my wife left me

That’s not all they have to contend with. “Bariatric surgery patients find themselves having to deal with the sea change that happens in their life as they lose half of their weight, or half of themselves,” says Pilcher.

“Their whole relationship with food changes, as do their relationships with spouses or partners, their family, and their coworkers.” In the first year after surgery, Pilcher says, patients often find themselves “trying to figure out who this new and different person is that they see in the mirror. Adjusting their self-image is not easy. They know they’re wearing different clothes, and the number on the scale is different but, if they close their eyes, patients tell us that they still picture themselves as fat.”

The divorce rate after weight-loss surgery is extremely high, according to Pilcher. So is the rate of job change. That’s not always a bad thing. Morbidly obese people, subject to a lifetime of discrimination, often come to feel helpless and accept situations others would not, says Pilcher. “Many patients, through the weight loss, become empowered to get themselves out of situations—work or marriage—that were bad,” he says.

Not everyone is affected in the same way, however. “If a patient in a long-term marriage was a normal weight when the marriage began,” Pilcher says, “that marriage is probably in pretty good shape to withstand the changes following surgery. If the patient was heavy at the time the marriage or the relationship began, however, there’s an 80% to 85% chance that that relationship is going to break up within two years of surgery.

“It may be that the patient’s partner becomes nervous because the patient becomes more attractive. It may be that there’s an abusive relationship going on, and the patient won’t tolerate it anymore. Or they might just decide that there are better options out there.”

The sudden discovery of many new options for relationships can be a challenge for some patients. “Promiscuity becomes a problem with some people, especially those who were overweight younger,” says Vickie Norrod, MFT, a marriage and family therapist in New Hampshire who has worked with bariatric surgery patients. “If they were obese during the years that they should have been developing a sense of themselves as a male or female and a sexual being, much of that development got sidelined.”