I am worried sick about my sister in law.

[CTyankee]

She has been obese for some twenty years and has diabetes. But seeing her recently, she has (in the past year or so) gotten what must be called "morbidly obese." I am not a medical person and she will not talk about it (and avoids both my husband and me)but something is going on that must have made her weight balloon like it has. She is only 68 and is now so heavy she can barely go up stairs or even get up from a chair. She has also had cardiac issues and is now on coumadin, as is my husband, but he has gotten thinner from his cardiac episode and treatment (I think he was "scared straight").

I am sure she is suffering greatly from this weight gain and I don't think it is necessarily from her eating more. I know she has good medical care so my husband and I are completely baffled and just plain scared that she might have a heart attack that will kill her.

Just wish I could understand what has happened to her...

[no_hypocrisy]

1. Is she being monitored by any physicians on a regular basis? Occasionally?

Her blood levels, blood pressure, blood sugar being checked regularly? Does she see a cardiologist?

What is her diet? Are you aware of her calorie intake?

[CTyankee]

4. I know that at least in the past she has been under medical supervision.

She has a cardiologist. She has been hospitalized a couple of times to get her heart beat under control.

I don't know what she eats now, but she never seemed to eat a lot, at least publicly. She and her husband are avoiding seeing us for any extended amount of time and her latest visit was marked by a kind of angry resentment about LOTS of things. They are both unhappy. I have emailed her with family news and she has stopped responding.

Something is going on and we're not quite sure what it is...

[MADem]

2. She might have other issues that make it difficult to lose weight.

How's her diet? Sometimes it isn't so much how much you eat, but what you eat.

Does she exercise at all?

The sad truth is, you can guide and suggest, but people will make their own choices. Hopefully she will make the right ones.

[CTyankee]

7. I don't know what she eats regularly. When we see each other we eat out

or we used to. She was leaving food on her plate as I recall. Her husband eats everything he wants and remains trim (he's much older and he also has diabetes). I can't shake the feeling that this has something to do with her emotional state but I don't know what that is...she has two lovely daughters and 4 healthy, happy grandkids...

[MADem]

11. Hmmm. Emotional state? Is it something organic to her (e.g. bipolar)

or is she upset because of circumstances--like, say, her husband is stepping out on her? If the former, maybe a medication adjustment is all she needs. If the latter, well...maybe she needs to lose weight, like say, the weight of a cheating spouse!

Maybe her children can intervene....as an in-law you'd probably get the stiff-arm (and sometimes a dose of resentment) if you tried to help, unless you already have a very close relationship.

[tridim]

3. If she's still gaining weight, she's eating more food every day.

Sorry to be so frank about it, but that's how it works.

I would query her about her food intake and help her to cut down.

[CTyankee]

6. Could it be possible that her insulin has played a role in the weight spike?

I really suspect that she avoids talking to us because she doesn't want to discuss her obesity. My guess is that she feels somehow ashamed of it. I'd like to email her daughter about it, but I know if she found out she'd be furious.

[dgibby]

10. Not necessarily true.

Complications of heart disease and diabetes include fluid retention. It's quite possible that she needs diuretics, especially if she's in congestive heart failure. Ascites/edema is also associated with other diseases, such as cancer, and is independent of caloric intake. It sounds as if she needs a complete physical, including a workup for depression. Questioning her about her food intake will only alienate her futher.

[Lex]

12. Considered that she could be moving around less every day?

How do you know for sure it's increased caloric consumption without more information?

[MineralMan]

5. I have a sister-in-law who is in the same situation.

She's just 56 years old, and can barely walk across a room. Her hips are failing, and her doctor has tried and tried to get her interested in doing something about her weight, but she will not. She can't have hip surgery because of her weight. My wife and I are very fearful that she will not live to see 60 years old. She has a 13 year old son, born in her 40s, and we're devastated at the idea of what might happen.

So, we have the same fears you're having, and are at our wits' end over what we can do to help. My wife has talked to her, but to no avail, as has her mother. It's a terrible situation.

[snowpup]

8. Fluid retension can be severe.

She may need diurectic medication to help remove fluid. I have heard of people losing 15 pounds over three days. This can be a complication from congestive heart failure--current doctor attention is very important. Otherwise, I would say that there is probably complicating depression and a feeling that she cannot change. Change comes in small stages. If she is okay regarding her medications, many doctors prescribe an exercise bike to just get moving (Air-Dyne) so that there is not so much stress on joints. Somehow, a nutritional change seems to be in order with a real nutritionist. Many people may respond well to a higher protein diet, but with the diabetes, kidney function needs to be taken into account and monitored. She needs a motivating reason to get out and about and to make the changes, and some nonjudgemental social contact might be a good thing.

[TNDemo]

9. She needs to get her thyroid checked,

among other things.