"I just don’t understand it,” Dawn said. “Why doesn’t my husband want me to have the surgery?” Tammy agreed. Her spouse was also unsupportive: “My husband said, ‘Just keep trying new diets—you should be able to lose weight. This surgery is too risky and doesn’t make sense.’”

You’ve decided that surgery is right for you, but your spouse is convinced it’s the wrong choice. What to do?

I sat down with Howard Halford, Bruce McKee and Mike Gibson, who were initially very nervous about their wives’ decisions to have weight loss surgery. They provided some valuable insights into the partner’s experience.

They’re worried you might stop loving them
Howard said, “I was worried about how our social life would change. Would she still find me acceptable?” Bruce echoed this by saying, “I was used to having a wife that looked a certain way and I was fine with it. I didn’t know what would change for her or for me after the surgery.” Mike cited statistics: “I’d heard how many people get divorced after weight loss surgery and I didn’t want that to happen to us.”

Many men ask me, “Will my wife still love me after the surgery?” We hear so many statistics about relationship challenges after weight loss surgery that it’s only natural to wonder and worry. The best way for you to help your spouse is to have an honest and loving conversation about these fears. You might say something like, “Sweetheart, it seems like you pull away whenever I talk about my surgery. Can you help me understand how you’re feeling?” Sharing feelings gives you the opportunity to bond. Most spouses are longing to hear that you love them and that you will not leave them after the surgery.

When you are talking, there’s some good news to share: Dr. Kelli Friedman and her colleagues at Duke University’s Weight Loss Surgery Center have found little to no valid research suggesting that WLS patients are more likely than others to get divorced.

They’re afraid your life is going to change
“I knew weight loss surgery was going to change both of our lives,” Bruce explained. Mike expressed a similar concern: “Our life revolved around food, drinking, going out and smoking—I knew all of those things were about to drastically change.”

Mike and Bruce are typical of many spouses who worry about life after surgery. They know how things work now—you barbecue steaks on Friday nights, you meet friends for brunch on Sunday, you celebrate successes with a special meal and drinks—but they don’t know what will change after weight loss surgery. What will you do for celebrations? Can you still go out for drinks with friends?

You can help your spouse by discussing your plans and how you can work together. If you won’t be drinking alcohol after surgery, how will this affect your time with your spouse and your friends? Have a conversation where you say, “You know, I really want to keep doing the fun things we love to do. I’ve been thinking about our Friday night happy hours—let’s still go, but I’ll have a sparkling water and you can have a glass of wine. What do you think?” Together, come up with plans for several of your favorite “rituals” that will work for both of you. If you’re nervous about triggering emotional eating, say that too: “Honey, I’d love to go to the Cake Factory, but right now, I think it’s going to be too hard for me to eat there. How about the Crab Shack?”

They have bad information
Bruce reported, “Initially, I was not supportive of my wife’s decision because I knew the risks were high. I thought a lot of people died from the surgery.” Mike felt the same way: “All that I saw on TV was that there were a lot of complications. People died, got sick—it sounded bad.”

What spouses need is good, honest information. Mike attended a support group with his wife and asked questions; Bruce went with his wife to meet her surgeon and talked to the clinic team about what to expect. Howard explained that he needed time to process the information he was receiving, and that an ObesityHelp conference was where “the light switch came on for me to get on board with the decision.”

You can help your spouse by encouraging him or her to attend a support group meeting, meet with your doctor, read posts on ObesityHelp, and talk to other weight loss surgery spouses. With more information, your spouse is much more likely to support you and the important choices you’ve made for your health.

They don’t know how to help
“I didn’t know what to say or how to say it. I didn’t want to hurt her feelings by commenting on her eating habits or exercise, so a lot of times I just didn’t say anything, and I know this hurt her,” Howard explained. “Then there were times when I felt guilty—should I have taken better care of her, should I have tried to get her help before, should I have done something differently?”

So many weight loss surgery spouses want to help, but they don’t know what to do or say. The best thing you can do is say to your partner, “Sweetheart, I know this is going to be an adjustment for both of us. You are so important to me and my success. I thought we could talk about how we can support each other during this time.” By starting the conversation this way, you’re expressing love and concern. You’re also giving your partner permission to ask how he or she can help you.

What they wish they’d known
Bruce said, “I wish we were more aware of the tremendous network of support groups and other post-op assistance, both locally and online.” Mike stated, “I wish I knew more about how to talk to my wife about how I was feeling, because I bottled it up and then would get angry because I didn’t know how to deal with it.” Howard agreed that the groups helped him deal with his feelings and talk about his fears.

All three men eventually became very supportive of their wives, and they report that their relationships are better than ever. They developed the communication skills to talk about their concerns, and WLS became an important milestone toward richer, fuller relationships. If you communicate honestly and openly, the same is likely to be true for you and your spouse.

Dr. Nickerson gratefully acknowledges the thoughtfulness and candor of Howard Halford, Bruce McKee, and Mike Gibson, who were kind enough to share their thoughts with her at the ObesityHelp San Antonio Conference. Additionally, Dr. Nickerson thanks Kelli E. Friedman, PhD, for sharing her research on weight loss surgery relationships.

Kathleen Nickerson, PhD, is a licensed clinical psychologist who specializes in working with couples and bariatric issues. She may be reached by email at [email protected].

January 2008