How Weight-Loss Drugs Led to a "Relationship Nightmare" For This Couple

Valerie Gill started taking Contrave, a prescription weight-loss medication, 11 months ago after experiencing weight-related health issues that she found uncontrollable with methods like diet and exercise. Like the many other Americans getting on weight-loss drugs like Wegovy and Ozempic in the last year, the 36-year-old has been navigating the changes the medication has had on her health — and beyond. But when it comes to her relationship with her boyfriend, there have been shifts Gill wasn't expecting. In fact, she calls the experience "an exhilarating relationship nightmare."

For Gill, such a vast lifestyle change has been a journey of support coupled with miscommunication and uncertainty. "My boyfriend has been supportive, but we've had longer conversations about body image, pressures, and the impact this journey has on us as a couple," she says. In some ways, she adds, the experience has made them closer, requiring them to embrace a new phase in their life together and make some lifestyle changes. But at the same time, Gill's partner has expressed worry that she is "overly concerned about my appearance or the pills, and not more about health and well-being," she says.

Weight-loss medications have shaped American society in the last couple years, with a May 2024 KFF study finding that 12 percent of adults have taken a glucagon-like peptide 1 (GLP-1) such as Ozempic. And as in Gill's experience, anyone's choice to take weight-loss medication can have a tremendous impact on their romantic relationships — from making the couple feel out of sync to being the cause for canceled plans. According to Rachel Goldberg, LMFT, PMH-C, "Taking diet medication can greatly shift the dynamic in a relationship because when one person changes dramatically physically or mentally, each person has to adapt and grow with the changes or they will start to grow apart."

Rachel Goldberg, LMFT, PMH-C, is a licensed therapist specializing in eating disorders.

Leanna Stockard, MA, LMFT, is a licensed marriage and family therapist at LifeStance Health.

In Gill's case, that's manifested in worries about not being "good enough" if she stopped taking Contrave; she's begun to believe that her partner's interest in her is contingent on her weight-loss progress. She started taking note of her boyfriend's praise when she started losing weight, and she wondered if the comments "carried some pressure to continue the change." That led to sometimes difficult conversations about her weight loss, she says: "Even trivial things, such as whether I'd lost or gained a couple of pounds in a single day, might be provoking tension and uncomfortable reactions." Overall, though, Gill feels her self-esteem has improved since taking Contrave.

Although Gill's gone through moments of insecurity herself as she navigates changes, weight-loss drugs can also lead to difficulties for a romantic partner who's not on the medication, Goldberg says. "If the medication helps the individual gain control over their eating, potentially leading to weight loss and improved self-esteem, their partner might feel threatened by the changes, especially if they had always bonded over food or going out to eat, and now those shared experiences are gone," she explains. "Additionally, watching a partner improve can be difficult if the other person is not making improvements themselves, leading to fears of being left behind or abandoned."

Then there's the side effects' impact, which, in Gill's case, has meant putting certain plans on hold. Leanna Stockard, a licensed marriage and family therapist, says that some of the side effects (like nausea or diarrhea) could "impact our desire to date or our interest in doing much outside of the home." Weight-loss medication can have emotional side effects, too. They might bring on adverse mental health symptoms, such as anxiety, depression, mood swings, low libido, and/or irritability.

But on the other side of things, going through a transformation can actually strengthen relationships. For instance, Goldberg explains that "in the past, one partner may have felt less interested in sexual or physical intimacy due to feelings of shame about their body. Once they begin to feel better about themselves, they might show more interest in the way they dress or want to engage in more physical touch." For Gill, her improved self-esteem did add excitement and intimacy to her romantic connection.

Anne-Marie Zanzal, 60, and her wife Tonda McKay, 62, have also experienced the more positive changes that weight-loss drugs can have on romantic relationships. They say they had reached the "fat and happy stage of life" but realized being overweight was affecting their energy levels.

Zanzal was unable to qualify for medication through her doctor and insurance, so she bought a compounded semaglutide via an online provider in August. "The first provider was very easy to work with, but there was no support and I had a lot of side effects," including nausea and heartburn, she says. In December, she switched to one through Weight Watchers and her side effects have improved.

McKay, who is diabetic and has a heart condition, received approval to start Ozempic in December — a change that has made a significant difference in their relationship. "Tonda is also afraid of needles, so I administer the dose for her," says Zanzal. "We discuss everything and we are both supportive of each other." She adds that McKay is now more active and energetic, which has allowed them to do more activities together. Plus, they both feel more attractive in their own bodies.

Though McKay has experienced some gastric distress and constipation since starting Ozempic, the couple say they feel more attractive. "It's nice to have her on this journey besides me," Zanzal says. "Everything is easier with a friend or in community."

Sarah Fielding is an acclaimed journalist with seven years of experience covering mental health, social issues, and tech for publications such as PS, The Washington Post, The New York Times, Insider, and Engadget. She's also a cofounder of Empire Coven, a space highlighting trailblazing women across the United States.