Ask your partner what kind of help they want from you, then give that help. Once your partner is in medical weight care, a prescriber is making the decisions about their treatment, and what you can add at home is the help they ask you for.
Is reminding them what to eat helping?
A household member's encouragement of healthy eating went with less weight lost in an 18-month trial of a weight program in which each person brought a household member along as a support partner. Each person rated the help their support partner gave:
| What the support partner did | What it went with |
|---|---|
| Encouraged healthy eating, in items such as "encouraged me not to eat high-salt, high-fat foods when I'm tempted to do so" and "discussed my eating habit changes with me" | Less weight lost |
| Offered choices and listened to how the person wanted to do things about their weight | More weight lost |
| Exercised with them, or used rewards or punishment for exercise | No link either way |
The support partner in that trial was a household member who also had to be interested in weight loss, and in one of the two programs the partner was treated too. Which way the link between that encouragement and weight runs is uncertain: partners may encourage more once they see someone struggling, or encouragement may be felt as controlling and get in the way of change.
Pressure, meaning criticism or restricting food to force a change, was measured among couples in which only one partner was in a program, which is closer to your situation if you are not in one yourself. One partner was randomly given either a structured program or a self-guided handout, and that partner reported how often the other would "criticize your poor food choices or physical inactivity". More of that pressure went with little or no weight loss among those in the program, a pattern that did not appear in the handout group.
None of this research looked at the partner of someone on a weight medicine. Anyone taking medicines that might affect weight was left out of the couples study, and the trial tested a diet and exercise program. The findings are about how a partner's help was received while someone changed how they ate, which still happens at your table.
What to do once you stop reminding them
Give your partner autonomy support, the kind of help people in that trial rated their partners on. It is given by:
- acknowledging the person's feelings and their own way of seeing things
- using neutral language and holding back from excessive control and pressure
- offering choices and options
- giving positive feedback that tells them something useful
Point that feedback at what they are doing, such as a walk they kept up, and leave their weight and body out of it. Two of the statements used to rate a partner were "I feel that my partner has provided me choices and options about my weight" and "My partner listens to how I would like to do things regarding my weight." Ask yourself whether your partner would say both of them about you.
Ask "What changes would feel realistic for you right now?" or "What has worked well for you in the past?", and make any offer to do something together one your partner can turn down: "I'm taking an exercise class this weekend. Would you join me?"
If your partner has asked you to keep them on track, reminders are part of the help they chose. Controlling or directive support often hinders weight loss, but it can sometimes be beneficial. Someone actively engaged in weight management treatment may understand why a partner tries to influence them, or may even welcome additional reminders, and partner reminders given in a relatively non-pressured way have gone with progress toward health-related goals. People in a structured weight program may be particularly affected by a partner's directive help, for better or worse. Keep to the reminders they asked for, in the form they asked for them.
Stopping the reminders does not mean going silent. Acknowledging how your partner feels and telling them what is going well are both part of autonomy support. Undermining is more than criticism of their efforts, and some of it needs no words: offering foods that do not fit their plan, or seeing their changes as an imposition on you or as a comment on your own weight or habits.
Is it all right to comment on their weight, even kindly?
If you comment on their weight at all, make it a remark that leaves them feeling good about their body, or say nothing about it. Among young adults surveyed about remarks from their own partners, remarks that made them feel bad about their body shape or size went with poorer emotional well-being than kind remarks or none.
What made a remark kind or hurtful there was how it made the person hearing it feel, not what the speaker meant, so a remark you mean kindly can still land badly, and only your partner knows how it landed.
Whether praise about weight helps body image is unsettled: findings on positive weight comments have been mixed, including in studies of college women, while negative ones are consistently found harmful, and a remark as warm as "You look great – have you lost weight?" still counts as talk about weight. Among young adults, hurtful weight-related comments from a significant other, and from family, were associated with disordered eating behaviors, in women and in men.
Leave shame out of anything you say. According to a 2020 international consensus statement on obesity stigma, written about public health campaigns and health care, strategies built on the assumption that shame will motivate people with obesity to change can result in the opposite effect, and may instead lead to exercise avoidance, unhealthy diets and more time sitting. If your partner brings up their weight, follow their lead on how much to say about it.
When to go to their appointments and what to do there
Go to an appointment if your partner wants you there, and go to take notes. Offer in a way that leaves the choice with them, such as "If you want, I can come to your appointment with you to take notes." Before the visit, ask what they want from it and what would help most from you.
Once you are there, the visit is between your partner and the doctor. They may want time on their own with the doctor for personal matters, or may ask you to step out to the waiting room for part of it.
A family member or friend at a visit can, among other things:
- help write down symptoms and questions beforehand
- remind your partner of what they wanted to tell or ask the clinician
- take notes, and help them remember instructions and follow-up tasks
- tell the clinician if your partner seems not to understand, or looks uncomfortable with what is being said
A clinic that follows a federal toolkit on including family and friends checks with the patient that they want you there and asks you to let the patient speak first; on a video visit it asks for the camera to show you both. Private time alone with the patient for sensitive topics is part of the same toolkit, so if you are asked to step out, take it as routine.
If your partner would like the person who goes to appointments with them to hold a copy of their written list of medicines, that person can be you (see A prescription kept private at home still needs a written list).
When to call their doctor, 911 or 988 while they eat far less
How little your partner eats is for them and their prescriber to judge, with one day of eating written down to show them (see No appetite at all? Start by writing down one day of eating). Changes in appetite, weight, sleep or energy are among the things to mention to a doctor at a visit, and helping your partner list them beforehand is part of the note-taker's job.
When they are ill, pay attention to how much they are able to drink, and if you think they may become dehydrated, call their prescriber's office or their own doctor's office before they become dehydrated. Mild to moderate dehydration has signs that include:
- thirst
- a dry or sticky mouth
- not urinating much, or darker yellow urine
- dry, cool skin
- headache or muscle cramps
If your partner cannot keep fluids down, set time limits decide when to contact their own doctor's office or their prescriber right away, so learn them together (see Can't keep fluids down for 12 hours? Contact a provider right away).
When dehydration is severe, it is a life-threatening emergency. Call 911 if your partner:
- loses consciousness at any time
- shows any other change in alertness, such as confusion or seizures
- has a fever over 102°F (38.8°C)
- has a rapid pulse or rapid breathing, which are signs of severe dehydration and of heatstroke
- does not get better, or gets worse, despite treatment such as sipping water or a sports drink with electrolytes
Other signs of severe dehydration include:
- not urinating, or very dark yellow or amber-colored urine
- dry, shriveled skin
- irritability
- dizziness or lightheadedness
- sunken eyes
- listlessness
With any of them, get your partner to an emergency department, or call 911, now.
The behaviors below may be some of the signs that someone is thinking about suicide:
- talking about wanting to die, great guilt or shame, or being a burden to others
- feeling empty, hopeless, trapped or as if there is no reason to live
- feeling extremely sad, more anxious, agitated or full of rage, or in unbearable emotional or physical pain
- making a plan or researching ways to die
- withdrawing from friends, saying goodbye, giving away important items or making a will
If any of them applies to your partner, get help as soon as possible, particularly if it is new or has increased recently: reach the 988 Suicide & Crisis Lifeline by calling or texting 988, and call 911 if their life is in danger. Low mood that is severe or distressing and has lasted 2 weeks or more, without those signs, is a reason for your partner to book a visit with their primary care provider (see Flat and tired for weeks while eating less? Book a doctor's visit).
If NicoCares connected your partner with the physician who makes their treatment decisions, your partner can send the questions you wrote down together to their care team from their own Spruce account. Use Spruce for those questions and never for a sign above: a Spruce message has no stated answer time, and each sign needs the doctor's office, 911 or 988 named beside it.
