"Honey, you're overweight, and I'm worried about your health." Is there ever a good time to utter these words?
The short answer is pretty much 'no'. As in, there's never going to be a time when someone is happy to hear that statement, no matter how much you feel they need to. After all, weight is a sensitive subject, and one most people would understandably rather not discuss.
But according to the Obesity Australia report No Time To Weight 2 - Obesity: Its Impact on Australia and a case for action, one quarter of the Australian population is now officially obese, and a third is overweight.
In other words, it's simply become a problem too large to ignore, no matter how uncomfortable the discussion may be.
But how can you bring up the issue of obesity with a loved one without hurting their feelings? Or, worse, pushing them away?
When it comes to the issue of obesity, Amanda Salis knows what she is talking about. Not only is she an Associate Professor and a full-time research scientist at the University of Sydney's Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders at the Charles Perkins Centre, she is also personally familiar with what it's like to be obese.
"I can speak to the issue of obesity from both sides," Salis told The Huffington Post Australia. "Not only in a professional capacity, but having had experience from my own past.
"I was obese and my family was desperate to try and help me. They would have died to help me, really. They loved me so much and they would have done anything because they knew I was suffering. It's terrible being severely obese. It's mentally a struggle, it's physically hard. Just breathing is hard, just walking is hard, and it's terrible to see someone suffering like that."
My doctor actually said, 'I mean, look at yourself! You're obese!' That didn't help.
But as Salis knows all too well, actually broaching the conversation surrounding someone's weight can be a hugely sensitive affair.
"In the end, when the solution came, it came from inside myself," she told HuffPost Australia. "I did lose the weight, but it wasn't due to anything anyone said.
"It wasn't my doctor, who actually said, 'I mean, look at yourself! You're obese!' That didn't help. All it did was mean I didn't go to a doctor again for several years for fear of humiliation.
"The more people mentioned my weight and asked 'should you be eating that?', the more I wanted to eat just to spite people. I didn't want to feel like anybody was in control of me."
According to Salis, even the most well-meaning of intentions will fall on deaf ears if the person isn't ready to take action. But that doesn't mean you have to sit back and watch a loved one destroy their health, either. The answer, Salis suggests, lies somewhere in the middle.
"The thing about change is that it always has to come from the person who is making the changes," she said. "It can never ever come from an external, 'hey I'm worried about you, why don't you come with me and join a weight loss club?' place.
"That's not to say that conversation can never happen. It's just it's better to wait until it comes from the person who wants to change. The ideas, all the ideas, have to come from that person. Your role is more to be a facilitator and a really empathetic listener.
"It's about really listening to what the person is saying and what their concerns are, rather than blurting in and imposing a solution."
Instead, Salis recommends 'motivational interviewing', an evidence-based approach often used by health coaches to promote change.
"It's a technique that has been put in place and analysed, studied and researched, and has been shown to be effective for things like smoking cessation, reducing alcohol consumption, reducing alcohol habits, and so on," Salis said.
"The idea is that, unlike some other philosophies, if you come in and say, 'oh it would be really great if you came walking with me three times a week and we can go to a weight loss club together and I can help you', then you're taking all the good lines.
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"The other person in the conversation will then, naturally, take the opposite stance, and say things like, 'oh no, the sun bothers me when I walk,' or 'I don't like being in a club' or 'I don't like other people to see me.' Basically, they will come up with resistance.
"Motivational interviewing is about switching that all around, so you take all the crappy lines and they are able to proffer the solutions themselves."
When those solutions start coming forth, let the solutions come from that person. It's important they feel like they own the solution, that it's theirs.
Unfortunately for the impatient ones among us, you may have to wait until the person broaches the discussion rather than the other way around.
"You have to be in a place where the person might raise the topic of weight themselves," Salis said. "And then, instead of blundering in with, 'you should try that new diet my sister-in-law was on' you might take the resistance line of, 'how do you feel about that?' or 'does your weight bother you?'
"You don't want to put words in their mouth. Let them come up with the solution.
"The key is to keep a really listening ear, to really listen to what the person is saying and try and understand their point of view and their feelings and to be really empathetic about that."
It might feel quicker to just tell someone what to do, but then they don't do it. Actually waiting until the timing is right works out to be faster and more effective.
Importantly, Salis points out motivational interviewing is not about playing the Devil's Advocate to the extent where you talk them out of their own solution. So if your loved one comes to you and says they are concerned about their weight, your role is not to then jump in and try to convince them they have nothing to worry about.
"It's not taking the opposite line." Salis said. "You're not doing that. It's just not immediately jumping on and taking all the good lines, and putting words in their mouth, such as 'oh that's a great idea! And you could also do this, and you could try this, and I could help you with this'.
"When those solutions start coming forth, let the solutions come from that person. It's important they feel like they own the solution, that it's theirs."
Finally, Silas stresses that while waiting to have 'the conversation' might feel like putting off the inevitable, choosing to wait, rather than force the issue, might actually be the better (and faster) solution in the long run.
"It might feel quicker to just tell someone what to do, but then they don't do it," Silas said. "People have to own their own solutions. We need to feel in control of ourselves.
"Actually waiting until the timing is right works out to be faster and more effective."
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