When considering vertical sleeve gastrectomy, most patients focus on issues like safety, efficacy, and affordability. Potential sabotage from unsupportive friends and family doesn’t usually make the “important factors” list—but it should. It’s easy to imagine yourself sidestepping unhelpful comments and actions, but the reality can be much tougher.

Why do they do that?
There are multiple reasons why people who are supposed to have your best interests at heart might try to hold you back on your VSG journey. Some of the most common:

• They’re insecure with themselves. This is probably at the root of most opposition patients face. Friends and family who don’t like the way they look might try to bring you “back in line” so they don’t have to confront their own insecurities. After all, if you’re fat, too, they don’t have to look too closely at themselves. There may be jealousy involved, sure, but it can also be guilt—guilt that they don’t have the same discipline or that they haven’t tried hard enough to get healthy.

• They don’t want things to change. This has more to do with your new lifestyle, rather than what your new body looks like. For instance, maybe your friendship revolved around cocktails and indulgent dinners, neither of which you’re interested in right now. Or perhaps your spouse shows his or her love by cooking (unhealthy) meals and treats. When others are forced to change their behaviors because of changes you’re making, they may lash out.

• They don’t grasp the big picture. Especially for people who’ve never had an issue with their weight—or who are truly comfortable with their larger size—the concept of a permanent gastric sleeve diet is simply one they don’t understand. Despite your attempts to educate them about VSG, a spouse or friend might believe that gastric sleeve in Mexico was supposed to be a “cure all” wherein you lost weight while eating the same stuff as before. People in this group likely don’t have selfish motives (though comments may still be hurtful, of course); they simply don’t appreciate that changing your health means changing your diet permanently.

How to combat the sabotage
The way(s) you resist often depends on the type of sabotage you’re facing, the motivation behind it, and your relationship with the saboteur.

• Be clear. It’s often helpful to give people the benefit of the doubt at first by assuming they don’t know how their comments are coming across. A simple, “That isn’t helpful” or “I know you don’t mean to be unkind, but that is hurtful” may be all it takes to start a discussion about what’s really behind the comments.

• Ask for help. It’s human nature to come to people’s rescue, so opening a conversation with, “I need your help,” can go a long way toward getting a loved one on your side. Don’t assume that people in your inner circle instinctively know how to support you best, so tell them! Tell your spouse that love feels like preparing sauteed veggies rather than cake. Tell your pal that you’re excited to move your friendship beyond dinner and into new adventures together.

• Take a break. You might not be able to avoid co-workers who are pushing cupcakes on you, but you can put other relationships on hold. That “friend” who’s constantly pressuring you to cheat on your gastric sleeve diet may not be a true friend after all. And the boyfriend or girlfriend who says they liked you better “before” might not be a keeper.

It’s certainly possible to be successful at VSG weight loss without supportive loved ones. But it’s much easier in both the short- and long-term if you’re able to resolve pushback from friends and family before they succeed in sabotaging your efforts.

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“Changing lives…one sleeve at a time”.