weight


Someone you care about is overweight and you're worried. Is it okay to tell them ... and can you do it without insulting them or making them feel degraded? NPR recently reported that even physicians can be uncomfortable in discussing weight with their obese patients.

We're not all supermodels - and let's face it - the supermodels aren't always the picture of health, anyway. A movement to improve the way society views weight, particularly for women, has met with limited success. So we strive to accept our natural curves and the changes that happen as we go from adolescence to childbearing to middle age and beyond ... and that's a good thing. But what happens when weight becomes a health threat?

Male or female, young or old, no one wants to be judged or lectured about weight, but this is a serious threat to health that should not be ignored. In an effort to learn more about how to broach the subject, Natural Choice Directory reached out to some experts to learn how they handle this sensitive issue.


Dr. Abrams has witnessed first-hand the ramifications of emotional abuse directed toward overweight people.

"Bullying from an abusive husband made one of my patients feel so depressed and isolated she lost many of her friends and her job. Hearing her story was heartbreaking. Fortunately with the help of our doctors, she was able to lose weight and regain her confidence. I only wish I'd gotten the opportunity to help her sooner."

Abrams says she's comfortable in being the person to bring up weight issues with her patients. "Often, our overweight patients come looking for answers to physical health problems without bringing up their excess weight. I point out how much they can do to address these problems by simply losing weight.

"From my first encounter with a new patient I look for the causes of the weight problem: poor diet, lack of exercise, hormone imbalance, depression, medications and many other causes have to be taken into consideration. Identifying the underlying cause helps patients feel safe and comfortable, allows them to talk about their problems, and helps in finding a treatment plan that they can successfully follow for long-term health."

In her naturopathic health care practice, Abrams takes the time to study patients individually and to set reasonable goals and expectations, including establishing lifelong habits for maintaining a healthy weight. "We provide emotional support and celebrate every successful step along the way," she says.


"I would say that you approach a loved one and talk about it as you would any other issue.

"As a physician, I treat obesity as a medical condition in its own right - not just an aesthetic issue - it should be treated as a medical issue - obesity puts you at risk for at least 20 other diseases. It's an exploding health situation. Be empathetic; don't moralize; don't use guilt. It's about health - not weight," says Dr. Krupa.

When interacting with patients, Krupa considers the power of words. You weren't "bad" -- you simply "ate off program this week." He encourages patients to take responsibility for their own health and wellbeing.

While discouraging his patients from viewing themselves as victims, Krupa understands the more complex problem of our collective psyche. As more of us gain weight, obesity becomes harder to recognize. Rates of obesity differ according to socioeconomic status, neighborhood, and access to healthy foods. Children are the prime targets of junk food marketers and are not taught how the foods we eat affect how we feel and perform.

For many of us, says Krupa, if our goal was to design a diet to become obese, we should probably stick to what we're eating right now.

Krupa advises patients to explore the reasons they've gained weight, acknowledging that motions, patterns, and environment all play an integral role in weight and health management.


"The weight issue comes up in standard medical questionnaires that all patients in my practice have to fill out. If it is an obvious problem, then I would bring it up as part of a list of health issues to be addressed. Patients are usually prepared to discuss this in an objective way with a physician.

"One way I keep the discussion objective is to include in my physical exam measurement of weight, fat composition, fat mass and body mass index, pointing out the normal range and how the patient's numbers may differ from the norms."

Mindful of the stress some of his patients may feel about their weight, Dr. Kitaeff provides relaxation training to help. "For example, this might involve visualizing oneself in a favorite place (perhaps outdoors), looking the way one would like to look and feeling the way one would like to feel."


As a life coach, clients come to Ms. Erika Renea for a variety of reasons, including weight loss. When that happens, she encourages them to remove personal emotional blocks that may keep them from losing weight.

"This includes purging our ANTS --- Automatic Negative Thoughts, metaphorical work for emotional healing, as well as goal setting and implementation. It is my belief that weight loss is much deeper than simply shedding a few pounds by exercising and eating better. I believe that we all have a perfect divine weight our bodies naturally want to inhibit. Unfortunately, our bodies can become a symptom for our unprocessed and unhealed emotions, causing us to crave certain foods and/or overeat. My approach to weight loss with my clients is to help address these issues and bring them into the light. When we bring emotions, thoughts, feelings, and past experiences into the light, it removes their power."

Before approaching a loved one about weight loss, Renea suggests that you ask yourself why you are doing so. Are you embarrassed by their appearance...want them to fit in...or are you truly concerned about their health. Remember, this is their journey - not yours.

When approaching someone else about their weight, "It is important to broach the subject from a place of concern and wellbeing, not from vanity and materialism," says Renea. "Are we discussing weight loss from a space of perceived cultural and media expectations, or from a place of personal happiness and well being? There is a huge difference and I feel the fear of speaking about it may come from sensitivities to our extreme cultural pressures around weight. Yes, it is so important to accept and love our bodies at all sizes, but if that excess weight has become a physical or emotional burden, isn't it time to address it?"


"Nearly every patient who comes to me, comes with the knowledge that they are overweight. A large percentage of my practice works with weight issues and the nutritional decisions that help or hinder our ability to meet our goals. I have never had to broach the subject unless it has related to the specific goals of the patient. For example, if an overweight woman is seeking help to enhance her fertility, I do tell her that a small decrease is body weight has been shown to increase the rate of conception. The next step we take is to create an achievable eating plan that will help her achieve this goal and increase her odds in creating the pregnancy she desires."

Dr. Torrance believes self-esteem and emotions are vital components of all weight-loss efforts. "I do my best to help my patients tease apart the reasons they make the choices that they do, and explore alternative ways of mentally framing situations so that the emotional burden is lessened, and so that the cognitive, good-choice making part of the brain can be successful."

In her practice, Torrance uses acupuncture to complement her patients' weight loss or maintenance plans. "Although acupuncture will never directly cause a person to shed pounds, it absolutely will help stabilize mood, promote proper digestion, encourage appropriate appetite and increase physical comfort. All of this helps with losing and maintaining weight."


Appearances can be deceiving. Dr. Krupa notes that the thin supermodels so admired by our culture can actually be medically obese, due to poor diet and lifestyle habits. All our experts agree that the issue is health, not looks.

We can take a cue from the experts. When our concern stems from a place of love and caring, it is more likely to be well received - and it's worth the effort.

Ann Pietrangelo is the author of "No More Secs! Living, Laughing & Loving Despite Multiple Sclerosis." She is a member of the American Society of Journalists and Authors and writes for sites around the web.


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