Dr. Jean Cates

After decades of struggling with her weight, Kathy Freeman, at nearly 300 pounds, finally made the decision to get weight-loss surgery at Erlanger hospital last year.

Although she had a strong network of support from most of her friends and loved ones, the 50-year-old nurse ended up losing a friend along with the 142 pounds she has dropped since the surgery.

“She was afraid my losing weight would change me from being who I was,” Ms. Freeman said, recalling the words of her friend, who lives out of town. “I couldn’t get her to open up enough to talk about it. ... I was very startled, very surprised, because I just automatically assumed everybody would be happy for me that I was doing something to take control of my life.”

For many who lose a significant amount of weight through lifestyle changes such as diet and exercise or through weight-loss surgery, the life-changing effects reach beyond improved health and quality of life, experts say. The basic dynamic of one’s relationships, including friendships and marriages, can change drastically as one’s habits, self-esteem and self-perceptions change, said Dr. Jean Cates, psychologist at the Chattanooga Lifestyle Center.

The emotions prompted by a friend or partner’s weight loss can run the gamut from envy to anger to fear, she said.

“Some of them get fearful that, ‘Well, you’ve been my friend when you were overweight. Now you’re going to go off and leave me,’” she said.

For the person who has lost weight, the newfound confidence and self-esteem that often emerges as a side effect of weight loss significantly can alter relationships, said Graham Brannan, social worker with Memorial Hospital’s Weight Management Center.

“People start standing up for themselves a lot more,” he said. “When you don’t think you’re worthy of respect, then you tolerate that (disrespect) from others. When you start practicing having respect for yourself, we stop tolerating that from others.”

Lifestyle changes also break down unhealthy habits that may have bonded friends in the past, such as watching TV and eating together, Dr. Cates said.

“When people lose a major amount of weight, they lose much more than weight. They oftentimes lose eating buddies,” she said.

Ms. Freeman, who now exercises regularly and carefully watches her diet, said she’s dropped from a size 28 to a size 10 and now is relieved of chronic pain in her legs and ankles.

The changes in her social life and personality also are noticeable, she said.

“I carry myself differently,” she said. “I feel like I’m more likely to be a little more outgoing and maybe a little more willing to take a lead role” in social outings.

By far, the biggest post-weight-loss change happens internally, and improved confidence can draw more positive attention to a person, Dr. Cates said.

But some of those changes, even seemingly positive ones such as more flirtations or better interactions in the workplace, can be upsetting to the person who has lost the weight, she said.

“It makes them angry because they say, ‘I’m still the same person that I was before, and it really makes me mad that now everyone’s nice to me,’” she said.

Mr. Brannan recalled a former patient at the Memorial Weight Management Center who had lost about 145 pounds. A new sense of self-respect led him to confront his wife about how she treated him, ultimately leading to a much healthier marriage, he said.

“He told his wife that it wasn’t just about her anymore. It was about both of them, and she had to decide whether or not she could accept that change,” Mr. Brannan recalled. “She was quite tearful and wanted to immediately accept that change, and he said, ‘No. You’ve got to think about it for a while.’”

Communication and understanding with loved ones is crucial when navigating such changes, Mr. Brannan said.

“When you make a lot of change in your life ... the people in your life are wondering, ‘Where’s my place?’” he said. “Know that people are going to have adjustments to make and you will, too. Allow for that.”

TIPS FOR THOSE

WHO’VE LOST WEIGHT

* When you notice the dynamic of a relationship is changing, ask your friend what he or she is feeling. Say, “I’m going through a lot of changes. Is this impacting you as well?”

* Find other healthy ways to bond with friends with whom you typically participated in unhealthy behaviors.

* If a friend makes a snide remark about your weight loss, evaluate whether it is worth calling him or her out on it. Some comments might be better to accept as part of their transition; hurtful comments you may want to address immediately in a nonthreatening way.

* Consider marital counseling or therapy to talk out the changes in your life.

* Give yourself and your friends and loved ones time to adjust.

Source: Graham Brannan, clinical social worker at Memorial Hospital’s Weight Management Center; Dr. Jean Cates, psychologist

LIVE ONLINE CHAT

Do you have questions or comments about losing weight, diet or nutrition?

Ask Kristen and Kevin Harvey, the trainers for the Chattanooga’s Biggest Loser contest, during a live online chat at timesfreepress.com. The Harveys will take questions online at 11:30 a.m. today.

SHARE YOUR STORIES

Have you lost a lot of weight? Tell us how you did it. Share your success stories, frustrations, diet and exercise tips, before-and-after photos, recipes and questions and story ideas. E-mail us at news@timesfreepress.com and please out “shape” in the subject line.

MORE ONLINE

At timesfreepress.com/news/shape, find a BMI calculator, a nutritionist’s column, a dieters’ blog, dieters’ success stories, FAQs on obesity, links to Web pages with information on healthy living.