I’m in my late 40s and have a brother who is a couple of years younger than me. He’s been happily married for almost 20 years and has a lovely daughter, who is in her early teens. Some years ago, he was treated for cancer (he has been in remission since), and I am happy he has managed to find his way in life. Our parents died two years ago, and we are all the family we have; we’ve had our differences, but in reconciling we probably understand each other better than ever. However, I can’t get over the horrible feeling that the food he and his wife provide for the family is far from healthy, and actually harmful. My niece is overweight and under-exercised. When I visit, the food is greasy, heavy on carbs and meat, oversweetened and wholly unbalanced – the kind of diet teenagers would cook for themselves. They have no sensibility for fresh produce or anything healthy. My brother is also overweight, which is a touchy subject, and I am at a loss as to how to address their eating habits, as I fear it could lead to a huge row. How do I talk to his family about this in a manner that is sensitive, concerned and without resentment? Raising the subject of food, weight or exercise with someone else has to be done very sensitively, if at all. It’s important to also think about what you hope to achieve. It isn’t clear whether your brother and his family have always eaten like this, or if this is a more recent thing and maybe a reaction to grief, fear and loss: not only of losing his parents, but also about his illness. I even wondered if maybe he was revisiting the foods of his childhood? Of course, not eating healthily, being overweight and not exercising enough is suboptimum, but simply telling him you’ve observed this isn’t going to change it. It’s far more likely that he will feel humiliated and more wretched about himself, which could be counterproductive. I consulted Avi Shmueli, a psychoanalyst, about your problem. We agreed that at the heart of your letter was, understandably, fear of losing the family you have left. You articulate it as worrying about your brother’s health, but I think it goes deeper than that: might the subtitle be, “I’m worried about my brother dying and leaving me”, especially given your newfound closeness? “As we go into middle age,” Shmueli said, “we tend to focus more on our own and others’ mortality, but here there’s the added background of your parents dying and your brother’s cancer.” Losing someone makes us feel not only more fragile ourselves, but more fearful for those around us. I couldn’t help thinking how your letter was about not just food, but family, and that there are two significant people missing at your table, and how that must feel. Shmueli also wanted to draw your attention to your use of the word “horrible”. It’s a word that seems to say a lot without saying much at all. “Many feelings can be subsumed under the term ‘horrible’,” he explained. I thought a lot about this. We often use the word, but what does it actually mean? Shmueli pointed out that sometimes we might use it to hide feelings we’d prefer not to focus on, feelings that are more hurtful or make us feel more vulnerable. What might those be for you? Beyond your age, you offer nothing of yourself. As the older sibling, do you now feel as if you are the head of the family, who has to parent your brother and look out for his health? That must feel like a lot of responsibility. Who looks after you? If you want to talk to your brother, it needs to be about what you really feel. It might start something like this: “I really love you and I worry about losing you.” But remember that hectoring is a poor teacher. Sadly, there isn’t a magic sentence you can say to fix this and keep everyone fit and well – that’s beyond your control. How close to him do you live? Could you agree to meet him for regular walks? On these walks you may also find space to talk about great recipes you’ve tried, or food markets you’ve found, and maybe, eventually, voice your fears. That way you get to spend more time with him, and you both get some exercise. Every week Annalisa Barbieri addresses a family-related problem sent in by a reader. If you would like advice from Annalisa on a family matter, please send your problem to ask.annalisa@theguardian.com. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions. Conversations With Annalisa Barbieri, a new podcast series, is available here. Comments on this piece are premoderated to ensure the discussion remains on the topics raised by the article. Please be aware that there may be a short delay in comments appearing on the site.