Weight loss surgery is life changing. It can dramatically change a person’s weight and overall health. However, the complete lifestyle overhaul that accompanies bariatric surgery can come with some unexpected transformations. Research shows weight loss surgery can also lead to dramatic changes in one’s personal relationships as well.

A study recently published in JAMA Surgery, looked at the effects bariatric surgery has on people’s personal lives and how it might change relationships.

The research showed that for those who were single, having bariatric surgery was associated with an increased rate of marriage and new relationships. But for those who were already in a relationship, bariatric surgery was associated with an increased rate of divorce and separation.

Those who lost the most weight were most likely to have a change in their love lives, according to the study. The study highlights the fact that changes in weight can affect more than just physical size. As a person's self-confidence and other lifestyle behaviors change with pronounced weight loss and improved health, other aspects of their personal lives can change, as well.

“People’s relationships change after weight loss surgery because the person has fundamentally changed,” said Dr. Anita Maximin, clinical psychologist in the center for bariatric surgery at St. Vincent Charity Medical Center. “The transformation doesn’t stop once the excess weight is gone. After they have gotten their health under control, they begin to look at other areas of their life where they can make improvements. That can cause upheaval in personal relationships if a partner, family member or friend is not onboard with their new life.”

No one wants to hear that improving their health and well-being could lead to the end of a relationship, but weight loss isn’t usually the root cause of a separation.

“For the majority of people, it doesn’t have anything to do with ‘I don’t love you anymore’,” Dr. Maximin said. “The dysfunction in the relationship was already there. Many of my patients were stuck in unhealthy relationships because they would rather be in the relationship than be alone.”

Once someone begins feeling better physically, and they start to see positive improvements in other areas of their life, it gives them confidence to address any unhappiness that has existed in their relationship or end it completely, says Dr. Maximin.

“Unfortunately, I see a lot of situations where the partner wants the surgical candidate to remain overweight and to subsequently depend on them. When the idea of weight loss surgery is brought up in a relationship like that, there can be a lot subtle sabotage and resistance from the partner,” she says. “The candidate then needs to think about if they want to be in a relationship with a person who doesn’t want them to be healthy.”  

Many people-of-size are in relationships where there is a lot of dependency on their partner for routine daily things. A spouse, or partner, may be helping with everything from bathing, cooking, taking care of the home and finances, to even the most intimate of things such as using the toilet. This creates a dynamic where the partner is used to feeling needed and if the situation changes to one where they don’t feel needed anymore it can cause resentment and a fear of being left.

Not all partners or family members have bad intent when expressing hesitation or fear over a loved one undergoing bariatric surgery.

“Many spouses I speak with in my practice are just afraid of surgical complications and anesthesia. They are scared of their loved one not waking up,” says Dr. Maximin.

Her advice is to have conversations with your partner about what they are really afraid of and then to address these fears together with the surgeon or medical team. 

“When reluctant spouses come to an appointment they usually change their minds and their fears are calmed once they meet the team,” she said. “Do your research, focus on the physical benefits of surgery and start these conversations early. In a healthy relationship your partner is going to want you to be as healthy as possible.” 

Dr. Maximin offers this advice – don’t let a fear of change hold you back. Issues in a relationship can be tackled one step at a time, but its best to try not to tackle relationship problems while preparing for surgery. Bariatric surgery preparation is grueling. It’s physically and mentally exhausting and it’s not the time to trying addressing deep-seeded relationship issues.

“Patients often put a lot of pressure on themselves that all of their issues will be fixed by surgery. Yes, you will feel better, but fixing a bad job situation or home stress isn’t a guarantee,” says Dr. Maximin. “That’s why it’s so important to talk to someone and get counseling.”