Dear Savvy Auntie,

My niece, Ashley, just turned 15. She’s a beautiful girl in every way, but she keeps gaining weight. She’s about average in height but must weigh more than 200 lbs. now. My sister, her mother, is worried sick – and so am I. I think Ashley’s pretty unhappy about this, but I don’t know how to approach her. Help!

Scared Auntie

Dear Scared Auntie,

The good news, and it’s very good news, is that you and your sister are reaching out for help. You’re way ahead of the game. Many parents, relatives, and even family doctors try to avoid this touchy issue at all costs and are completely in denial. Overweight teens hate feeling blamed for their health, and they get a lot of that in direct and more subtle ways. The adults around them know about this sensitivity and often just avoid the issue. That approach just does nothing to solve the problem, and left untreated, obese teens almost certainly become obese, unhealthy, and unhappy adults.

So, what to do? A good way to begin might be by sitting Ashley down, and just tell her directly that you’re nervous about bringing up a sensitive issue. You do not want to offend her, but as someone who loves her, you’re concerned about her health and well-being. That’s a good way to start this conversation. You can talk about the problem as a “weight problem” or “overweight problem.” Studies show that people really hate talking about “obesity” or “fat.” After breaking the ice and getting her feelings on her weight, you can then discuss some good options for a plan going forward.  They may include talking with a dietitian in your area, finding ways to get more active, changing the family’s diet, changing Ashley’s schedule to include healthier activities and food, or going to a weight loss camp that features cognitive-behavior therapy (CBT). CBT is a scientifically based approach to helping people stay motivated, focused, solve problems, and improve their self-control skills. You can Google dietitians in your area; ask your doctor for recommendations, or Google weight loss camps and programs with CBT to find some good options. Sometimes, hospitals or university clinics also offer outpatient CBT.

Whatever happens, your niece and your sister will appreciate your concern and support. You can volunteer to follow the same program as your niece (e.g., wear a pedometer to get 10,000 steps per day; adopt a very low fat diet). You can encourage your sister to do the same, to get as involved as possible to promote a major change in lifestyle for the whole family. Your sister will certainly get that advice from any professional treatment approach, but offering your support will be very helpful. If you’re willing to adopt the new regime in these ways, you can also help make it fun, enjoy new low fat versions of favorite foods, and volunteer to do active things with your niece. As an extended family member willing to literally walk the walk, you can help be a solution to this tough problem.

Dan Kirschenbaum, Ph.D., ABPP is a Professor of Psychiatry & Behavioral Sciences, Northwestern University Medical School & President, Wellspring – a Division of CRC Health Group.

Published: April 30, 2012

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