If I say something about her weight?

[LadyRabbit]

Oh God. This is not a thread about fat shaming, really it isn't, but I don't think I can go on any longer 'enabling' someone I love dearly to slowly kill themselves.

My DSis (younger than me) is a great girl. Funny, kind and witty. Very sensitive, but that in turn gives her great empathy with other people, and she is one of the most thoughtful people I know. However, she is also incredibly overbearing sometimes and while I always stick up for her, yesterday was another episode of witnessing her be prickly and quite rude to someone (who took it with good grace) because deep down I know she feels insecure and as a result overcompensates by being brash and sometimes offensive. I have seen her ruin friendships over the years and never said anything because I want her to feel that she always has someone on her side.

The thing is she is morbidly obese, and has been slowly getting this way since childhood. My parents tried to help her - special diet companies, gym subscriptions, therapy, you name it, they may not be perfect but they did do their best. Over the years, when my DM and I have had big heart-to-hearts with her we established that no, she isn't happy being this overweight (nearly 300lbs now) and she knows that it is part of the reason she has been on anti-depressants since adolescence. (She is now nearly 30.) I have other friends and relatives who are very overweight but they are definitely what I would call happy - in long term relationships, enjoying their work, healthy (apart from needing to loose weight). I am not overweight and haven't ever been, so I realise that I can't fully understand what it is like to be in her position but I can see that it has been impacting her life for nearly twenty years now with no sign of improvement, in fact the opposite. But because I haven't gone through what she is going through I have never felt I was in a position to say anything.

But - SORRY this is a LONG one! - I can't take it anymore. I can't take watching someone I love throwing their life away on crap food, no exercise, constant ill health, never having a relationship when all she talks about is wanting to meet a good man and have kids, taking more anti-depressants and all the side-effects (one of which is cruelly more weight gain). I want my sister to have a family, feel good about herself, go for the career things she holds back from, make friendships without fucking them up because her insecurity makes her behave weirdly. I love her and see all her goodness inside struggling to come out and my heart sinks when I haven't seen her for a few months and see she's put even more weight on and can't even walk down the street without needing to stop every ten minutes. And I hate the moment when people meet her for the first time - when I've talked about my sister to them - and register that I never mentioned her weight and their first comment is 'wow, you don't look like sisters at all'. That bit makes me want to cry for her.

I want to say something. Firmly, but with love and concern. I talked at length to a friend of mine who has lost an awful lot of weight, and he confirmed that it has to come from within the person themselves. But I fear it never will with my DSis, and as time goes on I feel I have to say something because if I don't it will be an act of cowardice masquerading as love and I love her desperately.

So WIBU to sit her down and say something? If you don't think it's U, how should I say it? If you think it's U, why? I genuinely need some advice because I don't want to ruin the relationship I have with her.

I think we are at a pretty similar point, greyhound - I'm in therapy, and am just starting to value myself enough to want to make healthy decisions around food. I haven't lost any weight yet, but I feel good about making some tiny steps towards a healthier me. It is a long, long road, though, isn't it? It is good to hear a positive story from someone who's further along it than me.

Can I just say a huge thank you to those of you who are sharing very personal stories about something so difficult. It has really helped me understand where my sister is at better. What makes me sad is how some people start feeling so rubbish about themselves at such tender ages. In my Dsis's case it was around 11 or 12. Nobody should have to feel that way. And I realise it's not as easy as someone on the outside just telling you to be positive. It's very hard to show someone what is wonderful about them when they just feel dreadful about themselves.

I've only skim read the thread but if she's taking seroxat then it's likely to affect her weight. I blew up like a balloon and my very thin mum did too when she took it.

Don't say anything, for starters it's not really your business. She won't thank you, she's not ready yet just be there for her, you don't have to rescue her.

I'm really torn on this one.

You sound lovely and it's obvious that you only want the best for your sister, but as someone who is overweight and gets constant 'pep talks' from my DMum, I know how easy it would be for your concern to be misinterpreted.

I also think the psychology is the root of the problem, not the weight, so simply trying to get her to lose weight will be a non-starter. In spite of my size, I have a DH, a daughter, job, friends, have done various courses etc, because I basically like myself and am confident in my abilities most of the time (I am considerably overweight & suffer from depression - am currently working on both - for my sake, no one else's).

Do you live close enough to your sis that you could support her practically rather than by talking about her issues?

You say she had started a small business based on her creativity - perhaps you could offer to accompany her to craft fairs which would help to boost her people skills and increase her confidence, seeing people liking what she does.

Is there a swimming or gentle exercise class you could attend together?

I would start with offering subtle, practical support - it sounds like you have a good relationship with her anyway and perhaps this would lead to her opening up to you more and you could use that as an opportunity to 'drip feed' some of what you want you say, rather than sitting her down and hitting her with it all in one go.

LadyRabbit... I've not read most of the other posts. I actually think you should speak to your sister. Okay, I get that she is very likely more aware of her weight, other issues emanating from it and their impact on her life than anyone else BUT maybe if you speak to her from the heart it will open her eyes and perhaps motivate her to tackle her weight problem. You say she is around 30? You don't want to wish you'd had this conversation with her at 40... It may backfire and exacerbate her problems but 300lbs is heavy and if you don't have that conversation with her and something happens to her as a result of her weight you don't want to wish you had.
I think it's worth the risk but she will need a great deal of tough love and support. Do you live near to her? I was going to suggest that you actually speak to her (maybe even write a letter to her outlining your concerns in a loving, non-judgemental way...that way you can choose your words carefully ( a letter means you won't say the wrong thing in the heat of the moment or have a confrontation if she is defensive) and she can come back to it over and over, think on it etc. You need to be brutually honest but put everything in the context of love.
I know you don't have to lose weight but I would actually offer to commit to a healthy eating plan with her and attend an exercise class with her (or if she's too self-conscious, have her over to dance like lunatics in the living room, anything you can do to work up a sweat! Buy her a second hand rebounder and tell her to bounce in the privacy of her own home..to music or TV. Offer to walk with her with the aim of increasing the length of time she can walk before stopping and gradually increase time and speed. It's the perfect time of year to start, especially if you have a dog...the dog has to be walked! Advise her to drink water if she's not long eaten, or eat a piece of fruit instead of a bar of chocolate. Ask her to reduce her portions, up the veg, steam and grill instead of fry and eat slowly.
Maybe offer to chart her progress by taking photographs so that she can see her progress (if she agrees to it). If she comfort eats or sees food as a reward, she needs to find a distraction (some kind of hobby that absorbs her completely) or take a short walk until the temptation passes etc. If food is a crutch she has to be able to recognise her triggers and do something other than eat. Other rewards could be a visit to the hair dresser's, a manicure, a facial, new shoes etc...
I think you may have more success if you join her, if you get what I mean. She needs some one to hold her hand but not be a push over. Once she starts seeing results it should give her confidence and urge her to press on.
Is she does not have severe or clinical depression then exercise should boost her mood. Also, St. John's Wort is said to help in milder cases.
If you offer to actively help her, rather than just tell her she's too big and needs to fix it, she's more likely to succeed, and it may bring you both closer.
I hope this doesn't sound patronising.
My dad died from a heart attack at 53. I'd begged him to quit smoking for years! I was still raising the subject - much to his annoyance - a fortnight before his death. I wish he had listened as maybe he'd still be here now. He didn't BUT I at least am at peace with myself that I told him repeatedly that I loved him and wanted him to quit for his health's sake. Your sister might not listen but you won't look back in ten or twenty years time and beat yourself up for not doing something. I hope if you decide to raise it with her, she listens and can make positive changes, even if little by little with support. She's in a rut but only she can get out of it...with your help it may be a lot easier. You're a lovely, caring sister. Let us know what happens.

LadyRabbit: can you pinpoint what triggered your sister's issues at 11 or 12?
Also, I'm no expert on meds for depression: would her current med lead to such great weight gain? If so, are there other effective anti-depressants she could try that don't have such an impact on weight?

Leoandboosmum I would urge you to read some of the other posts on here. And while I can see that your suggestions c

FFS

...suggestions come from a place of kindness and love, I am wary of the idea of the OP saying something simply to put her own conscience at rest. Because that's not the goal, is it?

Being 'brutally honest' with a depressed, over weight person will not work, it will make things worse.

The OP shouldn't say something just clear her conscience. Her sister knows she is overweight and unhealthy it's up to her to fix this if she wants to.

Suggesting st John's wort to someone who is taking anti depressants is patronising. Her gp will not just be handing them over to her without check ups.

If God forbid something did happen to her sister it would not have been prevented by any conversation the OP should have had with her sister.

Sometimes nothing you say is helpful, and you just have to accept that.

I'm sorry about your Dad btw.

DameDiazepam just one line in your last post hit home. The thing is, I've always felt that my sister's happiness is my responsibility even though I know it doesn't work like that. My DM has made me feel that it's somehow my fault that my sister is like she is - long long story but there is a big age gap and I left home a long time ago whereas my Dsis stayed at home until recently. We also live far away from each other - not my choice, a choice made by my parents who it has to be said made a hash of things in the beginning of my childhood and then overcompensated with my Dsis to make up for it. On one occasion my DM called me at work years ago when I was very junior and told me to get on a plane because my DSis was having an episode. I had no money at the time to do so but did it (lovely lovely boss who helped me out). I realise that older siblings have to step up sometimes but I just feel this enormous guilt that I can never so enough. And yes, for years (until my child was born and assumed priority) I would lie awake at night praying my sister wouldn't do something silly. It haunts me now, and I don't know what I can do about it. So yes, if my Dsis did do something I would feel responsible. Which is my own issue I guess but why I feel this need to help her and make it all okay.

Which is daft.

I feel a bit like that too with members of my family but I've learned to step back and let others take over. People get used to a member of their family taking responsibility and it's not fair. Awful of your mother to put you in a situation like that. But I expect that pattern of behaviour had been going on for a long time and this is an extension of that? It's not appropriate to buy an adult sibling exercise equipment and tell her to effectively pull herself together, if she wanted equipment she would buy it herself just as if she wants to exercise/diet she will do so off her own back.

Continue to love and support her, keep lines of communication open and let her know she can always talk to you. You sound like a great sister as you're so concerned x

blimey ladyrabbit you poor thing. have you got anyone supporting you? it sounds like an enormous amount to deal with

Have you read big brother by Lionel shrivel? She's an excellent writer and lost her own brother to this. Written from the point of view of the sister of a much admired older brother who is morbidly obese. Sorry if inappropriate I always find comfort in fiction. Feel for you op also find it hard if either of my lovely sisters unhappy I can't bear it

I would suggest counselling OP, it's really helpful and sounds like you could do with a proper way forward x

It reads like your parents failed to parent your sister properly and so you've, perhaps unconsciously, stepped into the role. I think your sister would benefit from talking therapies as the family dynamic sounds odd. I had a difficult childhood and I am sure my weight struggles partly stem from that.

Please don't take this the wrong way - your Sister might see you as part of the problem. The successful big sister who has everything she wants and yet abandoned or distanced herself from the family. This doesn't make it true but if your sister does have therapy don't take it personally if a lot of anger comes out. You sound lovely but your Sister's perception of your relationship might be different (I hope it isn't).

I think you might find counselling helpful too as you are also entangled in the same unsettled family dynamic.

One question - is your Sister seen by the family as a problem to be solved? This happened in my family with an elder sibling and caused a lot of tension until we all stepped back and recognised that only she could find the way forward and our role was to back her up in her journey not lead her by the hand.

I'm really torn on this one. I've been overweight and now obese for years, and what others have said here about it being a self esteem issue really resonated with me. What was the point in making a healthy eating choice when I'd still be ugly, worthless and pathetic?

It's only now that I've had my second period of CBT after getting physically disabled with ME (the first lot of CBT was in my teens when I disclosed abuse) that I'm starting to actually want to look after myself. It's not just with food - it's little things that emotionally healthy people can easily do, little things that boost my mood like making time for reading/piano/puzzles/baths etc where previously I'd tell myself it was a waste of time and I shouldn't let myself do it.

I'm actually enjoying looking after myself now and am making positive food decisions to nourish myself (waves at Dame :o) and it's only now that the inches are shifting. It's noticeably worse when my self esteem takes a nosedive (still happens sometimes, thankfully less often).

Sorry I've gone off on a tangent there, but the self esteem thing really struck a chord. I think unconditional love is the biggest gift you can give. I have never had anything but acceptance for my size, the change has had to entirely come from me. So in that sense I agree with the majority here that talking to her won't do any good. At the same time though I can totally see why you are aching to do SOMETHING. :(

I do think it's worth exploring the possibility of changing antidepressant though - if she's been on the same one all these years she may well be more resistant to it. Also weight gain/increased appetite as a side effect is not inevitable. There are lots of different types of AD - SSRI, SSNRI, MAOI, tricyclics - and various brands within those categories, so it may be that different types could work better (eg SSRIs do fuck all for me, but tricyclics actually helped) AND there may be one she could try that doesn't induce weight gain.

LeoandBoosmum - when I was on antidepressants, I was told I could NOT take St Johns Wort - it would have an adverse reaction. It is dangerous to suggest to anyone that they take any extra medication, even herbal medication, when they are taking a prescription drug, unless they have discussed it with their doctor.

As an example, I tried taking a herbal sleeping remedy whilst I was on citalopram - and didn't check with my GP or even a pharmacist first. The first night I took it, I woke up about 3am, and vomited. Same thing the second night. I stopped taking it - no more 3am vomiting.

Also, St Johns Wort is only really effective in mild-to-moderate depression - even high dose SJW did nothing for me.

Also, at 300lb, she will struggle with most of the exercise suggestions you made - I am not that big, and I can't walk the dog, or dance energetically or use a rebounder. My joints won't take it, and even a small walk leaves me in pain.

I am going to reiterate, in bold, because I think it is so important - if someone is this depressed, the FIRST thing they need help with is their mental health. If they can learn to like, even love, themselves again, they will start making healthier decisions. Whilst they remain depressed, they are going to find it immensely difficult, and any small set back will be seen as a huge failure, which will negatively impact their mental health, and make things worse.

The best thing that the OP can do to help her sister is to support her through her recovery from depression. Antidepressants are amazing - they saved my life on more than one occasion - but they are not the whole answer. I think they lift you out of the worst of the black depression, and enable you to function - sometimes barely, but still function - on a day-to-day basis.

I firmly believe that you need more, in order to recover - some sort of therapy or counselling. I had 2.5 years of group psychotherapy, and that helped me a lot - and now I am having 1-2-1 Cognitive Behavioral Therapy, and I can see such a huge change in my mental health over the past 3.5 months - and now, I am starting to be able to make the healthier decisions that may, in time, lead to weight loss and/or a healthier lifestyle. I couldn't have done this even 6 weeks ago.

This may sound dramatic - but I think severe depression is far more likely to kill me than obesity. I still think about suicide - it is further away, but still there. And I still would welcome death as a friend. That too is fading somewhat, but still there.

If a loved family member tried even the kindest intervention on my weight, it would push me right back to the depressive, suicidal place.

Just adding that Seroxat made me put on a huge amount of weight in a few months - something like three stone inside four or five months-ish. It was frightening, and it felt completely out of control. I deliberately 'forgot' about my weight for the eighteen months I took Seroxat, because I couldn't deal with it, along with all the other stuff, so I'm not sure whether the weight gain continued the whole time.

Agreeing that the OP's sister's mental state is what needs to be addressed first. Best wishes, OP. It's a difficult situation -I have a good friend with a younger sister who is almost certainly heavier than yours, and whose weight is having serious health repercussions, though she's only in her twenties, and my friend torments herself about what she should have dine fifteen years earlier to stop it - and you sound loving and concerned, but do bear in mind that your parents were wrong to try to get you to take moral responsibility for your sister. None of this is your 'fault', so don't let that cloud your judgement.

Whenever my Dsis engages fully with therapy, there is an improvement. However, it was taboo in my family and when we went for a family session my DM just turned it into a "woe is me!" rant which missed the point entirely. It is so obvious to me that Dsis needs to keep doing CBT on a weekly (at least) basis but she goes when she feels she needs it - which is whenever she has a manic episode or panic attack. I have gently tried to suggest that if she went regularly she might be able to prevent the episodes. Fell on deaf ears. She is however very good with her meds, doesn't change her dose according to whim which is one thing to be grateful for.

Honestly I don't feel bad; I was lucky that when emotional constitutions were being handed out I got a slightly more robust one than my Dsis so can cope better with what is definitely a very weird background (I haven't the stomach to go into it here or maybe ever: I'm so much happier since I met my DH and started building my own family I feel I have moved on from a blame game). But as another poster pointed out yes, I took on a slightly more sensible role than my DM who had all sorts of funny ideas about psychotherapy and such. It made me quite angry.

And yes I know for a fact that she feels like I'm the older sorted big sister, even when I'm not, even when I confide in her things I don't confide in most people. That is precisely why I have resisted doing the sit down and talk to her for all these years.

Thank you so much everyone, you can't believe how helpful this is being. I think you all stopped me from wading in for the wrong reasons.

If you think it would help, feel free to copy and paste my posts and show them to her.

I absolutely believe that regular CBT has worked a near-miracle for me, and I am more than willing to share that with your sister, if it would help.

another therapy related to CBT that i have heard good things about is cognitive analytic therapy

i should say, at one stage in my life i was "forced" to have therapy (CBT as it happens). i say forced, because while i was outwardly compliant, i did not want to be there and i was only doing it to "get everyone off my back" and stop them worrying about me. i went to all the sessions, said all the right things, acted the part, and ultimately was "discharged". of course, it didn't help, because it wasn't my decision and i wasn't attending for the right reasons. it was only many years later when i sought the help for myself that i was actually able to get the real value from therapy