Personality change after bariatric surgery is a fact, and marital conflict is often the result. After bariatric surgery, hormone levels dramatically shift, and the post-surgery dietary regime changes serotonin levels and neurotransmitter activity in the brain. Personality change after bariatric surgery can wreak havoc in a marriage and leave spouses completely unprepared.
Research tells us that divorce rates for marriages where one partner has undergone bariatric surgery appear to spike during the first year of post-surgery recovery.
It’s a fact that 80% of bariatric surgery patients are women, and it’s also a fact that women initiate most divorce actions.
Despite the fact that men who undergo bariatric surgery often have a lower weight loss, and experience more medical complications, men report significantly higher satisfaction levels, and feel better psychologically post-surgery post surgery than women. But they still can experience profound and perplexing personality changes.
Research clearly shows that there is a greater intra-psychic pressure on women undergoing bariatric surgery. For women, bariatric surgery is a decision fraught with personal and cultural expectations.
Bariatric surgery impacts troubled marriages in several ways at the same time. Women who have had the surgery tend to become impatient and dissatisfied with the constraints of their former life, while their husbands witness their wive’s transformation often feel threatened by their “new” spouse.
Bariatric surgery is a fast-track to personal transformation. The sudden nature of this surgical remedy for obesity can become a profound stressor on the patient’s intimate life.
After surgery, the brain, as well as the body, are adjusting to a new normal. Personality change after bariatric surgery can leave the spouses of these patients bewildered and unable to grasp the sudden onset of discontent in their now thinner partner.
Personality change after bariatric surgery operates on a neurological, chemical, inter-personal, and intra-psychic level. The marriages that survive have a strong sense of “we-ness,” and these more resilient couples typically avail themselves of counseling both before and after bariatric surgery.
These couples also pay closer attention to the information they are given about the emotional and social impact of the surgery. They understand that personality change after bariatric surgery are an inevitable part of the process of sudden transformation.
The stronger the marriage before surgery, the more resilient the couple will be during recovery.
About a year after the surgery, research tells us that some spouses may become less accommodating and selfless. They may advocate for themselves in rather direct ways that are not at all in keeping with their former selves. This new pattern of assertiveness can sometimes seem abrupt, blunt, and somewhat confrontational.
Perception is everything. Personality change after bariatric surgery can also be positive.
Chronic health problems which had been part of the previous lived experience such as diabetes, sleep apnea, high blood pressure, binge eating, suicidal thoughts and symptoms of Developmental Trauma do not magically disappear from the patient’s now thinner body.
Medical follow-up for pre-surgical co-morbidities is essential. Additional weight loss is not as rapid during the first recovery year while new habits and lifestyle changes are becoming established.
However, patients during the first year of recovery often lean into these problems and focus on improving their lifestyle and enjoying an expanded sense of themselves inhabiting a now thinner body. This abrupt shift in focus is sometimes unappreciated by their partners.
Some personality change after bariatric surgery is unarguably positive. Research tells us that many patients report the following benefits:
If your marriage is stressed by personality change after bariatric surgery, science-based couples therapy can help.
The best approach is to start couples therapy before the surgery and get on the same page. This therapy should include psych-educational elements of the predictable physiological and psychological shifts that this surgery will initiate.
Research tells us that personality change after bariatric surgery are handled better if couples have Generative Conversations and actively anticipate growth and change.
Couples who collaborate on lifestyle changes and offer mutual support have a better experience during the post-surgery recovery period. Couples who do not prepare are often startled, overwhelmed and blindsided by the sudden changes.
Take a hard look at your lifestyle before surgery. What are your shared values around food and activity levels? One of the common personality changes after bariatric surgery is a sudden burst of energy and a lust for life.
The patient might suddenly be treated differently by others at work. And this may present a profound challenge to the marriage.
Research also tells us that the most significant pitfall for marriage after bariatric surgery is that the patient may suddenly, perhaps for the first time, find themselves seen as an “attractive other.”
In an unhappy marriage, sexual acting-out can be a significant marital stressor, particularly in cases where the patient was obese during their teenage years. They may feel that they are making up for lost time.
This acting out behavior can be particularly problematic if the patient was also overweight for the duration of the marriage as well while a teenager.
For these patients, who may be experiencing the sexual attention of attractive others on a consistent basis… for the first time.
Patient Expert Cheryl Ann Borne reports that the odds of these marriages collapsing within two years after the surgery is an incredible 80 to 85 percent.
Ironically, the husbands of these women may have chosen them for who they are, and not for their sex appeal. And yet the power of feeling sexually desired is intoxicating and often propels these women into an uneasy crisis of identity after bariatric surgery.
It may not be politically correct, but it is sometimes true. Women struggle more profoundly with their identity after bariatric surgery than men who undergo the same procedure despite experiencing less weight loss and more medical complications.
This crisis of desire and identity is the most predictable and preventable issue that can be explored in a science-based couple’s assessment (such as our State of the Union Clinical Assessment) before the decision to undergo bariatric surgery.
Post-surgery dietary protocols can completely upend the patient’s relationship to food. Most diets require either limiting or eliminating carbohydrate intake. The surgery itself results in significant physiological changes altering the rate of the absorption of nutrients.
These restrictions typically change serotonin levels as well as neurotransmitter activity in the brain. Many patients report mood changes as a result of changes in their serotonin levels. Sometimes depression and anxiety manifest as less positive personality changes after bariatric surgery. It’s a curious fact that after bariatric surgery some patients become less depressed, and others become more depressed.
Recent studies have shown that some patients may show an uptick in alcohol consumption. Alcohol use disorder (AUD) after bariatric surgery is an area of emerging research which is somewhat controversial.
We don’t yet know enough about the effect of bariatric surgery on alcohol metabolism. But we do know that some patients will become problem drinkers when they weren’t problem drinkers before.
We also know that some former problem drinkers who had managed themselves well before bariatric surgery experience a post-surgical relapse.
What we do know from the latest research is that bariatric surgery results in:
Some kinds of surgery are less problematic than others. The jury is still out on the procedure known as “sleeve gastrectomy” and research tells us that there is at this point, insufficient evidence to suggest that alcohol absorption is negatively impacted by the procedure known as “gastric banding”.
Sleeve gastrectomies are increasingly more popular, so more research is needed.
Active AUD is a contra-indication for bariatric surgery. If you’re currently a problem drinker, your doctor is going to discourage you from undergoing bariatric surgery.
Marital stress from the experience of bariatric surgery is an emerging issue for couples therapists. Dedicated science-based couples therapists will keep up with the research in this area.
Some of the problems I’ve mentioned conspire together to compound marital stress on these families. For example, a new, developing dependence on alcohol can impair judgment and increase the likelihood of infidelity or other impulsive behaviors.
The couples therapists working with these spouses need to get up to speed on the science behind the emotional complexities brought about by a personality change after bariatric surgery.
For instance, I recently had a conversation with a bewildered, heartbroken husband whose wife had bariatric surgery about a year ago.
He described her as “once, a good Christian woman” who was an excellent mother to their three children. As a result of the surgery, she lost over a hundred pounds. He is confused and hurt by her personality change after bariatric surgery. His “new” wife now disappears for hours at a time, flirts, bar-hops, vigilantly guards her Smart Phone… and has become a problem drinker.
He has reason to believe she is lying about secret relationships with other men. “I just don’t understand it,” he said. “We were encouraged to enroll the counseling before the surgery, but we didn’t think it was important at the time. Now I see that was a huge mistake.”
Over 210,000 people in the United States will have some kind of gastric-bypass surgery this year. That’s a huge number of marriages and families that will be impacted.
Those numbers are growing in direct proportion to our waistlines. According to the National Institute for Health, more than 1 in 3 Americans are obese, and more than 1 in 20 fit the definition for “morbidly obesity.”
Weight loss surgery forces you to take a good hard look at your lifestyle and intimate relationships.
Personality change after bariatric surgery is a sign that a new self-image is emerging.
Your notion of who you are, and what you want may undergo a profound shift. Some of these changes will be healthy and exciting; others may be bewildering and challenging. Preparation is the key.
If you’re considering bariatric surgery, find an excellent science-based couples therapist who understands the physiological and psychological stresses and shifts that bariatric surgery entails.
Take a good look at any lingering, unresolved toxic issues that haven’t yet been addressed in your marriage.
Talk about the kind of marriage you have, and don’t be afraid to talk about the kind of marriage you want to have after the surgery.
If you both work together, you can both enjoy a happier and healthier life together after bariatric surgery.
Call us for more information 844-926-8753 to reach me, Daniel Dashnaw, use option 2
Daniel is a Marriage and Family Therapist. He currently sees couples at Couples Therapy Inc. in Boston, Massachusetts, three seasons in Cummington (at the foothills of the Berkshires...) and in Miami during joint retreats with his wife, Dr. Kathy McMahon. He uses EFT, Gottman Method, Solution-focused and the Developmental Model in his approaches.
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