A 54-year-old woman comes to the office for a yearly preventive examination.  She has no specific concerns.  Blood pressure is 144/95 mm Hg and pulse is 86/min.  BMI is 50 kg/m2.  Examination shows severe obesity but is otherwise unremarkable.  Fasting glucose is 128 mg/dL.  When the subject of her weight is mentioned, the patient says, “In my family, we just like to eat.  My mother is heavy, my father is heavy, and my kids are heavy.  There’s no point in trying to lose weight now.”  Which of the following is the most appropriate response to this patient’s statement?