My work at Methodist Hospital in Houston involves counseling weight loss patients in the Weight Management Center about matters of sexuality and intimacy. Whether you are young or old, thick or thin, healthy or struggling–sexuality is a natural and normal part of human experience. If you have been out of the relationship and dating scene for a while, or if you have shied away from intimacy in your relationship for emotional or physical reasons, you may discover that there can be many challenges associated with rediscovering intimacy and sexuality after weight loss surgery. Chances are, however, you can find happiness and fulfillment in this important area of your life.
Sexual satisfaction is highly correlated with body image for women. Research shows that if women feel fat, they are less sexual than if they feel thin. Although there are many possible explanations, women seem to have more trouble with confidence in the “dating game” after weight loss surgery than men. Many of my female patients tell me that they have a loss of libido prior to surgery. For most of them, this is improved after their surgery when they lose twenty-five pounds or more. Men may not experience the same body image issues, but they can suffer erectile dysfunction before WLS due to comorbid conditions such as Type 2 diabetes, circulation problems and medications.
When I counsel men and women as they begin to lose the weight, the first three months seem to be a “honeymoon phase” focused on diet and lifestyle changes. You’ll be starting to lose weight, gaining confidence with your new looks, getting compliments from others, and feeling very good about your success. Most of my patients who are married have noticed changes in their marriages, but usually these are positive. The women, in particular, start to dress differently and experiment with new styles. It’s refreshing to see. You may still have worries that the weight will come back, but for the most part, you’ll be healthy and feeling good at this stage.
Following the honeymoon phase, things change a little. Emotional issues start coming to the forefront, and you may start feeling your feelings more intensely. Women who were “hiding under their weight” may experience heightened anxiety. This is a time when counseling can be very helpful to guide you into “reframing” who you are now and dealing with old abuse issues. Sexuality and intimacy in a relationship may be glamorized or sought after at this time, but it’s not the best time to begin a relationship. I usually counsel patients not to get involved with a significant other during this phase. You don’t yet know yourself as a new, thinner person, and introducing another person into your life at this time is not fair to either of you.
I usually recommend that patients begin dating one year post-operative. If you haven’t had a lot of experience dating, I think “speed dating” is a wonderful way to begin. The advantage of speed dating is that you have many possible dates, but it is done in a safe, open environment where you are not alone with anyone. You can talk to many people, and as you do this, you learn more about what you are looking for. I also recommend joining clubs as a way to meet people. Many of my patients have had success with book clubs, gardening clubs, church groups, exercise classes, sewing classes, hiking groups, etc. The idea is to get out of the house and mingle. This is scary for many patients at first. Take your time; there is no hurry. I recommend going to one activity a week. This helps you build networks of social support, so that when you are feeling alone, you have someone to call and converse with.
Patients have asked me about Internet dating. This is certainly less intimidating than actually going out and meeting someone. I know it has worked for many of my patients, but it still makes me a little leery. Before you engage in online dating, remember that the person you are writing to may not be the person they say they are. If you go to meet someone, make sure a friend always knows where you are and the name of your date. Never go to someone’s home; always meet in a public place that you know well. Always have your own means of transportation.
Never, ever have sex on the first date; in fact, do not have sex until you both have been tested for sexually transmitted diseases. I have comforted many a patient who has contracted an STD on the first date, thinking her partner was telling her the truth. Remember, if you have not dated in a while, the rules have really changed. Go slow: never meet someone from the Internet physically until you have talked with him or her for more than three weeks. Always, always tell someone close to you where you will be, and keep your cell phone on.
Dating is never easy. It can be intimidating and feel awkward if you have not experienced it before. However, the best way to start dating is to date. If you need a little push as you sit on the rim of your “nest,” ask yourself, “What is the worst someone can say to me?” Then realize you probably won’t hear that, and even if you do, you’re not the same person who would have felt crushed a year ago. Go to it!
Information courtesy of Mary Jo Rapini, MEd, LPC
Mary Jo Rapini, MEd, LPC, is a psychotherapist with diverse specialties, including sexual therapy. Mary Jo is featured on The Learning Channel’s Big Medicine series.
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