What Impact Might My Obesity Have on My Family and Friends?

How Might My Friends and Family Respond to Me If I Have Obesity?

Friends and family will likely have a wide variety of responses to your obesity, which can affect their feelings, thoughts, behaviors, and interactions with you. These responses can be helpful or unhelpful, positive or negative, or even neutral. Some family and friends might respond with mixed feelings about your obesity. Their reactions might be influenced by a range of factors, including the nature of their relationship with you, the severity of your obesity, the impact on your functioning, and their pre-existing thoughts and feelings about obesity. Overall, your family members are more likely to be affected by your obesity than your friends, given that friendships are voluntary and more easily ended when they become strained or unfulfilling, as opposed to family members who are typically more emotionally involved and committed or obligated to maintaining some form of a relationship with you (Carr and Friedman, 2006).

In general, feelings of anxiety, concern, and even fear can play a large role in how your friends, and particularly your family, respond to your obesity. Your family members might worry about your health or the possibility of your developing an associated medical problem, such as diabetes or heart disease. They might fear that your life will be shortened by an obesity-related illness (NIH, 1998). Family members might worry that they will need to become your caretaker if your obesity is severe or your functioning becomes limited. Others might feel concerned about your mental health being negatively affected, such as having a decline in your self-esteem that results in avoidance and isolation, or the possible development of depression and anxiety (Friedman et al, 2005). Your family might fear that the quality of your life will be impaired and that you might not be able to participate fully in daily activities or in family life due to your obesity. Others might worry about your experiencing stigma, prejudice, and discrimination in the workplace or in society (Carr and Friedman, 2005). They might fear potential job loss or loss of medical insurance coverage. Family and friends might also be concerned about physical barriers or logistical issues about your obesity; for example, not being able to fit into the car comfortably or to find a seat in a public place.

As obesity and related behaviors continue or increase over time, anxiety, fear, and anger can surface among your family members and friends. Because there are many biological, psychological, social, and environmental factors that contribute to the development and continuation of obesity, friends and family members might have difficulty understanding why your obesity has not changed; this leads to frustration. They might also feel discouraged about fluctuations in progress, setbacks, and repeated weight cycling. They might be disappointed and lose trust when promises to change are made but then broken. More than being just frustrated about your obesity, family members and friends are likely to become angry about your unhealthy behaviors that have a negative impact on your lives together (Carr and Friedman, 2006). For example, family members and friends might be the most upset and resentful about behaviors that disturb your life and their relationships with you, such as compulsive eating, binging or purging, hiding or lying about food, unhealthy dieting, isolating and withdrawing from others, avoiding intimacy, and centering daily activities around food or on weight. There can also be anger regarding money spent on food or obesity-related illnesses. In cases of severe obesity, family members might become angry about having to help with hygiene or self-care. Gradually, these kinds of behaviors can lead to the development of significant anger, resentment, and contempt, as well as damage to and the end of relationships (Carr and Friedman, 2006).

Other responses involve feelings of guilt and shame. Some family members feel responsible for your obesity or feel guilty that they have contributed to your obesity or to your life in general. They might also feel embarrassed, ashamed, or even disgusted because of your obesity (Brownell, 2005). These feelings can lead to efforts to “fix” your obesity, such as controlling or monitoring your food intake, giving excessive advice, belittling or shaming you, or being overly involved. Conversely, others who feel guilty about your obesity might deny that your obesity could be a problem.

Apart from denial about obesity, some family members or friends normalize obesity and do not view it as a problem (Christakis and Fowler, 2007). A large proportion of the population is overweight, and individuals who do not weigh much above the norm might not be seen as having a significant issue. This can also occur in races and ethnic groups in which a heavier body type is considered as more socially acceptable (Carr and Friedman, 2005). Even in groups in which obesity is significantly stigmatized, there can be a sense of camaraderie, normalizing, and rationalizing between obese or otherwise stigmatized individuals, as people tend to choose friends who are like them. Sometimes, these bonds can be threatened when your obesity status changes. In these kinds of relationships, your friends or family members might rationalize their unhelpful behaviors, such as over-eating with you, or attempting to support, comfort or connect with you using food. At times, these individuals overtly or subconsciously thwart your attempts at change. Likewise, feelings of pity can also lead to minimizing or sabotaging behavior.

Family and friends can also respond to your obesity with acceptance and compassion, acknowledging your strengths and enjoying and loving you for who you are. These people might understand the challenges associated with being obese, but they do not define you, your character, or their relationship with you as being based on your weight. However, it is important to understand that even when trying to respond with support and empathy, others might not readily acknowledge your obesity, because they do not want to say the wrong thing and upset you. Even when you are identifying obesity as something you want to change or are identifying personal goals related to developing a healthier lifestyle, family members and friends might minimize the significance of your obesity or the need for an intervention due to their discomfort about hurting your feelings.

Is My Family Contributing to My Obesity?

In thinking about how your family members or family dynamics might be affecting your obesity, it can be helpful to reflect on your current family as well as your family of origin. Both your present and past family systems could be contributing to your obesity.

Dietary habits that you were exposed to as a child can directly affect your current eating behaviors. Perhaps you were raised in a family that did not prepare meals frequently, and you never became confident about learning to cook. Maybe you came from a family that ate a lot of fast food or frozen meals. Growing up, your family might not have been able to afford healthier food options. Your parents might not have been knowledgeable about healthy diets or could have provided you with misinformation about nutrition. Perhaps you were restricted from food as a punishment and bribed or rewarded with food for good behavior. You might have also learned to soothe yourself by eating instead of talking about your feelings or you observed your parents eating when they were upset. These types of scenarios influence what you have internalized about food and eating, thereby affecting your current diet and behaviors (Cruwys et al, 2015).

In addition to reflecting on your past, consider how your current family’s habits might be contributing toward your obesity. For example, a spouse might choose to buy or stock up on unhealthy foods that are tempting to over-eat (like chips, candy, and cookies). Children might not want to eat healthier foods or change their diet. Instead of structured mealtimes, family members might eat sporadically or graze throughout the day. Some families can be more sedentary and be “couch potatoes” rather than playing together, going outside, or exercising. Your partner or children’s sleeping habits can also affect your weight by causing you to stay up late or not get enough sleep, which increases your risk of obesity (Anderson, 2012). You might also feel unable to fit in grocery shopping and time to cook healthy meals on top of your family and work responsibilities. For many, childcare can be overwhelming and time consuming, particularly for mothers, such that parents do not prioritize taking care of themselves, eating healthy meals, or exercising. Overall, these barriers to change by your family members in regard to daily lifestyle choices can contribute to your obesity (Zweickert and Rieger, 2014).

Families often bond over meals; and family gatherings and familial ethnic and cultural practices often center around food; these practices can derail attempts at healthier eating (Zweickert and Rieger, 2014). For example, it is common to munch on snacks during family activities, like a barbecue, or watching sports, television, or movies together. Family gatherings and traditions almost always involve food preparation (like making cookies during the holidays, roasting a turkey on Thanksgiving, or simply going to get ice cream on the weekend). Immigrant families might also connect and teach younger generations about their culture by preparing meals from their homeland and eating together. During family gatherings, there can be an excess of tempting options and limited or no access to healthier choices. In addition, because these events often revolve around eating, it could be considered offensive not to partake, and there can be pressure for you to eat when you’re not hungry. Eating or drinking to manage social stress or to deal with underlying tensions among family members can also occur (Exline et al, 2012).

A history of stressful or traumatic life events and unhealthy family dynamics can contribute toward the development or exacerbation of obesity (Carr and Friedman, 2006). Research has established a strong correlation between stressful life events and the development of obesity. For example, a history of childhood trauma such as parental separation and parental death has been linked to obesity later in life (Alciati et al, 2017). Childhood abuse and neglect, including exposure to domestic violence, and particularly sexual abuse, are commonly associated with the development of obesity (Alvarez et al, 2007). A family history of eating disorders, mental illness, alcoholism, and other addictions can also have a negative impact (D’Argenio et al, 2009).

Stressful circumstances, feeling out of control, and experiencing conflict in your family or marriage can contribute to compulsive eating and obesity. For example, tending to a fussy baby or parenting a child with a disability can be stressful and result in overeating. Caring for aging parents or trying to cope with bereavement can be similarly stressful. Having a spouse who is unemployed or having financial stressors can make healthy eating difficult. Marital conflict has also been linked with appetite dysregulation. Unresolved negative feelings between you and your partner or spouse are likely to contribute toward overeating (Jaremka et al, 2016). Conflict, criticism, and blame can be particularly detrimental (Weihs et al, 2002). Having a spouse or a partner with an untreated addiction, mental illness, or an eating disorder will also likely negatively affect you. Moreover, being in an abusive romantic relationship might exacerbate feelings of low self-esteem and perpetuate coping by overeating, further intensifying poor self-image. Having a partner with low self-esteem can also contribute toward your obesity by enabling or sabotaging behaviors, such as your partner supplying unhealthy food, inciting binge eating, or denying the problem; some partners fear that if their loved one loses weight, he or she might leave them (Carr and Friedman, 2006). Others might encourage over-eating so that they can binge eat with you and decrease their guilt. In some situations, obesity itself can become a scapegoat for difficulties in the relationship to avoid acknowledging or taking responsibility for other problems.

Overall, dietary and lifestyle choices, resistance to change, stressors, interpersonal dynamics, unresolved conflict, abuse, trauma, grief, and loss in a family can contribute to obesity. Although you cannot change your past, exploring how it might affect your obesity in the present, often with the help of a professional, can help you uncover complex psychological processes, dysfunctional family dynamics, and even family habits that contribute toward your obesity.

How Might My Family Change Because of My Obesity?

The more your obesity negatively affects you, the more your family might change, and this can affect your ability to function. If you are constantly focused on your weight, your relationships are likely to suffer. For example, you might miss out on quality time with your family due to being unable to participate in activities because you lack the energy or physical ability to play with or keep up with your children or partner. You might have difficulty traveling and miss out on family events due to your size or a decline in your mobility. If your obesity is related to feeling bad about yourself, your response to these feelings might also change your family dynamics. You might push loved ones away or withdraw from your family. If you are experiencing low self-esteem, it might be difficult to stand up for yourself or ignore family problems that need to be addressed. You might also contribute to conflict by not facing your obesity and instead blame or attack family members.

Your obesity can also change your romantic relationships. Decreased quality time spent together can damage your relationship if you are preoccupied with weight loss. Obesity and poor body image might diminish your level of physical affection and sexual intimacy with your partner (Shah, 2009). If your obesity significantly affects your health and daily functioning, your spouse can end up becoming more of a caretaker than a romantic partner. Your relationship can also become strained if your obesity triggers controlling behaviors in your partner, such as attempting to monitor your food intake or your spending on groceries and food. Eventually, feelings of anxiety, anger, resentment, and disappointment related to obesity could lead to heightened conflict and can result in the ending of a marriage and dissolution of a family.

In addition to the possibility of heightened parental conflict, your children’s lives might change in other ways because of your obesity. It is difficult to teach healthy lifestyle choices to children if you are modeling unhealthy behaviors; your children are more likely to become obese (Rhee, 2008; Kimbro et al, 2007). You might also be unintentionally teaching maladaptive coping strategies, or impeding their emotional development if you are preoccupied with your weight, have low self-esteem yourself, or soothe or numb your feelings by eating compulsively.

Your family’s financial status might also change because of your obesity. You might have difficulty finding or keeping a job due to physical limitations or associated health concerns. Your family might be adversely affected financially by experiencing stigma that surrounds your obesity. Health concerns related to obesity might also significantly change your family by increasing stress linked to caretaking. Your family might accrue expensive medical bills or have difficulty obtaining insurance. At worst, your lifespan can be shortened, forever changing your family.

What Are Some Indications That My Family Is Not Dealing Well with My Obesity?

There can be a perception that you are not hurting anyone but yourself if you are overeating or are obese; however, we know that this might not be the case. It is better to acknowledge the signs that your family is having a difficult time rather than engaging in denial of distress.

The most obvious indications of poor coping are direct expressions of negative emotions (such as anger and resentment) about your obesity. Fighting and arguing about obesity-related behaviors are clear signals; for example, a spouse expressing frustration about avoidance of activities due to his or her weight. Controlling (managing your grocery list, limiting financial means for food, attempting to force you to exercise, or even putting locks on cupboards or the refrigerator) and monitoring behaviors are also strong indicators that your family members or your partner are not dealing well with your obesity.

Somewhat more difficult to detect is an increase in complaints or over- reactions to something minor. For example, a spouse who is complaining about the number of dishes in the sink might be expressing anger about how much you have eaten. Similarly, passive-aggressive comments are often a way to express negative feelings about a situation. Family members might also make shaming or belittling statements to change your behavior because they are dealing poorly with your obesity. Others might express negative feelings by joking about your weight, at your expense, or by indirectly making obesity-related “fat-jokes” (Tucker, 2014).

There can also be more subtle signs that family members are struggling with your obesity. Some feel embarrassed or uncomfortable with your obesity and distance themselves from you. For example, an adolescent might not want to invite a friend over after school because he or she is embarrassed by your obesity. Family members might also avoid discussing your obesity and related problems or avoid being around you. You might find that you and your partner are spending less and less time together. A spouse or partner might avoid physical affection or sexual intimacy.

Even though they might not understand whether a situation is obesity related, children often express sadness or guilt about behaviors they observe in a parent, given that children are more likely to attribute blame to themselves than to a parent. Some children express confusion or seem sad about their obese parent’s behavior. For example, a parent might avoid taking their child to the park because of weight-related issues, but the child interprets this as being because of some defect within themselves or feel unloved or abandoned, not comprehending the real reason. In addition, because of stress on the family system, some children act out or misbehave, whereas others attempt to be perfect. Because your children think concretely and have less capacity for emotional regulation than adults, you might need to observe carefully for indications that your children are not handling your obesity well, because it might not be as clear as with your adult family members.

How Might My Own Coping Be Influenced by My Family?

Everyone uses coping strategies to manage feelings and to deal with problems. Some of these methods are learned from our families and others we glean from later-life experience. Regarding obesity, it can be helpful to reflect on how over-eating might have become a maladaptive coping strategy and whether you and your family members are coping well with emotions or life stressors (Weihs et al, 2002). In some families, eating can become a primary method of coping with unexpressed negative feelings. Family members sometimes learn that eating makes them feel better or distracts them from their emotions. Some people eat to cope with feelings of sadness, loneliness, boredom, emptiness, anxiety, disappointment, anger, guilt, and shame. In particular, anger is often an uncomfortable emotion for many families, and it can result in over-eating. Others might eat to re-establish a feeling of control in a chaotic family environment or when they feel helpless and cannot alter their circumstances. Some people eat to cope with the belief that they are not good enough or are unloved (Holland et al, 2012). 

Unfortunately, feeling stigmatized by one’s family because of obesity has been associated with negative coping strategies, such as eating more, avoiding, and ignoring the situation (Puhl et al, 2006).

Being obese can also become a coping strategy for some who have experienced trauma. These individuals can use obesity as a way of coping with vulnerability because they feel safer and better able to protect themselves when their bodies are larger. Others use obesity as a deterrent against unwanted attention.

If you suspect that you or your family members are not coping well or are using unhealthy strategies for dealing with intense emotions and stress, it can help to seek professional support. It is unlikely that you will be able to lose weight and keep it off over the long term if there are unaddressed issues and ineffective coping skills that are affecting your obesity rather than just eating a poor diet or lacking exercise (Alvarez et al, 2007).

Is It Wrong for My Family Members to Resent Me and My Obesity?

As human beings, we would all like to be loved and accepted unconditionally by our families, and it can be extremely challenging to feel resented for having obesity. However, negative feelings about your obesity can develop slowly among your family members; and although some reactions might be unhelpful, or downright hurtful, your family members are entitled to their feelings, just as you can have your feelings. If you believe your family members resent your obesity, try to consider their point of view and the reasons that might be causing them to feel this way.

If your family members’ lives are being negatively affected by your obesity, their resentment can be understandable. For example, resentment might be a reasonable response if your eating or obesity result in isolation and alienation from your loved ones. Self-destructive, obsessive, and compulsive behaviors are also likely to trigger anger from your family. Lying about as well as spending excessive amounts of money on food or weight-loss products can also lead to similar reactions. Other eating-disordered behaviors such as binging and purging are also understandably distressing to family members (Carr and Friedman, 2006).

In contrast, resentment can be the result of a deeper issue in a relationship that might be obscured because of a focus on obesity. Because obesity is so visible and cannot be concealed, it can become a scapegoat for other problems in a relationship; other issues can be overlooked because the obesity is more apparent. For example, if one spouse has compulsive over-eating and the other has irritability related to anxiety, the obesity can be the more obvious of the two, although both problems are likely to negatively affect the marriage.

Overall, relationships are quite complicated and are affected by a variety of factors. If you feel like a partner or family member is resentful of you apart from your obesity, it can be important for you and maybe even for that individual to seek help, especially if you want to preserve or to improve the relationship. Working with a professional can help you process hurt feelings and establish realistic expectations. And, talking with someone who has an outsider’s perspective can help you discern your responsibility for the situation without taking on excessive blame. In time, relationships can heal when there is acknowledgment of how others have been negatively affected. However, it is important to understand that change is still possible, even if you do not ever get the kind of support you want from your family.

What Can My Family Do to Deal More Effectively with My Obesity?

One of the most important things for family members to do is to take responsibility for their feelings, thoughts, and behaviors and to evaluate their involvement and personal ways of coping. Obesity is not something that family members can cure or solve for a loved one. Ideally, family members need to learn how to set boundaries and to make choices so as not to suffer the consequences of someone else’s condition and choices. Ultimately, it is the responsibility of the person with obesity to seek health in ways that work. For family members, taking ownership and setting boundaries could mean stopping controlling behaviors or trying to fix the obese person. It could be expressing thoughts and emotions about the situation, gently but honestly, rather than attacking, being passive-aggressive, or avoiding the topic. It might include identifying and stopping enabling or sabotaging behaviors. Trying to listen and providing acceptance might be better than giving advice.

Accepting that obesity is a disease with multiple and complex causes and separating the person and their character from the disease, can be a helpful way to reframe the situation. Families can take comfort in the fact that they can still love and be supportive without having to like or approve of their obesity or related behaviors. Other ways to manage more effectively involve identifying and addressing unhelpful thoughts, such as black-or-white and all-or-nothing thinking. Recognizing cognitive distortions (such as the false belief that if they loved me, they would not over-eat or be obese) is also important. Other ways family members can more effectively cope is by focusing on strengths and successes rather than on failures.

Personal change is not linear, and there will be ups and downs along the way; obesity is not something that is alleviated overnight and might present a life-long struggle. It is imperative for families to support mental and physical health and relationship building, as opposed to just weight loss by the person with obesity. Family members will fare better by making a commitment to their emotional and physical well-being, having compassion, and setting appropriate boundaries. If these objectives seem overwhelming, and they can be, seek help from a professional or a support group to facilitate change and obtain additional support.

Are There Support Groups for Family Members of Persons with Obesity?

Obtaining outside support can be particularly helpful for both the obese person as well as their family members, and there are multiple options available, although access can vary depending on where you live. In general, support groups are led by peers or group members, whereas therapy groups are led by clinicians or other professionals. In addition, individual, couples, or family therapy can be beneficial (Weihs et al, 2002). Individual therapy can be useful for the person with obesity as well as for family members to process and explore their feelings, whereas couples or family therapy will address problems and unhelpful family dynamics together. These options have different benefits and can be complementary to one another. Initially, you might try a few different groups or providers to find the best fit for you and your family.

If you are unsure about the options available in your area, start by asking a primary-care physician, endocrinologist, bariatric surgeon, psychiatrist, or other physician specialist for a referral suggestions. Social workers, marriage and family therapists, and licensed professional counselors might also be able to direct you to local clinicians or support groups that specialize in obesity or eating disorders. Nutritionists and dietitians can also be excellent referral sources. In addition, there are on-line resources that have national directories that can help you and your family members locate appropriate support, such as the National Eating Disorder Association (NEDA) (www.nationaleatingdisorders.org) and the National Association of Anorexia Nervosa and Associated Disorders (ANAD) (www.anad.org). Overeaters Anonymous (OA) (www.oa.org) is a free member-led organization with support groups across the country. Al-Anon and Alateen (www.al-anon.alateen.org) provide specific support for adult and adolescent family members of a person with addiction. Although these latter two groups are generally considered to be for family members of alcoholics, they can still be quite useful for family members of an obese person because many of the same family dynamics apply. Lastly, although you might not consider obesity to be an eating disorder, do not rule out eating-disordered options prematurely, as eating-disordered behaviors encompass a wide variety of behaviors, including those that are related to obesity.

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