I don't agree that doctors have to be blunt to get the message across. This is an extremely sensitive matter, needless to say. So I approach the subject with the utmost sensitivity.
However, even with that approach, some people get turned off by it. The following is my typical talk to a patient who I want to eat healthier:
"I am concerned about his weight. He is a bit too heavy for his height, according to the growth chart."
"And I am worried about him because I know that kids who weigh too much have a much higher chance of getting diabetes in the future, and I don't want him to get diabetes ever."
"Now, I don't want him to lose weight rapidly. It's very dangerous for a growing child to lose weight in a short amount of time."
"Instead, I want him to maintain his weight and just keep on growing taller. This way, he can grow into his height."
"I want him to have three meals a day, with a snack in between meals. It's very important for him not to skip breakfast. And I don't want him eating any less. In fact, skipping meals and eating less is the worst way to have a healthful diet. Instead, I want him to eat until he's full, regardless of how much he eats. However, he has to consume healthful foods, such as vegetables, fruits, and lean meats."
"And instead of drinking soft drinks and juice, I want him to drink only water and milk. I am not limiting the amount of food or drinks, but only asking him to change the type of food that he takes in."
"I am worried about him getting diabetes because I spend many occasions giving parents the bad news when their sons get diagnosed with diabetes for the first time. I always feel terrible, because it's an incurable condition. Once you have diabetes, you're going to have it for the rest of your life."
And I turn to the child:
"Do you know what diabetes is?"
Usually the kid shakes his head.
"Well, it's when your blood sugar becomes too high. And you need to get shots everyday when you have diabetes. Do you like to get shots everyday?"
Usually, unless the kid is extremely disturbed, the answer is nay.
"That's why I don't want you to get diabetes, ever. Because I hate seeing kids getting shots."