This Is One Of The Biggest Weight-Loss Lessons You Can Learn From ‘My 600-Pound Life’

Sometimes episodes showcase what are probably unintentional acts of sabotage: In season three of the show, you watch Pauline, who weighs 678 pounds, accept a fast-food breakfast from her son and caretaker while laying in a hospital bed from which she cannot move unassisted. 

But other instances aren’t so innocent: In an episode from season two, Zsalynn, 42, who weights 597 pounds, says her mother often called her fat, and wouldn’t even let her lick postage stamps because she thought there were calories in them. 

Younan Nowzaradan, M.D., the show’s compassionate gastric bypass surgeon from Houston Obesity Surgery, maintains that without support, a weight-loss journey will most likely fail. “If they don’t have [support], it’s almost impossible for them to be successful in the long term, unless they remove those people from their environment. So they either have to change their dynamic with those enablers or separate from them if they want to succeed,” Nowzaradan told People.

So what can you do if you’re facing a similar situation at home? “If someone is going to make progress, it’s important to confront their family and friends about what support really means,” says Cymbeline Smith, a licensed marriage and family therapist. 

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Smith recommends first trying to understand why your support person is being anything but and trying to reframe how you interact with these people who are allegedly on your side. Step one? Take conversations about weight off the table.

“Start from ground zero: no body comments allowed,” she says.

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Then set verbal boundaries. “There should be no commenting on each other’s bodies at all. The support person may encourage health but not offer opinions on anyone’s body. You can say, ‘Thank you for caring. I know you love me, but please don’t comment on my body.’ “

She also says it’s a good idea to remind people that any compliments about the weight loss need to be without comparisons to the past or absolutes. “‘I like your body now’ can be very triggering psychologically,” Smith warns.

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Ultimately, Smith says that a weight loss will be undermined if it’s starting with a less-than-solid relationship. But all hope is not lost. You just need to take care of one before the other.

“Put the relationship first. Work on that,” she says, “then you’ll be better equipped to overcome anything else that gets in your way of a healthier weight.”