The Elephant in the Room, Part II

Yesterday I posted about the tension that can arise between friends when one changes their lifestyle. I am sure that some friendships have fallen by the wayside after someone decides that they cannot continue to eat, drink or live in a way that is basically unhealthy. While no one wants to sacrifice a friendship, sometimes the price is too high to continue with such a relationship. Within a family however, the problem can be even more difficult. What are the costs to our relationships and to yourselves of not living in a manner that promotes our own health and wellbeing?

Last week on the Biggest Loser, Michael spoke to his father (Ron) about how he could have let his children become so obese. Michael spoke of his frustration and anger about the situation. Unfortunately, Ron really didn't have much to say besides "you have every right to be upset". This really doesn't answer the question of how could he have let this happen? I have heard similar stories from others about their tendency not to criticize their family members about their unhealthy lifestyles. Keeping the peace seems to take precedence over pushing issues related to unhealthy behaviors.

This seems especially true when it comes to our children. As parents we are often counseled to avoid criticism or anything that will undermine a child's self esteem. The critical parent is often portrayed as overly controlling and overly concerned with the image of their children as an extension of themselves. While this characterization might have merit in some circumstances, when it come to weight and lifestyle issues, ignoring a child's burgeoning weight problem and lack of exercise is only setting them off on the path to ill health and disease.

When the child involved is still young there is always the expectation that they will "grow into their weight" or they are just "big boned". While I believe that dieting is a concept which should remain foreign to a child, parents are still the final arbitrators of the food that enters the home. Parents should strive to provide healthy foods for their children and not succumb to the pressure to provide high fat, high sugar treats because the children want them or "deserve" them. I am not aware of any child who was harmed by a lack of Little Debbies. Moderation and responsibility are the keys in this younger age group.

Teenagers and young adults however, present a further level of complication. Again as parents we have been counseled and quite literally preached at, regarding the unrealistic body images promulgated by today's media. We are constantly warned about the dangers of eating disorders and societal pressures to be thin. Yet the most recent health data show obesity levels on average at 16% for American youth, with some populations running even higher. Ignoring this elephant in the room is a disservice to our children. So what is a parent to do?

While being a good role model is a great place to start, it is going to take more than that to see behavior change in teenagers. Banning of junk food and becoming the first lieutenant of the food police will only lead to resentment and the potential for excess consumption when out of the house. By broaching the subject of overweight or unhealthy eating in a nonjudgmental but never the less honest fashion, a parent may gain some insight into what the teen is thinking, what they understand to be true and they may also learn what the teen has already tried in an attempt to lose weight. Asking a young adult if they would like to change and where they would like to start, allows them to remain in control but also opens an opportunity to provide assistance and guidance.

If the teen has no interest in making changes to their lifestyle, a discussion of the family's known health history and an offer of support in the future along with keeping healthy foods available may be all a parent can do. For those requesting assistance allowing this to be the child's journey, and supporting them while they find what works for them is key. Reversing a lifestyle of poor eating and inactivity will take many starts and stops and the path chosen may not always be the one a parent might choose for themselves. While there is a responsibility to avoid harm, a parent must otherwise sit back a bit and let the teen figure out what is meaningful and doable for them. By being open to looking at a problem in a new way we as parents might also learn a thing or two from our children.

The first step however starts with having the courage to talk. Let your teen or young adult know that you love them and worry that the path they have chosen will lead them into an unhealthy future. Offer your assistance and support in a way that does not blame or shame and let them decide what to do next. Just don't ignore this elephant - in the end it makes a very big mess.

Lessons From Tonight's Biggest Loser

Although I spent many years practicing Medicine, and have encouraged probably hundreds of people to lose weight, I had never watched the reality television program Biggest Loser. Until now. Since checking out the show when it started this fall, I have become as hooked as anyone. While I resent the product placements and overdone theatrical breaks, there are none the less, many messages that really hit home regarding the struggle to achieve a healthy weight and lifestyle.

In tonight's episode Aubrey was sent home. The mother of several school and preschool age children, she arrived home to tears and vowed to continue her daily workouts. Aubrey cited her desire to be healthy for her children and to be a role model not only for them, but for her massively obese father as her motivation to maintain her training and new lifestyle. She gained nine pounds in her first two weeks home.

When faced with the daily decisions of family life Aubrey found herself putting others before herself. One telling scene showed her stowing her workout gear after her son asked her for homework help as she headed for the gym. Now if she had said "figure it out yourself" and headed out the door, the talk of her being a self-absorbed bad mother would have been flying before the next commercial break. I am not saying what I think she should have done, but it does point out how hard it is to make lifestyle changes that require you to make time for yourself.

As a society we are very quick to judge another's actions and anything that smacks of self promotion or self importance is often labeled as indulgent or selfish. Yet isn't Aubrey's motivation her desire to be healthy and a role model for her children? By always placing herself last on the priority list isn't she modeling that she doesn't count? That healthy behaviors need to take a backseat to everything else, like household chores and homework?

While living at the Biggest Loser ranch the contestants do not have to cope with these daily decisions, yet learning how to integrate new healthy behaviors into their lives at home is the key to maintaining their weight loss. And placing workouts before dishes, or laundry, or even homework is one of the choices they will have to make. It is one that we all have to make. Sure it is easier and quicker to grab some takeout food on the way home from work, but is it going to get you to the weight you want? Is it in line with the type of foods you want to be eating, or feeding to your family?

At the end of tonight's show Aubrey has gotten herself back on track. It probably required some tough decisions, at least a few of which required her to acknowledge her own self-worth and the need to place herself higher on her own list of priorities. It is a lesson we can all learn from. Self care is not the same as selfishness and requires time that has to come from somewhere. Only after we admit that we are important can we give ourselves permission to take the time and make the effort to live the healthy lifestyle we desire. It is not just what we desire, but what we deserve, for ourselves and our families.

Now who said reality TV isn't about real life?