‘My obese husband drinks, smokes and has had a heart attack, but will not change his lifestyle’

Tell Me About It: The move from obesity to wellbeing can seem like an insurmountable task for many

PROBLEM: My husband recently had a heart attack, which he recovered very well from. He has since started to attend a cardiologist who has told us both that whilst a heart attack is very serious the one that he had was at the milder end. He has been obese for more than 20 years, his diet is very unhealthy, and he eats two dinners each day, a healthy one at home and a takeaway at work. He also eats a fried breakfast a couple of mornings a week, he smokes and drinks a couple of pints each night. He has a very senior job in a well-known company, and he works at least 60 hours a week to ensure that he makes all the bonuses he can in his already lucrative position. Our children are raised and financially we are comfortable.He has absolutely no intention of changing any aspect of his lifestyle. Any time I have tried to speak with him about my concerns, he assures me it was a mild heart attack, and the medication will prevent a recurrence. I’m no doctor but that sounds to me like nonsense. We have very definite retirement plans, but I am terrified that I will lose him and that his arrogance will deprive me of a husband and our children of a father, and their future children of a grandfather.

How can I get him to see sense?

ADVICE: We cannot get people to do what we would like them to do, in spite of having their best interests at heart. What we can do is create an interest, or a motivation, for change but only if the person we wish to influence buys into this or can see relevance in it.

Your husband had a crisis – a heart attack – but this did not jolt him into living a healthy lifestyle, so creating frightening scenarios will hardly have the effect you wish. This means you must rethink the situation. Is it likely that he is reacting to your position of righteousness by resisting any suggestions you make? Or is he a person who responds to attempts to control him with huge resistance? You must take your lead from him, from his perspective.

There is little point in starting your campaign from your own view as this is likely to be very far away from where he is. What you have said is that he is interested in providing well for the family, and he has been driven to work long hours in order to achieve this aim, so he may be open to seeing a new aspect of providing, that of being healthy. However, you also say that he is arrogant, and this is a barrier to his openness to engaging with you, so it is important to investigate this.

Arrogance is often presented as an overconfidence or inflated sense of self, but, in truth, it often masks fear, and, in this case, it may be a long-standing fear of being unable to change or even a fear of death. The only way to find out is to approach the fear with compassion and curiosity, as challenging it head on will only result in a further increase in the barriers of arrogance and dismissal. You love him and want to have him in your life for as long as possible so start by ensuring he knows that this is your bottom line. Do not force anything on him but with patience enquire of him what might help him if he were to take one step towards a healthier life.

The move from obesity to wellbeing can seem like an insurmountable task so small targets with lots of appreciation is necessary. It may be that he needs someone other than you (as you are too invested) to be his guide in this and if this is the case step back and stop monitoring him while he finds the support he needs. These supports may be medical, physical (as in a nutritionist or physical trainer) or emotional/psychological.

Our relationship with food is a complex and is often deeply rooted in a web of meaning that has connections in our past, our families and our cultures and may require varied interventions. It might be helpful if you tell your husband that you are committed to him, regardless of what he decides to do or not do, and you will be there for him if he fails or feels shame or has to start from scratch again.

In order to fulfil this commitment, you too will have to do some work on yourself as your habitual responses to him my not have been helpful. Your desire to help can manifest as control and you may struggle giving this up as it can feel as though you are giving up on his wellbeing and so go against all your instincts. However, this might be exactly what is needed for him to take responsibility for his own longevity. The organisation Bodywhys might be a good support organisation for you as it offers expertise as well as support that can assist you on this journey.

In the meantime, you might think of some goals or adventures (walking all the Camino type project) which can get both of you excited for your future together.