Jim Brooks arrives at the fitness club at about 10 a.m. every weekday.

He runs 20 to 35 miles each week.

Weekends are to recover and rebuild.

The Zeeland, Michigan, resident chooses a treadmill from among the 46 inside. The machines are identically purple and black, in two rows. Wall-mounted flat screens offer a diversion beyond the panel displaying speed, incline, heart rate, calorie and other indicators.

Sometimes during his workout, someone will approach him.

That didn’t used to happen as much.

“When I go to the gym, it’s kind of sad,” said Jim, 40. “The people who wouldn’t talk to me before—the prettier people—all seem to talk to me because I look better. I feel better.”

Losing nearly 120 pounds will do that, he figures.

His wife, Christine, knows how he feels.

She dropped 113 pounds.

Jim and Christine are part of a larger-than-you-might-think subgroup of weight-loss patients—couples who both undergo bariatric surgery.

For those who have more to lose than just weight, the procedure can be as life-changing as it is lifesaving.

Accountability partners

Jim and Christine both chose sleeve gastrectomies, which has become the No. 1 choice of patients and providers.

The procedure accounted for less than 20% of gastric surgeries at the beginning of this decade. They now total about 60% of bariatric surgeries nationally, often done with minimally invasive laparoscopy.

More than 95% of the procedures by Spectrum Health bariatric surgeons are done with flexible video equipment using small incisions and smaller tools. The previously dominant procedures, such as banding and the “gold standard” Roux-en-Y bypass, have been eclipsed dramatically.

Jon Schram, MD, of Spectrum Health bariatrics, performed the sleeve procedure on Christine in 2014 and on Jim in 2018.

“It’s very common, in the 20% range, for a husband and wife team to be doing it separated by a few years,” Dr. Schram said.

Fewer than 2% undergo the procedure at the same time, he said.

That’s a benefit, Dr. Schram believes. Those who’ve witnessed success in their partners are better prepared. They understand more than most what to expect. They draw inspiration from each other.

“They’re called accountability partners,” Dr. Schram said. “They get a little bit into a competition. It’s harder for them to get off the rails.”

Christine, 48, remembers a stretch where her husband’s weight seemed to fall away. Hers, not so much.

“I got a little bit jealous—and motivated—probably because it was so much easier for him to lose weight,” Christine said.

Her tone suggests the envy still surprises her.

“I didn’t have the mental breakthrough like Jim did,” she said. “Mine took a little longer.

“He really encouraged me, especially when he sensed that I was struggling. That’s the key—and communication. I know several couples who have had the surgery and ended up splitting up.”

When it comes to relationships, it’s complicated.

In one post-operative study, couples attributed their success to the joint effort.

“The impact of having a life partner and friend undergo a similar life-changing operation deserves further attention,” the authors noted.

A large Swedish study also found most partners report their relationships stay steady or get better. Improved eating habits, physical and emotional health, and intimacy are common experiences. (The research included all couples where at least one partner had weight-loss surgery.)

The study also found breakups were more common than in a comparison group without surgeries.

That’s not always a negative.

As some patients gain self-esteem and reorient their lifestyles, they may leave unhealthy relationships. Other times, the study found, the increased stress can prove too much for “already vulnerable relationships.”

Teamwork

Dr. Schram is part of a larger team.

Nurses, dietitians, behaviorists, exercise specialists and others provide support.

“We have three psychologists,” he said.

Patients are prepared, mentally and physically. They often first must lose a portion of the weight on their own. The experience preps them for surgery. Moreover, it readies them for the lifestyle changes the surgery requires.

When Christine underwent the surgery, she knew it had come time.

Both sides of her family had a history of strokes. One grandmother died in her early 40s.

“I was following right in her footsteps, unhealthy, overweight, the medications weren’t quite working right,” Christine said.

A physician assistant mentioned surgery.

“With my depression and being overweight, if that was an option … I started to look into it. I was really skeptical,” Christine said.

She dropped 41 pounds prepping for surgery, then another 77 to date. She weighs 150 pounds. Her maintenance goal is 145.

While on her journey, Christine watched her husband struggle with life events and extra weight.

The death of both parents within eight months hit especially hard.

Diabetes had taken his father. Cancer took his mother.

Jim was close to his mom and wanted to be with her as her health declined, Christine recalled.

“There were six, sometimes eight hours, in chemotherapy,” she said. “That’s a long time to sit there and, well, there’s a Wendy’s right next door.”

“Everything was kind of junk,” Jim said.

Depression kicked in. He noticed his kids doing some of the same things he’d done.

Jim and Christine’s blended family includes five children, three from previous marriages and one together, and also Jim’s niece. Christine’s two daughters are 25 and 22. Jim’s daughter is 18. Their daughter is 15 and his niece is 12.

Jim weighed more than 300 pounds before his surgery in September 2018.

His goal now is 190. He’s typically been about 1 pound away, but recently he hit 195.

“The holidays killed me,” he said, laughing.

Jim no longer desires some foods. Red meat, for example.

“Hamburger, steak—I can’t handle them anymore,” he said. “I get sick.”

For Christine, it’s the same with heavier creams and cheeses.

Workouts are now a weekday routine for Jim, a broker for a company that provides trucks for manufacturers. His preference for listening to dubstep on the treadmill says a lot about his commitment.

“It makes you go faster,” he laughed.

But both Jim and Christine stress theirs is a new lifestyle, not a quick fix.

Two or three trips to the buffet are no longer an option. Smaller stomachs require smaller portions. Exercise is key. So is the long view.

And for that, they have each other.