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The question

I’m very worried about the health of my high-school friend. We are now both in our mid-60s and have a close and great friendship. We get together regularly along with a couple of other high school friends, for dinners with our spouses, for movies, golf, and always share lots of laughs. Now I worry that my friend might not be alive much longer. The problem is his weight and his denial about his health. He has already had a heart attack a few years ago and could stand to lose at least 50 pounds. He has a big hard belly, his face is quite red and he is often short of breath. He says that his doctor tells him that he is perfectly healthy. I care about him and I don’t want him to die prematurely but I don’t know how to talk to him about this issue.

The answer

First of all I should say it’s possible to be overweight and still be (relatively) healthy.

I should know! Well, about the overweight part. But I also hope to continue to live a long and productive life.

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And the fact his doctor signed off on his health should tell you something. Of course, it’s possible he’s lying about his doctor’s diagnosis/prognosis, but if not, unless you are a doctor yourself (and have run a series of tests on your friend), you should perhaps step back and defer to the opinion of a trained professional.

The other good news is: Vis-à-vis your friend’s heart attack, they say it’s the first one that kills you. Which doesn’t exactly sound like good news, but what this saying means is, if the first one doesn’t kill you, the subsequent ones are less likely to do so.

But I understand. It’s hard to know how to approach someone whose health you’re worried about. I’ve had friends, I blush to admit, and my wife, and even my offspring, approach me at various points and say: “Dave I’m worried about your health.”

And I appreciate it. I have smoked, in my time, and I have also been overweight in my time. Now, I suppose in part thanks to people’s cracks, I’ve lost weight (I’m very proud of myself) and I vape!

(I love vaping. It may well save my life or at least extend it for a bit.)

I think it would be quite touching if you simply said something along the same lines of what you said to me, i.e. “I enjoy your company and I would hate to lose you to health issues.”

Now, of course that could be a fraught conversation, especially if he takes “health issues” as a euphemism for “You’re fat and I’m worried you’re going to keel over because of it.”

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Which is kind of what you’re saying.

(Idea: maybe work hard to maintain eye contact and try not to glance down at his “big hard belly” when you talk about his “health issues.”)

Basically, it’s hard to know how to tell someone you think they should lose weight and they’re in horrible shape.

Of course it stings. It zings. But ultimately, I have to believe the recipient of this type of comment will appreciate the candour. After all, it’s better to hear stuff said to your face than behind your back.

Now, whether you should get into specifics is another question. Giving someone dietary and/or exercise advice is always going to be a ticklish matter.

But my friends do it to me all the time: “Hey Dave, get up early, try yoga, meditate, you’ll become more mindful” and yadda yadda yadda.

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Basically, as with all advice, take it on a “take it or leave it” basis. (And I say that as an advice columnist.)

Hopefully your friend will have the same attitude. I don’t think you’ll be outside your boundaries if you suggest he hit the treadmill once in a while or go for a jog – but if he pooh-poohs you then let it go.

Always bear in mind that, much as you may care for him, you can nudge him one way or another but ultimately the state of his health is his own responsibility.

Are you in a sticky situation? Send your dilemmas to damage@globeandmail.com. Please keep your submissions to 150 words and include a daytime contact number so we can follow up with any queries.

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