Having Healthy Relationships After WLS

Healthy Relationships With Family, Friends, Co-Workers After WLS

September 16, 2020

Relationships After WLS With Family, Friends, Co-Workers After WLS: What's Healthy and What Isn't

The need for connection is a natural human desire. Research shows as infants we seek to bond with our mother. From this develops a soothing feeling that teaches us an emotional and social attachment (Ainsworth, 1973; Bowlby, 1969). Maslow’s “hierarchy of needs” also speaks of our need to belong is secondary only to our survival need. Personal and work relationships can change after bariatric surgery. Having healthy relationships after WLS is an important aspect of your journey.

Knowing we have this innate need, what happens post-surgery when we are faced with relational challenges. How can one have a true connection with family and friends when they do not understand your new life post-surgery? Below are a few relationship challenges and a discussion on how to navigate having healthy relationships after WLS.

Concern for Your Health

Some family and loved ones have become accustomed to view you from their perspective. In other words, they only know you as a person that was overweight. Therefore, when they see you having smaller portions or choosing healthy options to them it is a surprise. This is not your problem but their old perspective of you. In some ways, it is a mental retraining process for them, learning the new you.

I have seen many patients who complain family is very concerned about their weight loss. Stating that they are losing too much weight or look “unhealthy” and “too small” even if they have a healthy BMI. The person usually has good intentions, but this does not negate how those statement can hurt. At times, this can leave the bariatric patient feeling hopeless or question changes. It can also lead to isolating when no one else in the family has experienced this journey.

Cosmetic Surgery Argument

Another situation that can be difficult for the bariatric patient is a conversation with loved ones about having cosmetic surgery. Excess skin or needing a lift in other areas can be an issue post surgery and contribute to body image issues. No matter how much exercise or weightlifting at times the only solution is cosmetic surgery. We use the term cosmetic surgery, but removing excess skin is not always about vanity.

Excess skin can be a health issue causing hygiene problems, infections, back pain, or painful chaffing.

The benefit of body contouring is more than just cosmetic. It can improve quality-of-life, emotional adjustment, and allow one to be more physically active in the long run. In a recent study, it was found that body contouring surgery is related to less weight gain in the future because quality of life improved as compared to those who did not have plastic surgery.

Overly Supportive Partner

Often those closest to us can hurt us the most. Many partners and spouses want to be supportive but instead can become domineering. In an attempt to be supportive some partners think they are doing you a service by telling you what’s healthy. For example, some partners feel the need to remind the patient what they should be eating or how to exercise. The relationship changes from a supportive partner to someone who is an domineering parental figure telling one what they “should” be doing to stay healthy. This can build resentment.

Further, it can also feel like a control tactic linked to fear of losing the relationship if one confronts the partner. Although the patient will appreciate someone being encouraging, constantly monitoring or criticizing is not helpful. Begin a series of conversations about what you need from your partner as well as distinguishing what feels supportive versus condemning.

Children & Home Life

Family may have trouble adjusting to your changes and choice of lifestyle. There is a period of trying to figure out unexpected changes. In this stage of re-figuring family changes it is good to map out and acknowledge loss, learning, and expectations as as a family life. It may entail accepting family’s concerns while educating them. Discuss limits on eating out, cooking style, eating schedules, and time needed to workout. Keeping healthier snacks and family getting used to you saying “no thank you.”

Some family members may take your “no” as a personal rejection. Initially, family members may pushback, try to guilt a yes out of you, or resist the change. This can cause anxiety in the bariatric patient knowing you will be challenged or desiring to keep peace. Be prepared take ownership of making your meal separate from the rest of the family.

The pressure from extended family members can also be very strong. For example, when we feel alienated or criticized at family gatherings and events. You may feel singled out when you bring a healthy dish to the gathering. Educating family that gift giving food is not going to work anymore.

Conversations with your family about expressing needs and engaging each other in forming healthy goals can create cohesion by giving everyone a way to work together.

Remodeling family patterns takes time. It may also lead to disconnecting or spending less time together if they disagree with supporting you.

The question becomes how do you preserve relationships or improve them? First step is to learn to set healthy boundaries. After some self reflection practice setting boundaries. Identify your limits so that others know what you need. The path to problem-solving includes confrontation in a firm healthy manner. It also means giving up expectations. Do not expect everyone to understand or be empathetic to your journey.


If we take responsibilities for our feelings we can use them to understand and create healthier relationships. When we become angry with someone for not understanding our journey and believe it is their responsibility for our anger, we are in trouble. We will continue to be angry until the other person decides to correct the problem. This may never happen. You cannot control someone else only your own emotions. This is not to say they should not be held accountable. Blaming them will keep you in emotionally in bondage.

However, if we realize the anger is something we need to work on internally then we can begin to solve the problem. For example, if someone says something negative or judgmental towards us at a social outing regarding our eating habits we can either choose to feel judged or we can look inside and see that those feelings may be reminders of a time you were not accepted. Understand your feelings. You may need to decide to set a boundary for yourself such as not attending an event or if you are hurt to confront the person in a healthy way.


Whenever we feel that we are attacked or a victim of another's expectations we need to understand where this is rooted. What is allowing us to feel pressured by their expectation? We can choose to listen, analyze, or ignore hurtful words. If it is not your problem then return the feeling to the rightful owner. You do not need to comply with what the person believes. If the person's attitude was positive but they are misinformed you may want to engage in a conversation about your new lifestyle.

We cannot enable others by agreeing to their problem with our new life. Feeling pressure with a tendency to agree leads to anger. We must get in touch with what we are feeling and place a boundary rather than blaming the other person or ignoring it.

Having Healthy Relationships After WLS Conclusion

Boundaries in relationships can sneak up on you and feel uncomfortable. However, to be authentically yourself means you have to place boundaries. Learn to recognize the opportunity to educate others about your needs. Time will allow for you to discover your boundaries and help others adjust to your new needs.

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Bertha Rodarte


Bertha Rodarte, MA, PhD is a bilingual (English/Spanish) licensed clinical psychologist, specializing in health psychology. She earned her PhD at the University of Texas at Austin. Dr. Rodarte has over 13 years of experience with bariatric patients. She provides pre-op psychological evaluations for WLS and therapy for patients needing additional support.
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