My friend is 5'9" and 285 pounds...that's a BMI of 42.1 or so (can't recall the exact number). She eats portions bigger than I do (and I eat A LOT), and it's unhealthy food. The extent of her exercise is basketball practice once a week (we're on separate teams, but practice, at least for me, isn't extensive exercise) and games once a week (her team has her pretty much on the bench the entire time, and when she plays, her job is to stand in the key and push people so the coach's kid gets the ball). She came to the gym with me the other day (and I'm pretty sure she won't willingly come back-she didn't fit in half the machines, and wasn't capable of most of the other motions). She was winded walking at 2.5 MPH or so (that was mainly killing time while I got my elliptical training in). I don't know what to do-she's going to be dead by age 20 if someone doesn't say anything-but I don't want to hurt her feelings. I figured you guys would be the best to turn to. Any advice?

You should figure out why she's eating such large portions. Is she hungry all of the time? She could truly have a metabolic disorder. I would casually bring the subject up somehow, and if she takes the bait, see if you can convince her to go to a doctor and get some bloodwork done. See if they can pinpoint any underlying conditions. At 285 lbs, a diet is no laughing matter, and needs to be done slowly and carefully with lots of support and with a doctor's supervision.

I think it's just the way her family eats-all of them, excluding her sister (who tries really hard to eat healthy, and does a good job when you consider that the closest thing to vegetable in that house is tater tots), are obese. Her mom's diabetic, too, so it's extra important for her to attempt to be healthy.

I was going to attempt to bring her with me for my next physical, but I'm probably going to get yelled at for weighing under 125 (it was an accident, though...) and I somehow doubt she want to watch that.

A metabolic disorder is a distinct possibility-I clearly remember a sleepover when she whined so much that she was hungry that I wound up making a hot dog at 2 am. I was not a happy person.

Mikaela, we are often a product of our environment (to overuse a tired cliche). IMHO, it's important to look at environmental factors first, rather than jumping on the whole disorder bandwagon. True, she really might have a metabolic disorder, or some other disorder, but I'm seeing a growing trend of people blaming their obesity and lack of self-control on someone or something else. It's time for her to take control. In this case, a little positive motivation can go a long way. Complimenting her on activities she can do well may help her get excited to do them again. Even if it's something as simple as walking on the treadmill, a little encouragement may help her get back onto the treadmill.

In my experience, it's difficult to go to the gym when you know how much you can't do. When someone takes the time to compliment you on how much you can do, it can change your entire perspective.

My ex-girlfriends father was a chain smoker and liked to drink. Everyone in the family was concerned but no one ever said anything. He had a stroke, is nearly paralyzed on his right side and is very immobile and unhappy now. When he had his stroke, he was home alone and no one would have found him except by chance for probably a few days (his wife was out of town). The reality is, they were lucky they didn't lose him completely.

In the end, the lesson I took away from that was that, while it wasn't anyone elses responsibility to make him live healthy, it became everyone elses burden when the repercussions for his lifestyle finally hit. Honestly, your friend will have her feelings hurt no matter how you tell her, and there's probably a good chance that she will be angry. Odds are she'll be angry at herself, but she'll take it out on you.

I'm not going to sugar coat it either, she may not want to talk to you or be around you for a while; you may lose your friend, temporarily, but in the end she will realize that you only did it because you care about her and because you want her to be happy, healthy and, most importantly, alive.

It may sound dismal or over-the-top, but I've missed too many opportunities to say what I should have said in my life, and it cost me more than I ever thought it could. Today I'd much rather lose a friend for a little while because I cared enough to say what needed to be said than lose a friend forever because I didn't.

Keep in mind your friend may not appreciate your attempts to help her. If she is anything like me, she won't do anything about her weight until SHE is ready. I had a number of conversations like that growing up, and none of them ever went well. It wasn't until I was ready to do something that I was able to make the changes in my life that I needed to make.

Very well said Brandon. I think, often, the status of our weight is equated to acceptance. I think it is important to really accept and value your friend no matter what she weighs. Maybe then she will learn to value herself and have one of those "wake up" moments.

I'm a former big eater, married to a big eater (probably helped me put on a lot of my weight too, but hey - I wasn't complaining then!)

While we don't work out together yet, I'm trying the "passive motivation" technique. If it works for me, maybe it will "rub off" a bit... I think I'm making progress!

Other than that, your friend already did something VERY important by getting on the treadmill in the first place. Remember that for people that are so overweight even walking is good cardio and burns a heckofalotof calories. And it only gets easier with time! The elliptical is also good for us fatties, and nobody says we have to race anybody.

If she's for it, let her stick to that treadmill even at her slow speeds. She'll see progress soon enough and that will be great motivation for her. Screw the machines she can't fit in right now - freeweights are also a possibility and come in all shapes and sizes.

But hey, in the end it's her decision. If SHE wants to get healthy then you can show her the way.

As said, all we can really do is teach through what we do; at some point this and all the facets that make up obesity will tip the scales in favor of proaction.

if you are concerned, how about talking to her basketball coach in confidence about your feelings about her and see what he/she recommends?

I know for me I didn't do anything until I personally really wanted to change. I had others telling me I need to get in shape. I had heard of all the health complications that could be involved. I would even joke about having as my goal in life to be the fattest man in the world.

But then something snapped in me and getting in shape became something I knew I had to do, not just what someone else was telling me. I don't completely understand what initiated the snap but I know that people telling me I needed to lose weight and the benefits of getting into shape certainly helped in this process. I appreciate everyone who reached out to me over the years.

I think you should try to have some conversations with her about her health in a caring, friendly way. She needs to value herself enough to care to get into shape, and her friends can help her to realize her value. I don't recommend shrugging off your concerns, you should talk with her in my opinion. But also be happy that she got onto the treadmill, and encourage her to do it again, and again.

To those mystifying, magical moments.

Snap.

I'm leaning more toward the "mind your own" side of things.

You can also try pointing and laughing at her while she eats.

(She'll probably appreciate that better than having her friends create posts discussing her on the internet. )

Too harsh? I'm being serious, because what helped realize that I was fat was when an acquaintance pointed at my gut and made a joke, "you're obviously no stranger to the buffet." That got me to realize what I looked like. What then got me started was a company contest to lose weight.

Ultimately it's your friend's choice. You know her better than any of us... so you should know what motivates her better than us. So far the only thing we know is she might be motivated by food. And something tells me that offering her a sandwich if she loses 20# isn't going to work.

I am more leaning towards this as well, I am one who thinks:

'If you can't grow a pair and say it to my face then what gives you the right to talk about me behind my back.'

Breaking eating habits are going to be hard. It's obvious that she's eating until she's very full and it appears her family has taught her to be this way.

Maybe start her out by eating smaller more frequent meals and break the habit of needing to be absolutely full when she eats a meal.

Mikaela, didn't I once see you mention that you are in your early teens? Assuming that's true, and assuming your friend is in the same age range, I think there's very little you can do for her. The peer pressure at that age is TREMENDOUS. If she can ignore it and continue doing what she enjoys, she's likely to stick with that inertia over any advice you give her. She will probably even resent your intrusion.

Like others have said, nothing is going to happen unless she wants to change, first. I guarantee you that at 285 lbs for a teenager, someone has already commented on her weight before, either nicely or in a mean way, and it didn't do anything. Just enjoy her friendship and hope she comes around on her own. Weight and appearance are intensely personal areas of one's life, and it's hard to push your suggestions onto someone else.

Arby and Brandon, I completely agree.

Mikaela, I know your motivations are great and you love your friend and are worried about her health. I know it can be really painful to see someone you care about getting more and more unhealthy.

But, do you think she isn't aware of it? Do you think she doesn't realize she's overweight? What do you think your saying something would accomplish?

In my experience, and in my family's experience, no one starts losing weight until they decide to. As everyone here knows, it's HARD to lose weight and even harder when you're starting with a lot to lose. You have to be responsible for every single bite you take, for changing sometimes lifelong habits to get yourself exercising. I'm sorry but I really doubt anyone has the power to talk a person into those kinds of massive changes. They have to want it for themselves.

So, what can you do?

First, don't mention her weight. You'll only hurt her and damage her self-esteem which isn't likely to motivate her to do anything but eat. But you can suggest healthy activities to do together - maybe practice basketball together during the week, go on walks together. If she's very out of shape, you'll have to start easy until she's fitter. Don't center your get togethers on food (like going out to a restaurant). Get together at your place for a girls night in and stock up on healthy but yummy snacks. Share recipes for healthy stuff you've discovered. See what's going on in your town (festivals, concerts, speakers, activities) that you guys can do together.

I'm sure if you're there for her and show you care in all these ways it will do far, far more for her health and well-being than some kind of intervention talk.

Good luck!

That was great advice Kate... I am sure that is the best way to go about it...

Mikaela,

I know most of the advice given here has been to not talk to her about her health. And I believe that is because it would be easy to talk to her and be negative, and she has likely heard plenty of negative from people before. A negative discussion about her health could hurt your friendship and her self esteem. But it is very possible to talk with her and be very positive, and share all of the great things that you see in her. My guess is she needs someone who believes in her for who she is. You may not be close enough to really talk about her health directly at this point, but if you are, then you will know. You won't want to make her feel any worse than she may already feel, but at the same time I know you want to be a good friend and help her. The best way to help her is to build her up, believe in her and this will help her believe in herself. Then she might be willing to make a change for herself, because she needs to want to do this for herself or she will never do it.

To get her more active, i would invite her to do activites with you, walks, to the gym, bball, etc. Don't take her to your physical, especially if you are going to be talked to about being under 125, that is not going to help. As far as her seriously loosing weight, I know from my own experience, she has to want to loose the weight, and in general the more you bug someone to do something the less they want to do it.

what jeff b. said!

are you a counselor, jeff?

I completely agree with people about NOT mentioning her weight to her but encouraging activities. So she was walking 2.5 mph... that is something! And if she weighs that much its going to be hard and she needs to start slow. Chances are that her basketball practice probably feels high intesity to her and i'm glad to hear that she is at least doing that. But as someone who is overweight, hearing from a friend who is not really overweight that they are concerned can just put you off... I'm 5'8" and when I was a tennis player and 165 lbs people still called me fat and told me that i needed to try harder. I was hurt because I was trying as hard as I could. It discouraged me so much that I put myself down and quit.. now its 5 years later and i'm angry because I let myself get to 275!!! I have been working hard over the last year to lose the weight but its not easy. My friend lost 50 lbs in 6 months and i lost 5.. She asked if I was trying and when I told her that i joined a gym she said "Good! I am so glad.. I have been concerned about you"... I know that shouldn't have been a negative comment but I was completely insulted.

A long story longer.. She knows she's overweight and it wont matter what anyone tells her. She wont lose weight until she is ready. Play basketball with her. Invite her back to the gym with you. Maybe stall so she has to pass more time on the treadmill. If she notices that it makes her feel better she'll start to increase her speed and time spent there on her own!

Teenage years are rough and i am sure its hard for you to see your friend overweight, but this is something she needs to decide on her own.

Best of luck!

I was kind of taken back by this post. I too am very overweight and if one of my friends wrote this blog about me I would be raging.

I have admitted to myself that I need to lose weight and I am really trying. My friends are a great support group and that is all you can be to her. You do, like others have said, need to wait until she is ready.

If you push her you might push away her friendship. I don't know what younger girl admits her weight at that age but I find it funny you know all that information on her. I am sure it is something she is not proud of. The way you talked just didn't seem very positive to me and that is what you need to be is positive. I feel like you were trying to embarass her with the post. Do acitive stuff with her at home or just go for walks. She doesn't need to join a gym right away to lose weight so don't pressure her to go back.

I think that you need to focus on your own health goals and be ready to support her when she comes around.