relationships after bariatric surgery

How to Set Boundaries in Relationships After Bariatric Surgery

September 9, 2020

Relationships After Bariatric Surgery

As a clinical psychologist who has worked with bariatric surgery patients for almost 20 years, I’ve learned that bariatric surgery is a powerful tool when used by a well-prepared individual. One of the things patients need to look at is their relationships after bariatric surgery.

This surgery can be so positively life-altering that I refer to this as not just an operation, but a transformation. While being individually prepared mentally, emotionally, physically, and for some spiritually is necessary, it is also well known that having support alongside this procedure can aid in overall success with relationships after bariatric surgery. 

This speaks to the power of the healthy collective. Since support is validated by the research for success, it is important to identify ways to optimize positive relationships and minimize negative ones.

There are two primary relationships people generally have: Functional and Dysfunctional.  

Simply, functional relationships help the process and dysfunctional relationships hurt it. The hope is that the closest of relationships (e.g., family, friends, romantic partners) will also be the most functional ones. 

Functional Relationships: Some examples of functional relationships are when someone reaches out with genuine care, cooks you a healthy meal, takes a walk with you, and cheers you on during good and bad times. 

Dysfunctional Relationships: On the opposite spectrum, if you are in a dysfunctional relationship you may find someone being critical and negative of your decision to have surgery, bring you unhealthy takeout meals, and is skeptical of your success. 

We have learned from patients in dysfunctional relationships that some people in their inner circle will say they are losing too much weight or they’re looking unhealthy. It is imperative to remember that the most important individuals to determine this are the patient’s surgeon, primary care physician, and comprehensive bariatric surgery team. 

How a patient feels and their bloodwork will tell more of the health story rather than someone that is trying to potentially sabotage a patient's success.

So what are some ways to optimize functional and healthy relationships post-surgery?  One important aspect is to ask for help. This can be very challenging for some in my clinical experience. 

This may be because when people have reached out before they have been hurt in some way. Working through some of these emotions and learning how to ask for help can help.  It’s also meaningful to have people in your life who know how important doing this surgery successfully is for you.

Educate Close Trusting Friends and Family Members

You can also respectfully inform and educate close trusting friends and family members on the dietary program post-surgery. Some individuals may choose to join you, to some degree, on this journey by cooking, prepping, and eating healthier meals right alongside you. 

When it comes to relationships, it is important to identify unhealthy relationships and learn to build healthy ones. If people choose not to join you, know that it is their personal choice. Focus more on the people that want to be advocates of your journey. Those are the healthy relationships you want to build, foster, and appreciate.

Setting Boundaries: Also, many bariatric surgery patients that I’ve met over the years take on too much. They work many hours. They have many family responsibilities. And sometimes they have difficulty saying “no."  Remember saying no is a way to establish a healthy boundary in relationships after bariatric surgery. No does not mean never. It often implies respectfully setting limits.  It is a way to express that “I just can’t right now.“ 

It is valuable for patients to learn respectful ways to say “no”  that will prioritize your overall health and well-being to optimize long-term success with surgery.

Your Relationship With Food

It is also crucial to set a healthy boundary with the thing that greatly contributed to the medical diagnosis of obesity: food.

Setting Boundaries: It is healthy to set boundaries with food and food-related situations. Try to have a plan and be prepared on the types of foods that you may eat that day, week, or in certain situations such as a party, football tailgate, or work potluck. 

For example, if you’re attending a food social function with food (which most of them are), try to learn about the menu and ways to help well ahead of time. Ask if you can bring a healthy dish as then you still have a good choice if surrounded by unhealthy options.

Also, be mindful of the emotional relationship that many people have with food. Food can be a comfort, reward, and emotional reliever in so many situations. To set healthy boundaries with food, it is helpful to identify other things that may offer comfort and a sense of being rewarded. The more non-food rewards you allow regularly, the less you will need that experience from food.

Relationship With Yourself-Be One Step Ahead

With bariatric surgery, just as in life, it is often better to be one step ahead than one step behind. You deserve it to yourself to be intentional and mindful about the things in your life that help you be healthy and prioritize your commitment to your decision to have this surgery. You can still be involved in helping others and being there for them during times of need. 

You can still volunteer your time, energy, and resources to others but it’s important to not compromise your own. Many people have put their own needs on the back burner and that also can contribute to developing health problems and gaining weight over time.

Focus on yourself as much as you focus on others. So as you can see one of the key boundaries to set in this journey is with yourself. Give yourself grace. Give yourself understanding and kindness. Offer yourself self-care, self-compassion, and a system of self- monitoring that can enhance the overall success in the weight loss surgery journey.

When To Consider Counseling Support

If you do have difficulty setting boundaries in any of these areas, please consider counseling support. You’ve already made an investment in your health, wellness, and future so engaging in the counseling process may only aid in that investment. 

Engaging in counseling should be viewed as a strength, not a weakness. It shows your willingness to do what it takes to be successful with this surgery process. If you do not like the term counseling, consider it coaching or a health consultation.

Bariatric surgery is a powerful tool.  But it is even a more powerful tool with a commitment to yourself and establishing healthy boundaries in relationships after bariatric surgery.

relationships after bariatric surgery
Ravi Sabapathy


Dr. Ravi Sabapathy is a clinical psychologist with The Bariatric Center of Kansas City. He has advanced and fellowship training in health and medical psychology. He has also served as a past consultant to the Kansas City Chiefs. He has proudly and humbly assessed and treated over 15,000 bariatric surgery patients since 2002.