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Treatment Hurdle: Saboteurs

Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.

This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.


Weight-management efforts can be sabotaged in many ways. Support from partners, family and peers is often essential to coping with the long-term lifestyle changes needed for sustained weight maintenance. Unfortunately, close friends and family too often undermine a patient’s weight-loss efforts. The sabotage may be unintentional, as with a group of friends whose only means of socializing is to meet for dinner in a particular restaurant. Other times, friends or family may feel threatened by the patient’s decision to lose weight and the effect they expect this decision to have on their own lives. A jealous spouse, for example, may be concerned that a partner is attempting to lose weight to attract a new mate, or that he or she will attract more competing attention after losing weight.

If a patient’s spouse appears to be posing a barrier to weight management, it may be worth inviting them into the office to discuss their concerns. An open discussion may help reduce resistance.

Well-intentioned spouses on the other hand can act like “food police,” looking over their mate’s shoulder at meals and asking whether or not they are “allowed to eat that.” These spouses need to understand that the only question they ought to ask their partner is: “Is there any way I can help you?” Intrusive questions risk triggering oppositional defiance. Exploring your patient’s perceptions of how friends and family may undermine their efforts at the outset of a weight management program may enable you to help reduce any negative effects.

Social and professional obligations can also sabotage a patient’s efforts, as participation in activities centred on food and alcohol may be important for both personal and professional success. Someone whose job involves “wining and dining” potential clients may find sustainable weight loss very difficult.

Support, counselling and motivation from the medical team are essential, particularly during the weight maintenance period when the initial motivation to lose weight has decreased and the patient receives less positive reinforcement from watching the needle go down on the scale and hearing positive comments from friends and family.

© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.

The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.

Members of the Canadian Obesity Network can download Best Weight for free.

Best Weight is also available at Amazon and Barnes & Nobles (part of the proceeds from all sales go to support the Canadian Obesity Network)

If you have already read Best Weight, please take a few minutes to leave a review on the Amazon or Barnes & Nobles website.


  1. This is yet another blog post from you that rings unbelievably true for me. Are you a former fatty yourself? 🙂 You have profound insight into the psychology of the obese.

    Despite my wife’s very best intentions and her explicit wish to support me in my weight loss, she has inadvertently and probably unconsciously played the role of “food police” in the manner in which you describe. “Oppositional defiance” is a diplomatic way to describe my reactions to this behaviour, which have ranged from outright anger to passive aggressiveness to an enormous hidden binge later that night after she’s gone to bed.

    She and I have had a few discussions about this recently, and I’ve learned that she had no idea that even simple accountability-motivated questions to me about my food choices in the moment can have hugely deleterious effects on my state of mind. The clearest way I could describe to her what I needed from her might sound unfair to the other partner, but it was this: I need her unqualified, unflinching, and most importantly, her non-judgmental support in all aspects of this.

    My spouse is the one person in the world whom I need to feel I can turn to for support no matter how badly I might have failed today or this week. If I fear that her response to my failure will be in any way harsh, negative, or judgmental, I’m far more liable to hide my nutritional indiscretions from her in the future and to undermine our relationship in other ways. Unfortunately, this tends to start a negative feedback loop that can be really difficult to stop, and by the time you’ve figured out what’s going on, ten more pounds have found their way onto your body.

    Thanks for your continued great work and writing here.

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  2. Oh, this is so true! Dealing with other people’s discomfort with weight loss is something that should be discussed more.

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