This study utilized a qualitative, phenomenological methodology to study obesity. The purpose was to better understand the experiences of obesity, treatment and weight loss from the perspectives of formerly obese individuals, their partners and as couples. The participants consisted of six couples mostly from rural communities. In each couple, at least one the partners had experienced weight fluctuations into the obese range and had achieved at least 50% of his or her weight loss goal. The couples participated in two semi-structured interviews, both individually and as couples. A genogram was constructed with each couple to help identify family of origin influences on their weight individually and as a couple. The participants were considered the experts. The findings of this study were enhanced by use of multiple data sources. Salient meta-themes from the findings included: 1) Fluidity of the experience 2) Family of origin: weight metaphors, childhood stories and obesity fear factors 3) Weight gain, role changes, and social isolation 4) Weight communication: perceived boundaries and inadequacies 5) First-order/second-order changes 6) Body image dysphoria 7) Weight as the third person in the relationship Recommendations for weight loss must include hope about weight loss treatment, and how to begin the journey. Marriage therapists cannot assume that weight loss resolves peripheral issues for the couple; indeed, for some couples, weight loss further complicated their marriages regarding issues of sexuality, social connections and quality of life. Body image dysphoria may persist after weight loss and may require psychotherapy. This study further identified the need to educate and provide support to the partner of the overweight spouse. Some partners are able to provide support; others feel incompetent and intimidated by the sensitivity of weight. Perception of partner support was also identified as an important factor in weight fluctuation. The overweight individual may require guidance in recognizing and receiving partner support. Ostensibly, the importance of support from partners through treatment and weight loss cannot be overemphasized.

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