I met up with my best friend today. She's been overweight (OK, obese) since I first met her - she put five stone on with her first child and never lost it. Over the years she's always said that she hates being fat and I've tried to encourage her when she's tried diets and tried to offer advice based on what's worked for DH. She can be very sensitive, so I tend to back off from being too blunt because I am a complete coward don't want to lose her friendship.
Today she told me that she'd been to see the doctor about water retention, and that the doctor had given her a stern lecture about her weight, referred her for an urgent appointment with a dietitian, and given her strict instructions to keep a food diary and come back in one month having lost 8lb. She said she told the doctor that she didn't eat a lot, but that the doctor didn't seem to believe her. (She actually probably eats more healthy food than me, but her portion sizes are HUGE compared to mine. She has it fixed in her head that as long as the food she eats is that which is commonly deemed 'healthy' (cereal, yoghurt, rice etc.) then it doesn't matter how much of it she eats - she doesn't really 'get' calories.) She said the doctor thought she was "in denial" and scoffed at how silly that was, because she knows that she she needs to lose weight. Then two minutes later she said that she'd had five chocolate biscuits with her cup of tea, but that she wouldn't be putting that in her food diary. Isn't that denial? 
(I did say that to her, but she thought I was joking.)
The doctor told her to cut out all unnecessary calories - no potatoes, pasta or rice. She came home and said, "F* that." She said that her DH had got the exercise bike out for her, but that she never had time to use it because she was always out on the school run or feeding the baby. But I was round there for nearly two hours and she only spent 15 minutes or so feeding the baby, and the rest chatting to me.
I really am getting worried about her now, because I always thought that she did want to lose weight, but was hindered by not really understanding calories or carbs or dieting or portion control. Now that the doctor is so concerned about her health, I would have thought it would give her the kick up the bottom that she needs to really sort herself out, but it seems to have done the opposite - she seems to have lost her motivation and the stubborn streak has kicked in. Before now she has badgered me to go to a gym with her, and I didn't really want to - I prefer classes. But I did join a gym a couple of months ago to get rid of my baby weight. I told her I can get her a free guest pass and we could go together and try things out and have some fun, but she just refused point blank. I've lost a stone in a couple of months, and she said I look old and gaunt and I'm too thin. 
I'm not upset, because I think she is just being defensive. But it did make it extra hard to say anything about exercise, because I just sounded like a gym nut / convert. And I didn't really need to lose much weight in the first place, so I felt like going on about it was rubbing it in.
Sorry about the long post. What I want to know is, am I being a crap friend by massaging her ego and going along with her denial? Should I have come out with it and said, "Look, the doctor's right - you are not going to lose weight unless you do some serious exercise and start counting calories properly"? I always thought that no-one else can make you want to lose weight - you have to do it for yourself. But I do want to help her and I can't help feeling that I've let her down by not being more blunt. Then I think the doctor was incredibly blunt, and maybe my friend is still a little shellshocked and defensive after that and just needs a little time to come to terms with what was said - so maybe just being there for her if she needs me is enough? Aaarrggh - I don't know what to do! What would you do?