After WLS, Can You Have a Happy Marriage or Relationship?
September 28, 2016During our first meeting with patients, we always discuss the fact that the weight loss surgery journey puts some stress on relationships and especially on marriages. This surprises some, but we know that some marriages struggle after bariatric surgery and that the divorce rate probably increases somewhat in the years following surgery. I don’t think that this means that bariatric surgery makes marriages worse, rather, I think that by putting some stress on the relationship (changed eating patterns, physical appearance, possible increased energy and activity levels) it may expose weaknesses that already existed. If the relationship was already on shaky ground before surgery, it may continue to struggle unless some increased effort is spent shoring it up.
Now, I’m no expert in marriage and family therapy--I’m a surgeon. But in spite of my career (some surgical training programs actually used to boast of the high divorce rates among trainees as a sign of the quality of the program), I have been happily married for over 10 years. During those years, I’ve had the chance to think a lot about a few things that I’ve done well as well as the things that I’ve totally flopped at. I’ve also worked with thousands of patients during their weight loss journey, and in doing so I’ve noticed some of the characteristics and habits that seem to help some couples grow even closer, while others may struggle. As a firm believer in the institution of marriage, my hope is that through sharing my observations you’ll be inspired to take steps to strengthen your own marriage. These principles could be applied to any close relationship.
Principle #1 - If It’s Important To You, It’s Important To Me
Early in our marriage, my wife would often try to get me to go dancing with her. She is an avid dancer, so dancing to her is not only a way to burn calories but a way to connect with me. As a busy surgical resident, I told her on one occasion that I didn’t want to spend my few precious hours of free time dancing - it wasn’t my hobby and it wasn’t important to me. She bawled, asking me: “Why can’t you just say, ‘If it’s important to you, it’s important to me?’” Fast forward nearly a decade later and my perspective has changed. Thankfully, she’s stuck with me through some really tough times. We now have three children, busy careers, and a myriad of other obligations in the community.
I have not transformed into a skilled ballroom dancer, but I now do my very best to dance with my wife, even when I’m tired, and even when it’s country dancing because it’s important to her and for that reason alone it should be important to me. In other words, even though I feel self-conscious on the dance floor, I’ll sacrifice my pride and time to make her happy. In our “all-about-me” increasingly individualistic society, it is easy to view marriage as a way only to get our own needs met--as an ends to a means. We may consciously or subconsciously think that we are married in order to get something out of it. However, maybe a marriage relationship should better be viewed as the best classroom we have to learn how to serve another human being, and while so doing so we become better humans ourselves.
Someone I respect taught “The more we serve our fellow man, the more substance there is to our souls. We become more substantive as we serve others. Indeed, it’s easier to find ourselves because there’s so much more of us to find. Almost magically, as each partner focuses on the other, his/her own happiness increases." A wife of one of my patients, Jane, has made great efforts to meal prep for her husband so he always has healthy options to eat on the go. Another patient’s husband accompanies her to support group each month because that is important to her. Another patient’s spouse goes running with her regularly to help her with her exercise regimen.
Take home message: Find out what is important to your spouse, and make it important to you. This brings me to my next point- to know what is really important to your spouse, you must make time to communicate.
Principle #2 - Talk and Laugh Together!
When marriages end in separation or divorce after bariatric surgery, patients frequently report differing versions of “We just grew apart…”
After WLS, patients and their spouses may experience a range of different feelings and emotions.
Patients frequently feel an increase in confidence and energy, which sometimes leaves their spouses feeling jealous, left out, or not good enough. The best way to deal with these emotions is by….drumroll….talking about it! This may seem like a no-brainer, but schedule technology free time to communicate with your spouse. In many of our lives, if it’s not scheduled, it will not happen. Schedule weekly walks, sit-down dinners, etc, where the purpose is to evaluate the relationship and learn to improve together. As you make communicating with your spouse a priority, your understanding of him/her will increase and so will your love. Warning - not all communication is equally effective.
One day when I was in my fellowship training, I came home from work to find writing on the bathroom mirror by my wife. She had been reading a “relationship” book and wanted to help me hone my communication skills. (Remember, I said I had some “flops”?) Scrawled across the mirror in red whiteboard marker read “Is it true? Is it kind? Is it necessary? Is it helpful?”. We were to mentally ask ourselves those questions before speaking. At first, I just chuckled and didn’t give it much thought. (Surgeons are essentially trained to be abrasive and outspoken.) But over the years, the questions have begun to sink in and as we have grown in our marriage, our kindness has improved and our communication has deepened as we have learned to ask ourselves those questions.
Another important aspect of communication with your spouse is humor! I can’t count the number of times that I’ve been particularly grumpy and my wife has turned it around and made me laugh at myself. Laughing together can be the best medicine. “A good sense of humor is an escape valve for the pressures of life.” Post-op patients sometimes complain of issues with loose skin, hair loss, losing weight in “weird” places first, stinky gas, etc. Although these are real issues, the happiest patients I know laugh about them. These patients and their partners focus on nurturing one another and don’t dwell on the unpleasantries of life.
Principle #3 - Work, Work, Work
Like most things in life, sowing happiness in marriage follows the law of the harvest. We reap what we sow in relationships just as we do in a career, with exercise, or any other task we take on. Basically, to have a great marriage, most of us have to consistently work at it and practice.
I remember (re)learning this lesson about work as a medical student. I decided that I wanted to do some medical work overseas, while at the same time learning a new language. Easy, right? As I had already learned fluency in a second language (Spanish), I figured that learning a third (Portuguese) would be a piece of cake. So I bought a few audio tapes and squeezed in a few hours of language study in between my medical studies. Time flew by and almost before I knew it, I found myself sitting on a bus in Mozambique next to some random guy who was talking to me nonstop in some unintelligible language that at some point I figured out was Portuguese. For some time in the country, I felt completely lost and disappointed and had serious doubts in my abilities.
However, one day as I felt particularly down, I had an amazing epiphany--that all it takes to learn a language is work and practice! The realization that it didn’t require some magic potion but instead was a really simple formula of consistent work and effort set me free from my own fears of inability. And so, encouraged by that thought, I increased my study of the language, and before we left a couple of months later I was able to converse fluently about most subjects with the natives.
I often thought back on that principle as I continued on with my training. When I was getting yelled at by an attending surgeon for not yet being a world-class knot-tyer, I tried not to get too depressed about it, for I knew the secret formula to improve. I didn’t have to be a natural-born knot-tying genius--I just needed to work at it. My mother-in-law can attest to the fact that multiple times I left suture sewn to her couch, trying to get some practice in as I spent time with their family (and she STILL let me marry her daughter). And so just as it goes with any skill, nurturing the marriage relationship just takes work and practice.
Most of us probably aren’t born natural whiz-kids at being married. Worse, often we have very poor role models that have taught us exactly the WRONG way to do it and what comes naturally to us may be exactly the wrong way to do things. But this can be overcome. It may require coaching from someone who better understands the principles of healthy relationships, like a therapist or counselor, but I believe that like anything else, being a good partner is a learned skill. Imagine how many brownie points you get just by telling your partner that you want to be taught how to be a better partner!
The definition of work is “sustained physical or mental effort to overcome obstacles and achieve an objective or result.” If your objective is a strong marriage, before and after WLS, then you’ll be willing to put in SUSTAINED, continued effort - the same sustained effort you’ll put into your meal planning and exercise. In marriage, that effort may come in the form of extending forgiveness, writing your spouse a love note, planning a date, attending marriage counseling, showing patience, overlooking your spouse’s annoying habit, stealing an extra goodbye kiss, remembering the mid-day phone call, asking how you can help your spouse, praying or meditating together, offering reassurance, bringing home flowers, or simply remembering to say thank you.
Sacrifice In Marriage
So what does this all boil down to? I think the answer is sacrifice. As a surgeon, I am often put in a position where I must choose to either continue sleeping or answer a patient’s phone call at 2 am. In other words, I frequently must choose if I will sacrifice my own sleep or free time to give 110% to my patients. I must also make that decision every day in my marriage. Am I willing to sacrifice watching a college football game to help my wife put the kids to bed? Am I willing to sacrifice my pride to go dancing with my wife? Am I willing to let her choose Chinese food when I’ve been wanting Mexican all day? On my best days, the answer is a resounding yes. Looking at marriage as a 50-50 proposal is doomed to fail.
I know that in my own personal marriage (sorry honey!) I find myself sometimes only giving maybe 20% towards the equation, and she puts the rest of the work in. Obviously that isn’t sustainable long-term, but there will always be periods of life, for us it’s been almost a decade, where one partner or the other just can’t put in their 50% and if the other partner isn’t willing to sacrifice a part of themselves and pick up the slack, then the marriage isn’t getting the 100% of what it needs, it slowly (or quickly) crumbles, and then ultimately fails. For some time the “contract” may work and benefit both partners, but ultimately times will come where one or the other isn’t getting their 50% back which will lead to discontent and resentment unless both partners are willing to sacrifice.
In a successful marriage before and after WLS, both partners have to be dedicated to something bigger than themselves, that the marriage relationship is valuable and worthwhile - and that the other person’s needs are as important as one’s own. As patients prepare for surgery, they are required by insurance to see a therapist for the bariatric psychiatric evaluation. We love this requirement because it helps us and patients see if they have a strong support system in place - especially in their own home. If you are considering surgery or are a post-op patient, take a look at your marriage and evaluate how you are doing in the three areas above and talk with your spouse about how you can improve as a couple.
What are things that you do to keep your marriage strong after WLS?
Author’s note: Please know that I am not suggesting you should stay in a bad marriage at all costs. Abusive behavior shouldn’t be tolerated. Unfortunately, some partners just aren’t willing to change and work together and this may be impossible to overcome. But I believe that most, if not all people, are good deep down and will respond to love and forgiveness and can be taught just like I can.
 | ABOUT THE AUTHOR Dr. Benjamin Shadle is the Medical Director for Bariatric Surgery at Sutter Roseville Medical Center and continues his dream of helping his patients achieve healthier and happier lives through bariatric surgery and impacting the health of families for the better. He understands that obesity, diabetes, hypertension and other related diseases can have a tremendous negative impact on a patient's health and quality of life as well as family members.Read more articles by Dr. Shadle! |
