This is the final blog to the relationship series and perhaps the most difficult. Most of the patients I worked with who have had weight loss surgery struggle with the following steps. It may be because these steps are the most difficult for us even without surgery. It also may be that the marriage or relationship was so broken prior to surgery that it seems hopeless. I usually advise patients not to make changes for at least 18 months after surgery, especially in your relationship status. You can anticipate many changes in yourself this first 18 months and if you work the following steps it may help you restore and begin to mend your relationship.

      Once again...the first step is to remember to "slow down". This is a process that takes time. You are changing in your looks, in your attitude, and in your energy level. Don't make changes too quickly and step back from time to time and reflect.

Step one: Listen

• When a spouse, family member or friend expresses concern regarding your personality changes listen to them and try not to get defensive. They may have valid points. When one person changes (you) everyone else around you has to change also. Make sure your behavior changes are positive ones (getting into fights with people who use to bully or ignore you is not a positive change).

Step two: Empathy

• Even though you may feel proud and great about yourself after surgery remember responses from others is unpredictable. Don't judge or value yourself according to other's judgments or comments. You didn't have the surgery to please anyone else except yourself; always keep a sense of who you are. Your losing weight makes everyone close to you contemplate their own body image. Be understanding with others, and remember what it felt like to not like your body image.

Step three: Allow those close to you time

• Give your loved ones time to get to know the "new you". If they treated you without respect in the past don't expect them to treat you differently now. You may need to set new boundaries with them. Some people who love us can never show it. This is a good time to learn to walk away from "toxic" relationships or hurtful words. You can love someone but chose not to be with them.

Step four: Assert yourself

• Asserting yourself is not getting angry or hostile. It is being able to say "No" gently but firmly. It is being able to stick up for your own values without feeling guilty. You have a purpose to your life and only you can fulfill that purpose. You must be able to defend your purpose and know that this is okay and, in fact, necessary. You don't have to use mean or ugly words-you just need to be firm about how far and to what extent you are willing to put yourself out for another. In other words: be sure to make boundaries. Also make sure that within your boundaries there is ample space for you to feel safe and able to grow toward a better you!

Have a great week!!

MJo