Extreme weight loss brings extreme problems

Dear Amy:

My husband had weight loss surgery about five years ago and, although he’s lost an incredible amount of weight, no one prepared me for the extreme psychological changes.

He is healthier and has more energy and confidence, but the negative changes blew me away.

He has become obsessive-compulsive. He writes down everything that goes into his mouth. He weighs himself every morning completely naked and documents it to the ounce. He has become self-absorbed, and is worrying only about himself.

Along with that, he is going through a midlife crisis. He bought a couple of sports cars and cruises around on the weekends. He goes out a couple times a week by himself for a few drinks.

He has such a high opinion of himself, he could be cheating for all I know, since our sex life has changed; I can’t get used to how he looks.

He’s lost so much weight that he looks like an old man. His skin is hanging off of his body and he will not have it removed.

Everyone tells him he looks good to his face, but they tell ME he’s way too thin, or they ask if he’s sick.

I’ve checked some weight loss websites and I’m reading about the effects of extreme weight loss on a marriage and family.

Apparently, I’m not alone. We tried counseling, but he refuses to admit the change in him. He blames ME for not accepting him since the weight loss.

I am now “self-counseling,” reading others’ stories, and trying to learn how to cope. What do you think, Amy? — DISTRESSED

Dear Distressed:

The psychological impact of extreme weight loss is being increasingly studied, because our current obesity epidemic is making extreme obesity, and extreme weight loss, more common.

Some of your husband’s habits (keeping a detailed food and weight diary, for instance), are recommended after surgery as a way to keep the weight off. His other habit — drinking alcohol — is NOT recommended. And going out a couple times a week without you is not good for your relationship. Plastic surgery to remove extra skin is very expensive, and carries some risk. (But then, this also applies to sports cars.)

He may have slipped into compulsive behaviour or an eating disorder, but you do need to understand that this change has brought on a whole-life transformation (for him), that is altering not only his own physique, health, and outlook, but also the way the world relates to him.

There is no question that some of your husband’s behaviour is not good for your marriage, and yet you are completely focused on him and his changes, without understanding that in order to stay together, you will also need to change.

You may be mourning the man your husband was before his weight loss, but that man is gone. The guy who replaced him might be a jerk, but if you want to stay together you should both focus on change and compromise.

Dear Amy:

What do you think of people who have long coughing fits in restaurants or coffee shops where others are eating?

I say that they should get up and excuse themselves until they’re done, or, if the cough is chronic, they shouldn’t come out at all until they’re well. They should do this out of consideration for other diners, who might catch whatever they have.

My wife thinks I lack compassion, although she agrees they should at least excuse themselves until their coughing fit is over. What do you say? — UNEMPATHETIC

Dear Unempathetic:

I agree with your wife. Unless it is your waiter who suffers from a coughing fit while serving you, your first reaction should be one of compassion, rather than assuming that you might catch whatever illness the person has.

And if you have a suppressed immune system, making you susceptible to illness, maybe it is you who should stay home.

The thing about a coughing fit is that it is — a fit. It comes on suddenly, and the person coughing assumes that it will end soon. Be nicer!

Dear Amy:

“Trying to Forgive” described her feelings of betrayal because her husband’s best friend (a pastor) knew he was having an affair, but didn’t tell her.

Amy, I am a pastor, and discretion is an important part of our pastoral role. The pastor friend would have violated this if he had told her.

— PASTOR

Dear Pastor:

I was focused on his role as a friend, rather than a pastor. Thank you for the clarification.