DETROIT When Vincent Welch went to an orientation class before having weight-loss surgery at Henry Ford Hospital, he brought along his wife, Michelle - something that's encouraged because the operation and lifestyle change can make such a big impact on a marriage.
"One of the first things they tell you, in the first hour of the orientation, is that the divorce rate for bariatric patients is really high," said Vincent Welch, 50, of Warren, Mich. "It kind of caught us by surprise."
Michelle Welch was afraid. "I was freaking out," she said. "Here's what happens. One person in a marriage gets the surgery. They lose weight. They start looking good. And the other one either gets jealous, or the other one doesn't want to be married to them anymore."
Vincent is a retired autoworker. At his heaviest, he ate four or five meals a day and topped 500 pounds. It was not uncommon for him to eat an entire pizza by himself.
Doctors told him he had to shed the excess pounds. But if he had the surgery and lost the weight, would he stay with Michelle, 43? She had struggled with weight, too. She weighed about 350 pounds. "I was scared" of losing him, she said.
Vincent had weight-loss surgery on Dec. 13, 2007. Over 18 months he lost about 300 pounds. Michelle was proud of her husband, but their relationship became strained. "She became jealous about every little thing," he said.
At one point, he got down to 185 pounds.
Their relationship was tested but, he said, "She never had anything to worry about. I loved her, as is. And she loved me, as is, whether I was heavier or thinner."
There are several reasons someone might get a divorce after having bariatric surgery, according to David Sarwer, an associate professor of psychology at the University of Pennsylvania.
"In general, we know, after bariatric surgery, that people tend to feel much better about themselves," said Sarwer, a member of the American Society for Metabolic & Bariatric Surgery. "But what we have found is that weight and weight loss can actually play a more complicated role in a marriage or romantic relationship."
Henry Ford Hospital offers support groups led by a dietitian and a psychologist that meet twice a month before and after surgery.
"When people are morbidly obese and their activity level is low, they may not feel they have choices" to leave a bad marriage, said Anne Eshelman, a clinical health psychologist who works with bariatric patients.
Eshelman runs a support group for bariatric patients. About 2,200 bariatric surgeries have been performed at Henry Ford since 2002, and Eshelman said every situation is different.
"Sometimes, there are tensions in a marriage because of the lifestyle changes," Eshelman said. "If one person has surgery and the other doesn't, there may be lots of conflict."
After her husband had bariatric surgery, Michelle Welch saw a dramatic change. He had more energy. He was so much healthier. And she started to worry. About herself.
Could she do the same thing?
"I never pressured her," Vincent Welch said. "I never made her feel bad or awkward when I was losing weight."
Michelle had bariatric surgery on March 29, 2010. At her heaviest, she weighed 353 pounds. She has lost 133 pounds. "My knees are thanking me big time," she said.
In some ways, she had it easier. She had a built-in support system.
Research shows that family members who have weight-loss surgery together will lose more weight than doing it alone.
Vincent has seen a dramatic change in his wife. He beamed with pride as he talked about how she lost the weight but grew as a person.
They have lost 431 pounds combined.
"It's even better than it used to be," Vincent said. "Because we both did it," Michelle said, "it made our marriage 10 times stronger."