Marriage, Family & Strangers After Weight Loss Surgery

Question Below Submitted By:  

Tonya H (a patient from Oklahoma City, OK)

Before surgery, nobody really talked about the “elephant in the room” (that would be me LOL), but they would talk about how fat this person & that person were, as if it didn’t or shouldn’t affect me…but it did. So much that I’d cry.

When they asked what was wrong, I’d tell them that if that’s how they felt about fat people, that’s how they felt about me. I was told I wasn’t fat, I was fluffy– which I found equally insulting & patronizing. But they stopped the fat talk when I was around.

Now, after weight loss surgery, they’re very supportive & tell me how great I look.

Each of my family members’ reactions have been very different…

My oldest (30) wants to take me to eat & trusts I’ll stay within my boundaries, but he’s worried about me dying because he knows of several people who have.

My middle son (26) wants to police everything I put in my mouth & feels he has the right to reprimand me when I eat unapproved foods. He once went 3 days w/o speaking to me because I’d eaten 4 small fried shrimp, then blew up at me when trying to talk it out. I understand his concern & love him for it, but I told him it wasn’t a common occurrence & I’d be the one to suffer any consequences my body felt I deserved.

In all fairness, the mother of one of his friends had weight loss surgery, lost weight, broke ALL rules ALL THE time & somehow passed away — I had to remind him that’s not me not what I’m doing.

My youngest trusts me to know what I can/can’t tolerate & knows I’m not gonna force more in than I should. He’s pretty laid back about it all.

My husband is great — most of the time. He loves that I look healthier & my Type 2 diabetes is resolved & that I think more highly of myself.

However, intimacy has taken a BIG hit since surgery. If I’m not experiencing nausea (14 mos after my RNY), I’m feeling with gas, bloating, &/or diarrhea or not feeling very sexy because of all the loose, saggy skin.

The worst, though, are the aforementioned GI issues. Most of the time I don’t even have a warning when it’s gonna hit & that’s the LAST thing you want happening during THOSE moments.

And the smells — OH MY GOSH! For that reason alone (& the ensuing reactions) I find myself regretting ever having made the decision to have surgery. But I did, so here we are… not as close, physically anyway, as we once were.

As for how strangers perceive me… I’m no longer the object of small children pointing & telling “Mommy, look at that fat lady!” (which the mother would pretend to ignore, only to have it repeated). I no longer get looks of abject terror as I make my way down the aisle of an airplane & I now fit in my own seat w/o encroaching upon the small amount of space allotted to the stranger in the next seat.

Still, I think I miss the intimacy more than I enjoy all the good stuff I listed. It was always an area we enjoyed often. Sure, there was a little body image issue, but not often enough to affect that part of our relationship.

Now, it can be weeks or more than a month we go without, not for lack of want, but for the uncertainty of “what may happen” & I now get hit with frustrated questions like, “Are you ever gonna wanna do it again?”, outta nowhere & that puts me on the defensive.

Spontaneity is a thing of the past. These moments must be planned & prepared for. By prepared, I mean I won’t eat anything until after intimacy, & I mean all day with nothing but water or maybe tea, & we all know that’s a no-no bc I’m not getting my protein.

He doesn’t know this. He thinks I had a sudden surge in my libido or I’m having a good GI day, I don’t want him to feel guilty. But that’s life now. Nobody prepped us for this possibility.

Too late now. And yes, I take anti-gas & anti-diarrheal medications, to little or no avail. I carry body spray everywhere I go, just in case.


Expert Responses to the Question Above

Clinical Psychologist's Response to "Marriage, Family & Strangers After Weight Loss Surgery"

by: William Hartman, PhD

Tonya really does a wonderful job of summarizing so many of the typical post-op issues! She doesn't even have to look outside her own family to find all common reactions — the general enthusiasm and support; the fear of her dying or becoming seriously ill; the food police / lecturing about what to eat (this frequently comes from the fear, above). And oh yes, thankfully, the laid back, trusting one who will let Tonya and her surgery go about their business of weight loss and health and healing.

These are all issues that are commonly and constructively shared and discussed in live support groups and appropriate online forums.

The intimacy issues with hubby are also common but it’s harder for people to discuss these things, and I applaud Tonya for reaching out about them.

The part that is due to gas, bloating, etc., I will of course defer to the medical experts; I am a psychologist.

As for the saggy skin — there is much research supporting that while the weight loss itself boosts self-esteem, the skin is an issue and reconstructive surgery does wonders to further build self-esteem. Of course, that is expensive and insurance rarely covers.

But during the preoperative psych discussion, we routinely ask about it and if there is any way to start saving for it, it is worth doing. We also talk in support groups about ways of getting around it—how to dress, talking about it with spouses and lovers, and so forth.

BUT for a really sensitive, explicit and thorough exploration of intimacy, I highly recommend my friend and colleague’s recent book, XL Love, by Sarah Varney. Sarah interviews a number of couples, where one or both spouses have been or are extremely obese; a number have had surgery and some not. There is very detailed information about the newness of intimacy after weight loss and the hesitancy on both spouses’ parts to return to intimacy. It really is intense, straightforward, honest and sensitive reporting and storytelling.

Finally, Tonya is hardly the first person to weigh out postoperatively the costs and benefits of the surgery — if she had known about the changes in intimacy, the not-so-nice reactions of family and friends, and so forth, would she have traded those for the resolution of her diabetes, the ability to fit into a plane seat, and the ability to walk down the street without being humiliated?

Right now, her feeling is "not worth the trade." But I suspect if she keeps talking it out with sympathetic peers, keeps working on the physical issues, and does a bit of the reading described above, she’ll come to terms with her decision.

And one more thing some of my patients do is play out the "what if I hadn’t had the surgery?" scenario — the continued and worsening health, mobility, etc. Helps put things in perspective.

My best wishes to Tanya and the many others like her who don’t come forward but who need the help and support!

~Bill Hartman

(click here to inquire about or contact Dr. Hartman at The Weight Management Program of San Francisco, Inc.)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Life After Weight Loss Surgery
- Weight Loss Surgery Support Groups


Patient Responses to the Question Above



My husband had the gastric bypass surgery. The weight loss is amazing (too extreme in his case), but no one prepares you for the personality change; the obsessive-compulsive behavior, the neurosis, the mid-life crisis, and being self-absorbed. Everyone tells him to his face he looks great but behind his back they're asking me if he's been sick..."He's way too thin!"

He writes everything down that goes in his mouth. He packs a lunch every day yet comes home starving because he is not eating enough. There is no sex life because he looks like an old man and so different than what he looked like through most of our marriage. He bought a sports care and goes a lot by himself.

This is very hard to handle. I want the man I married back!

fiancee had sleeve surgery

by: Robert DIaz

Mr fiancee had the sleeve surgery February of 2017. Before the surgery she was 300 lbs and shes 5 foot 2. She went all the way down to 231 and in the past 3 months shes gained 9.5 lbs. I have been real hard on her to maintain her excercise because at times she tends to slack a bit.

I myself gained a lot of weight, when I was 26 I was 240 lbs and in 2 years at 28 I went up to 360 lbs. I lost some of the weight and went down to 313.9 lbs. in which where I am at now at 31 years old.

She thinks I am being too hard on her, although I feel I have to be to hard on her because when she was at 300 lbs are sex life went down tremendously and she was putting me on the back burner which I though was not cool at all. I felt it was a slap to the face because when I gained my weight, yes I felt depressed and yes I hated it.

Although, I never once changed towards her, our sex life and how I treated our relationship. I dont want her to put me on the back burner again. We have a lot of arguments about the weight loss and I feel we might not last. Am I being too hard on her? Am I doing what a boyfriend/fiancee should be doing? Looking forward to hearing the feedback, thank you.

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