Talking It Out

We looked at how, not content to be third best, Colorado declared its intention to be the healthiest state. The Department of Education put together a guide for school nurses and other interested parties. The Healthy Weight Toolkit puts a lot of emphasis on Motivational Interviewing, which is all about the roots and growth of change in a person. Adults who are in a position to help the young are urged to talk less and listen more, a philosophy that includes even — to some adults — the radical step of actually asking the troubled youth’s permission before doling out advice.

Not your magical hero

In any counseling situation, the affirmation of a person’s strengths is important. But there can, as some troubled individuals have remarked, be too much of a good thing in that department. In reference to larger social unrest, many women (in particular) have said to the press, or to their social media connections, things like, “Don’t tell me how strong I am. Not when I’m dealing with garbage I shouldn’t even have to put up with in the first place. Don’t project onto me your fantasies of steadfastness and nobility. I don’t want to have to be strong. I want to be respected, validated, and sometimes even taken care of, in a way that the world and other humans seem unwilling to do.”

That is a prime example of how someone who is trying to help can miss the mark. Whether objectively they are right or wrong, some people just don’t want to be told, right now, how strong they are. It might be the wrong bullet point to lead with. At the very least, counseling a mixed-up kid might be different from dealing with a maladapted adult.

Motivational Interviewing

Motivational Interviewing has proven to be very useful in helping people with addictions, and one of the nuances to practicing this skill is the realization that people go through several stages in taking on the challenge of change. The earliest is the pre-contemplative stage, when the subject has not even considered the notion that change might be desirable. The usefulness of motivational interviewing lies in nudging the person along to the point where they are willing to contemplate making a change. Then, they need an effectively administered boost to another level, that of preparation.

From there, the person will hopefully (and with thoughtfully administered help) enter the action stage, which can be exciting and even exhilarating, at least in the short term. When being un-addicted or in some other improved state becomes the new normal, however, the person who offers guidance will need to switch into a different gear. The long haul, the daily sameness of the maintenance stage, will in the best-case scenario last a long, long time, and living within it may need a whole different kind of support.

This is why it is so important that teachers, school nurses, and parents understand the point and purpose behind motivational interviewing. These helpers often need help themselves, because they can’t always win. No matter how sincere their compassion or how well-honed their skills, helpers are sometimes unable to help, because the overwhelmingly necessary ingredient must come from the subject herself or himself.

That ingredient is commitment, without which no change is possible, and it has to come from within. There is no way to administer a dose of commitment, there are only ways to help an individual find their own unique path to commitment. From the Healthy Weight Toolkit:

You are listening to me when:

• You really try to understand, even if I am not making much sense.
• You grasp my point of view, even when it’s against your own view.
• You allow me the dignity of making my own decisions, even when you feel they may be wrong.
• You do not take my problem from me but allow me to deal with it in my own way.
• You hold back the desire to give advice (or only offer it with permission).
• You give me room to discover what is really going on.

Your responses and feedback are welcome!

Source: “Colorado Healthy Weight Toolkit,”, 12/01/14
Source: “Motivational Interviewing,”, undated
Image by Fotos PDX/CC BY 2.0

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Profiles: Kids Struggling with Weight

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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