Motivating a friend to exercise and improve health behaviors

¶ … Friend

The colleague and friend I selected has worked with me on fundraising projects and has been a neighbor and friend of our family for several years. She is respected in the community for her advocacy for children's education in particular, but also for her support of local nonprofit organizations that raise money and awareness of the homeless, of the local teen center, and of the group that fights to protect open space from development, so it can remain as habitat for wildlife.

Describing the Situation

What I would like to have Elaine change is her diet; but especially I would like to change her attitude about -- and her indifference to -- exercise. I would like to coax her into starting slow and going for walks, with me and another friend we have in common, and get her into the consciousness that walking is enjoyable and healthy as well.

She is in her late 40s, overweight to the point of being obese, and for an African-American woman, that is problematic as far as her health is concerned. She comes from a big family and she has four children (all grown up now) but her main concern while raising those kids was not taking care of her, but rather, taking care of them. The family dinner typically was a pot roast, potatoes, gravy, and a steamed vegetable. For breakfast it was bacon or ham and fried eggs, hash browns -- very heavy in calories and in fat. These are typical of the meals she grew up with and she continued serving these meals for her own family.

My own research shows that African-American women have "the highest rates of being overweight or obese" when compared with other ethnic groups in the United States (Office of Minority Health -- OMH). In fact nearly four out of five African-American women are either overweight to some degree, or obese, OMH (a division of the U.S. Department of Health & Human Services) explains. The OMH also points out that 19.6% of African-American high school girls are overweight (compared with 13.6% of Caucasian girls), and since Elaine has two girls -- one in high school and one attending a community college -- and they are overweight, this is a family issue. My strategy will be to convince Elaine that she could be a good role model for her daughters while she improves her own chances of better health.

But my strategy doesn't include lecturing her about her health necessarily, albeit her health is the issue I am planning on advocating for without being preachy or dogmatic. As background, I have learned that in addition to 3 out of 4 African-American women being obese, one in 4 African-American women who are 55 or older "has diabetes," according to womenshealth.gov, a project of the U.S. Department of Health and Human Services. Type 2 diabetes (which is the most common type of diabetes) can result in kidney failure or "amputation" (having a toe or foot removed) (womenshealth.gov).

The womenshealth.gov site notes that there are some risk factors that people cannot control, like one's age, ethnicity, or one's family history. But there are preventative measure that can be taken and this is the point of my strategy to change Elaine's habits and coax her into going for walks. "Maintain a healthy weight," is number one on the list of things that can help a person avoid diabetes; "Eat low-fat, well-balanced meals" is number two (and not at the top of my list for Elaine); number three is the key to my plan for Elaine: "Make physical activity a habit" (womenshealth.gov).

The recommendations for physical activity are more than I am hoping to get Elaine to do; for example, 2 and a half hour of "moderate-intensity aerobic activity" a week would not work for her to start off. Nor would an hour and 15 minutes of "vigorous-intensity aerobic activity" be acceptable in this case; I'm just talking about a brisk walk for maybe twenty minutes every day or every other day, at least (womenshealth.gov).

Exercise acts like a drug, according to a peer-reviewed article in the British Journal of Pharmacology; it is like a drug because it causes a "…myriad of beneficial effects for health" and in fact could be described as a "psychoactive drug" (Vina, et al., 2012).

How the person responded and how I could have done it differently

The next day I saw Elaine after work and I hugged her as I usually do. Without me asking her what her decision was, she knew I was hoping for a positive answer. She said she would try it for a couple weeks, but asked if I would be mad at her if she dropped out. I said of course I would not be mad. She asked if this was really because I wanted a walking partner or was I trying to get her into an exercise program? I assured her, walking is proven to be beneficial not just for physical health but it also helps the mind stay sharp.

Her husband said he didn't care if she got involved as long as the house was kept clean and dinner was ready for him when he came home. That made her say to me, "I will have to make sure what I do doesn't upset my husband," and I instantly said not to worry we will get our walking done in time for her to be there for her husband.

I wouldn't have done anything differently. In fact on our first walk, two days after she agreed to walk with me, I reported on a 20-year study (www.health.com) that showed the lack of exercise, not our tendency to overeat, was causing many of us to gain weight. She smiled, because she did not want to hear me urging her to give up her meals (that are mentioned earlier in this paper). She even talked about buying a new pair of walking shoes, which made me very happy because she was buying into my suggestions.

In conclusion, how do I respond when someone asks me to change? I admit I may be hesitant to try something new, but it depends entirely on who asked me and what the suggestion is. I did quit smoking cigarettes a few years ago when my best friend urged me for weeks, and once I did quit, I felt so much better (even though I gained some weight). My approach to Elaine was carefully thought out and because we had a good friendship to begin with, things went very well, and she is changing, one step at a time.