I have done a lot of travel throughout my career, and I remember at first being shocked over a series of trips to India where I had gained some weight. Some of the people there - who were all generally super friendly - would come up to me and express very directly that I had gained weight, and just looked at me smiling, waiting for a reply. I didn't really know what to say at first. But later on I realized that they didn't express themselves to be mean or cruel, rather, they just wondered in a casual way. It wasn't a big deal to them, but they were far more open about it than others.Simliarly, my wife is Czech, and I met her in Prague, and over there, at least 10 years ago, it was rare to see obese young / middle-aged people. They have a more direct way of discussing things such as weight as well.Perhaps being open and candid with others is helpful if done in a tactful way. We shouldn't use excuses or ignore potential health problems in our friends/family.