Hey there, it's Dr. Susan Peirce Thompson, and welcome to the Bright Line Eating® Weekly Vlog. This week we're going to talk about a provocative question. Does significant weight loss affect romantic relationships? How do GLP-1 weight-loss drugs affect romantic relationships? Let's dive in.
In 2018, a big study out of Sweden was published that looked at not GLP-1 medications, those drugs weren't on the market yet for weight loss, but at bariatric surgery outcomes and long-term romantic relationships. What they found was that when you look at people who had obesity and got bariatric surgery compared to control subjects, people who had obesity and never got bariatric surgery, or people who are matched along various demographics, there were thousands of people, two different cohorts in this study, thousands of people, the people who were married when they got bariatric surgery were significantly more likely to get divorced after the surgery at some point in the future compared to people who never got the surgery and people who were single when they had the surgery were significantly more likely to then get into a partnered long-term relationship, get married or partnered than people who did not have the surgery. In other words, the surgery predicted a relationship change, and furthermore, the degree of weight loss predicted a relationship change in a dose response manner. In other words, the more weight someone lost after surgery, the more likely they were to get divorced if they were married to start out with. And the more weight someone lost, the more likely they were to get partnered if they were single before the surgery in a dose response manner, meaning the bigger the weight loss, the bigger the likelihood that it would affect their relationship status afterwards. So interesting.
To my knowledge, no comparable studies been done on GLP-1 medications, but earlier this year, the New York Times published an article by a woman named Lisa Miller, who in 2024 and early 2025, interviewed 25 people who'd been on GLP-1 medications to talk about their relationship challenges, struggles, situation as a result of these GLP-1 medications, roughly 25 people specifically, she says more than two dozen people. So, I'm thinking that's at least 25. Okay. What did she find? Did she find, Lisa Miller, as she went out to talk to people who were on GLP-1 medications about their experience? Well, the article really focuses on this couple, Jean and Javier. Now those aren't, I mean, they're kind of their real names, middle names for anonymity. Okay, so Jean was 53 years old and living with overweight or obesity, the article doesn't state which, but living with fatty liver disease, and she had at least 60 pounds to lose. She was at least probably dealing with Class-1 Obesity before taking the drugs. She got on Zepbound after her fatty liver disease got worse, and it was starting to look scary. So, she got on Zepbound, which is a tirzepatide, this is the Eli Lilly medication. That's a compound medication. It's GLP-1 and GIP put together, wo hormones, put together even more effective than Semaglutide or Ozempic/Wegovy, that drug for weight loss. She got on Zepbound and she described it as a miracle. She just was over the moon with the results.
She lost 60 pounds relatively quickly, and her marriage utterly changed as of the time that the article was published. She and her husband had not had sex since she went on the medication, not once, 10 months in. So, she's 60 pounds down, 10 months in. They've never been in couples counseling, but now they're in couples counseling. They had each gone to individual counseling before. They'd been married for 15 years and they both said that the time since she went on this weight-loss drug was the hardest in their marriage. The couple's therapist gave them an exercise to do. It was a touch exercise. The exercise was to be together and for one person to touch the other on the body, but not the erogenous zones, and for the receiver to say what they liked and didn't like, and then for them to trade and switch. They did the exercise. Javier liked it and asked to do it again, and Jean said, "No, I don't want to do it again." And Javier was like, well, this is driving me nuts. How am I supposed to reconnect physically with my wife if she doesn't even want touch, if she doesn't even like touch, if she's a no to touch, where's the hope? Where's the possibility? He said, "Her body is a mystery to me now. It's different. I want to explore it. I'm curious. It's a new body to me." And she said, "No."
What she reports is that the weight-loss drugs gave her her "no" back, that she had been a "no" for sex for about five years and had been a people pleaser, a codependent, a people pleaser, a go along to get along kind of gal, and had been just having sex that she didn't want to be having for five years. With the weight-loss drugs, suddenly she was able to say "no" in all kinds of ways, no to alcohol, no to social engagements she didn't want to participate in. No to staying out later than she wanted to stay out, no to extroverted type activities of all sorts. She sort of found her inner introvert and discovered how much she just liked being home, reading her Kindle in privacy, and she started saying no to all kinds of things that she used to say yes to. She started saying no to staying out late with friends, with Javier, with her husband. They used to go out and drink and eat and stay out till one or two or three in the morning with friends, the life of the party. And she started saying no. She started negotiating with Javier before they would go out, what time are we going to be done? I don't want to leave here any later than 11 or whatever. So, before they would even arrive, they would negotiate an end time, never later than 11 for her. And they used to stay out till one or two or three in the morning.
Things really changed. Jean got mad, angry, livid actually at how obvious it was, how differently the world treated her with those 60 pounds off her body. Suddenly, people at work were noticing her and asking her to give presentations to the board and to senior management, and all of a sudden, her marketing skills and her public speaking skills were noticed and were taken advantage of and in a good way. She was pleased about that and also secretly mad. I've had these skills the whole time and they didn't count when I had 60 extra pounds on my body. What's up with that? She suddenly noticed how differently the world responded to her, and it made her angry actually. It made her angry, and she and Javier started to fight a lot. Their arguments, they would say would go from zero to 60 in a blink, just short fuses, short fuses in the house. The article doesn't really wrap it up like what's going to happen with Javier and Jean. Basically, what it said is suddenly they're talking about divorce.
Interesting. Thinking back to that Swedish study that having bariatric surgery seems to greatly predict divorce after significant weight loss. What are the factors here? Is it possible that weight-loss drugs are taking away people's sex drive? Well, there's some studies on that and they're mixed, actually. There's a large study that shows actually the opposite, that weight-loss drugs are increasing sex drive. There's other qualitative studies showing that weight-loss drugs are decreasing sex drive. The data are not clear on that.
What else could be going on here? Well, what seems to be going on? One of the factors, there's a lot of factors here. We're going to cover a lot of them, here we go. One of the factors is that the weight-loss drugs are shifting people's identities, their identity as a foodie goes away. They suddenly aren't that interested in food. Their identity as a party animal and a let's stay out late person is going away. They're not so interested in alcohol anymore. For Jean, her identity as a people pleaser went away. She suddenly found her no that she did not have access to before, and she started using it. Her identity shifted. That seems to be happening to people a lot. Remember GLP-1 receptors are all through the brain, not just in the appetite, satiety centers of the brain. They're all through the brain, kind of like Prozac. A selective serotonin reuptake inhibitor doesn't just impact mood because serotonin isn't just related to mood. Serotonin is related to sleep and sex and all kinds of things. So, you take a selective serotonin reuptake inhibitor like Prozac, and it affects all kinds of systems. GLP-1 medications are the same. We're just now discovering all the other aspects of people's mental state that are impacted by these drugs, and a lot of them seem to be creating identity-wide shifts in people that they just feel like different people afterwards. Javier in this article said, "You're a different person, Jean. I don't recognize you anymore. You're different to me. You've changed." Okay. So, identity seems to have shifted.
Another aspect to this that I think Jean and Javier's marriage might highlight is that there was a predictor in the couples that Lisa Miller interviewed a predictor of better outcomes after taking a GLP-1 medication was that the couple prior to the medication had some looseness in how they navigated things like mealtime. For example, couples who didn't tend to eat together fared better after the medication. Couples where dinnertime was a sacrosanct thing and one would bake a huge thing and serve it for dinner, and it was part of their social contract that the receiving spouse would ooh and ah and eat a lot of it, those couples had a hard time. If the receiving spouse then goes on a GLP-1 medication, and just isn't hungry for dinner anymore, isn't going to eat a lot, and you're still the providing spouse who's not on a GLP-1 medication and is still baking, still making dinner every night, and suddenly your partner's not showing up to the table, doesn't want to eat, isn't that hungry, that can be a huge change. So, couples who were not in lockstep before the GLP-1 medication fared better, couples that had more relaxed expectations about things. I'm not expecting you to come out and drink with me and my buddies. I'm not expecting you to appreciate my cooking. I'm not expecting you to, whatever. Couples that were not as much in lockstep around the daily habits of life fared better. Maybe Jean and Javier were a couple, the article doesn't get into this too much, but were a couple who did tend to share dinnertime together. It did get into that they did used to go out with friends, drink and stay out late, and now she sort of broke that social contract.
It's an interesting thing about relationships, like long-term committed relationships are somewhat resistant to change. There's a social contract that builds up day after day after day, month after month, year after year, where you expect your partner to behave like they behaved last year and show up in certain ways. And when one person changes dramatically, it has an impact on that whole system. It has an impact on everything on the other person and the unit of the relationship itself.
One thing that the article also got into is that some of the partners split up because the weight loss itself created a shift in social standing and expectation of a partner. Let me go back to data. I used to teach this in Psych 101. There's data showing that couples are matched generally in social desirability. Typically, they're pretty matched in attractiveness. So, these studies are done with photographs of people, and these photographs get rated by independent. They just pull undergraduate students into a psychology lab at a college campus, and they say, here's a stack of a thousand photographs. I want you to rate these people one to 10 on their physical attractiveness. You do that with a hundred undergraduates with a thousand photos each, and you can get a pretty good rating of how attractive is this person. And then you sort of see who's partnered with whom. Sure enough, those numbers correlate pretty strongly and where it doesn't, the partner who's less attractive has a lot of money or has other things that raise their social desirability. It's not PC, but it's true. This is just kind of how people partner up. So, when one person loses a lot of weight in our society, our western society, that typically means that their social desirability increases a lot. And what that can mean is suddenly the other person is feeling more insecure, and the person who just lost a lot of weight is thinking, "I could do better." So, that is a reason that people sometimes break up.
Then lastly, there's hormonal changes that happen. Remember, hormones affect a lot of our behavior, our thoughts, our moods. Hormones, a lot of them are stored and made in fat. When you change your adipose tissue structure significantly, when you lose a lot of weight, suddenly that can affect your hormones. The article talks about a guy who go on a GLP-1 medication, that weight loss parlayed into him, rediscovering running as a hobby, the running fed back into more weight loss, and before you know it, he's 5'10" and 125 pounds. His wife is thinking, you don't look well, my friend. You look sick, you look gaunt. And he's thinking, I'm just going to go out and run another marathon. Luckily he got himself together, consulted with a doctor and started weight training and eating a little bit more, started adjusting the amount of GLP-1 he was on to spread out the dose a little bit more so he could eat a little bit more. He gained a little bit of weight, and he got on testosterone because the GLP-1 medication and the loss of muscle and loss of fat had resulted in his testosterone sinking to near negligible levels. He wasn't having sex with his spouse anymore. She was getting pretty grumpy, thought he looked way too thin, and he didn't have any testosterone on board anymore, so he wasn't ever wanting to have sex. After he got just some mindfulness on that situation and shifted some of those variables, got on some testosterone, etc., they started having sex again.
A lot of factors. A lot of factors. This relates to Bright Line Eating too. We help people lose a tremendous amount of weight here in Bright Line Eating. It's what we do, and we also help people change how much they eat and how they relate to food in general. This also breaks a lot of the social contracts that people have unspoken built up in their relationships. It's just interesting to note how people relate to their partner when they lose a lot of weight. It was interesting, the article talked about sometimes that weight loss isn't attractive to the partner. Oftentimes, people are partnered with someone because they find them attractive. Shocking, I know, but sometimes someone likes the voluptuousness, likes the extra booty, the extra oomph, the extra meat on the bones, and then the partner loses weight, and the person's like, oh, I liked you better before. It can be challenging when someone shifts in all kinds of ways. I mean, I did it. I lost 60 pounds very rapidly 22 years ago. I was married already. My husband and I were married for three years or four years maybe when I lost all my weight and we survived it. It was hard. It wasn't that easy on our marriage, all of it, the shift in the social contract, even though our marriage wasn't super well established yet, the shift in all of those things, what I ate, when I ate, how my body was, all of that, it took a lot for us to adapt to it. So, I really appreciate that the light is starting to shine on how significant weight loss, especially with weight-loss drugs, can affect primary relationships.
Now, we're in the middle right now of a massive event called, "Weight-Loss Drugs and Beyond: What Really Works for Lifelong Success." I'm teaching people about weight-loss drugs, but also about how they work and how you can get the same effects naturally without a drug. Since the event is still happening just for another couple of days, I want to say there's a link below this video where you can click and go directly to participate. Just click on the link and see what's still available in terms of what you can watch, what you can participate in. That means that right now, Boot Camp registration is open. It's open for a limited time, and I hope you will click the link below and learn about what we offer here at Bright Line Eating. That's the weekly vlog. I'll see you next week.
