Q: I've gained several pounds since getting married. My husband thinks he is supportive of my weight-loss efforts, but he doesn't exercise or make healthy food choices himself. How can I lose weight without my husband's support?
A: Each of us is the person most responsible for living a healthy lifestyle. But we're not islands when it comes to our weight, and family and friends can profoundly influence what we do.
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That's the message in the important new book "Thinfluence," written by my Harvard colleagues Dr. Walter Willett and Dr. Melissa Wood, with Dan Childs. (You can learn more about this book on my website, AskDoctorK.com.)
As explained in the book, our personal choices are enmeshed within a web of interconnected factors. They include your family, friends, even co-workers and community. These factors have played a role in getting you to your current weight -- and they will have a role in how you move forward.
Our family, be it parents, siblings or spouse, often hold the greatest sway over our ability to practice healthy diet and exercise habits.
In "Thinfluence," the authors teach you how to recognize different attitudes that prevail in families. They explain how these attitudes impact your weight, and they teach you how to change the dynamic. You can enlist your family and friends to help you -- and discourage them from making it harder.
For example, your husband may fall into the "audience member" category. A typical audience member may say: "You eat your salad and go on your run. I'm proud of you! Meanwhile, I'm going to have my steak and watch TV."
By encouraging you with his words, your husband may believe he is supporting your effort. He may not realize that by sitting on the couch while you are out running, he is dampening your resolve to exercise. Or that by stocking the pantry with chips and sweets, he is constantly challenging your willpower.
Acknowledge the support that your husband has expressed, then gently turn his attention to the ways he may be sabotaging your efforts. Point out what he is doing when he is doing it. This might help him recognize the effect he is having.
Better yet, you may even turn the tables and get him to adopt some of your healthy lifestyle changes.
A patient of mine, a woman in her late 30s, had a pretty healthy diet, but she rarely exercised and was overweight. And heart disease ran in her family.
I told her that by exercising for 30 minutes at least five times a week, she could greatly reduce her risk of having a heart attack. She knew she would have trouble adopting this new routine without help.
So she told her husband, also a couch potato, how important this was to her and asked him to join her. By making a pact to do it together, they both were successful, and they remain in very good health.
• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.