I read, with interest, the story about Donna Simpson who is already weighing in at 600 pounds and wants to gain to 1,000 pounds to achieve her goal of being the fattest woman in the world for the Guinness World Record (she already holds the title for being the fattest mother after giving birth in 2007). Ms. Simpson is consuming 12,000 calories per day (normal caloric intake for a woman her age is 1,500 to 2,000 calories per day), and taking her toll on taxpayer dollars, as she can only walk 20 feet and has other health issues. How does she make her money? Perhaps this is the sickest part. She has a website where men pay to watch her eat. Ms. Simpson has a boyfriend who encourages this behavior, and he weighs in at a slight 150 pounds. When asked why he does this he reports, “I know where she is and I love to watch her eat.” Her boyfriend suffers from insecurity and control issues among other things.

This story is extreme and it saddens me, but it happens on a smaller scale with overweight patients I counsel about their eating behaviors and lifestyles. Many of my patients report that their weight loss attempts are being sabotaged by their spouses. How could someone who harps at you to lose weight and tells you they don't desire you when you are overweight, be the main contributor to your weight problem? It happens over time, and it happens because even though you are overweight and your partner may not like it, they derive a sense of security with you not changing. There is also a fear that as you lose weight you may become more sexually appealing, and your spouse may worry that you will cheat. Your spouse may not like their own body, and if you change yours they may become threatened that you won't desire them. There are many reasons your spouse may want to cook you dinner with extra butter, or discourage you from going to the gym, and possibly withdraw love if you become too thin. The important aspect of sabotage is to become aware it is happening and not get drawn into it. Sabotage may look like this:

• Your partner may begin to tell you that you look sick or pale when you lose weight. They may focus on your health and try to make you feel panic or concern.
• They may begin to say in front of you to friends, “My wife or husband has abandoned me.” Or they may say, “My husband/wife won't eat with me anymore, and they have changed since they lost weight.” This is the tactic of love being equal to food and may contribute to the weight problem you are struggling with currently. Love has nothing to do with food. One is fuel, one is an emotion.
• They may make a special meal for you, full of fat and not on your meal plan, and then pout if you don't eat it. This is a control issue, it is best to acknowledge the effort that went into making it, and suggest you take the meal or “special cake” to work for your friends to see what a thoughtful spouse you have.

The best way to thwart sabotaging behavior from your spouse is to sit down with them and talk to them openly and honestly before you begin the lifestyle change. Tell them you are unhappy at your current weight, that you are concerned about your health, and with the appearance of your body. Tell them you need their support and help with this transition, because you love them and you want to stay healthy to be a better partner to them. Then have a list of suggestions to give them that will help you stay on track with your lifestyle changes. You may need to reassure them that no matter how you look you will always love them most. Even secure partners need to hear this once in awhile.

Suggestions for the partner of someone trying to lose weight and to change their lifestyle:

• Offer to take a walk or go to the gym with your partner. This means a lot. The gym can become the place the two of you go to get away from the kids, and it can become your “date night.”
• If you become frightened with your partner's success, just say it. Tell them you are feeling jealous. They will understand, and most likely it will flatter them, and they will love you more for your honesty.
• When you go to the grocery store do not bring home your partner's trigger foods. Instead, save that money in a jar. Tell your partner that as soon as they lose the weight they want, the two of you will go on a vacation. Tell them the money came from what was usually used on junk food.

Losing weight and making changes with your lifestyle is extremely difficult. It can be made twice as difficult with a sabotaging spouse or twice as easy with a supportive spouse. Make sure you discover which of those you are married to. It is never too late to change.