This may not be the best place to ask this question, as I assume most of the clients whom you coach (because this is SELF coaching scholars) are already aware that they are overweight, and are coming to you with help on how to change that… I am a clinical massage therapist.

I have a client who wants help relieving back, leg, and foot pain, and she is also over weight by about 300 pounds… what is the kindest way into addressing that any pain management will be temporary until the extra weight being placed on the spine has been reduced?

I ask her in our sessions about what she does to “relieve stress” what she thinks about her “work life balance” and what her “dietary choices” are like…. and the answers always indicate that she keeps a very healthy lifestyle minus the back pain, as it limits how active she can be. And in my head I am dying to tell her that nutrition is SO much more of a key than exercise in terms of weight… but she hasn’t asked for my advice, or opinions about her weight. She’s just asked me to help her get her pain number down and get her range of motion back to where she can walk.

I know that in this situation and they way this group works, the coaching I am asking for isn’t about her… or changing her answers or behavior, and so I want to be clear that what I think is, “The pain relief treatments that I am able to perform on this patient will only be temporary… long term solutions, must include weight loss” + “I wish I could just tell her that” + ” I am not sure that I am following ethically boundaries by continuing to treat her for a condition that is beyond my capability to help”
Feelings: Sad / compassionate… for her… for me for anyone who lives in pain instead of facing their mind and eating habits.
Action: Continue treatment plan
Result: Treatments do not reduce in frequency

Any thoughts, experiences, or feedback? When someone presents with one thing, and you want to call attention to another more important issue? Or ways to think about how to help someone (or at least ethically do your job with someone) who isn’t really ready to face the true work ahead? I struggle with this one, because it isn’t really a belief that I want to change… I don’t want to believe that I can out-treat the effects that amount of weight place on the spine. I don’t want to believe things that science doesn’t support. Instead I want to find something to think and feel that helps me lead her to a better, more ethical solution to the pain she has.