I'm on the 'shut up and say nothing' bandwagon. Regardless of what you think of the situation now, you're not thinking down the road as to what you expect from her.

I am her. I was never a small kid, but in my late twenties, whether quitting smoking had anything to do with it or not, my thyroid crapped out - but I didn't know that at the time. I went from perpetually needing to lose 20-40 pounds to carrying around a 150 pound monkey on my back. It only took about eight months to gain and it wasn't going anywhere. A few pregnancies and early menopause later, and I think I was more than 200 pounds over what I want to weigh. I've spent my whole adult life being your friend: knowing exactly what to do to lose weight, and unable to do so.

It wasn't until my mid-forties that we discovered my thyroid purely by accident, because the medical profession tends to default to the 'eat less, move more' solution without really looking any deeper. But it's taken me another ten years to finally find what works for me - because what works for me may not work for anybody else.

Over the last three years, I have fought the big fight and lost a hundred pounds (I think probably that it's a lot more - because home scales aren't made for the people who actually need them.) I've had setbacks and managed to get back on track, but I am still plugging away.

The point is, gaining the weight, for whatever reason, is super easy to do. But you get to a point where you figure what the hell, it's not even worth it to try anymore. Because you've failed a thousand times. And nobody who hasn't been there has any idea what it takes to do this.

And shut up about it because you have no idea, not only how bloody hard it is, but how much it HURTS. There is pain in losing this much weight that no one talks about. And changes to your body that leave you seriously considering going back to your old ways because nothing looks even remotely okay.

Fat's fat, but ugly is something even worse. And there's no answer for that. People tell you how great you look and how amazing you are and what an inspiration. Then you go home and peel off the compression garments you now have to wear and soak your knees and re-wrap your feet. And you try no to look because nothing looks like anything you've ever seen before.

You're asking her to commit to years of working a plan that works so slowly, it doesn't feel worth it. And it doesn't matter how easy someone wants to make it, it's still not going to make her feel good any time soon. And likely not better - at all.

It's not like quitting drugs or alcohol or cigarettes. Because you still have to eat. And every bite that goes in carries someone's judgement or a past failure. You have no idea the monumental task ahead of her. The level of commitment, determination, and strength a person has to muster - a person who is already so beaten by defeat.

But no, let's just go suggest something that you think will help. Let's remind her that the world thinks she is less than. Let's pretend that you have any inkling of what she's going through and what it'll take for her to heal. Because that's all you can do - imagine.

So what do you do?

If you do truly care about her, the only thing you can do is watch. And wait. And don't stop watching even for a second. Because every once in a while, without telling anyone, she'll suck up the courage to give it a go. She'll decide to try. She'll make the very smallest of efforts. Maybe just for a few hours. Maybe a day or two. God help her, maybe she'll last a week.

And when that happens, everybody get the fuck on board. Casually work in the background to support and encourage. Sneak up on her. You can't be obvious. She'll know, but she won't want you to know she knows. Help her find her own momentum.

Because that's the help she needs. It all has to come from within; you cannot give her purpose no matter how much you want to. And when she catches a glimpse of it, help her make it shine.

And when it all falls to shit again, wait it out. Maybe next time.