Jeanne started taking Zepbound, a weight-loss drug like Ozempic, in March 2024. She and her husband, Javier, spoke to me at length earlier this year about how they felt about their bodies. And about each other’s bodies. They hadn’t had sex since Jeanne started taking the medication. They became furious with each other.
In one of our interviews, Javier described his bewilderment at the physical and emotional changes in his wife of 15 years. “I’ve told her: ‘I don’t recognize you. I need a road map,’” he said to me. They asked to be identified by their middle names because they were speaking openly about subjects so intimate that many couples don’t air them, even in private.
After the article was published, I checked in with them from time to time. To be honest, I wasn’t sure their marriage would make it. I had witnessed thick tension between them when we all sat before a roaring fire at a restaurant as they debated whether Javier sincerely supported Jeanne’s decision to take the medication. Javier insisted he did. Jeanne worried that he privately thought she was taking the easy way out. The mood felt explosive. The parents of one child, they talked about divorce.
In spring 2025, during a video chat, I noted a thawing between them. Jeanne was smiling, her body language more relaxed than I had seen it before. She said their dynamic was “not as anxious and angry” as it had been. Javier, also smiling, called their relationship “not toxic” and “not horrific.” Still, they said, they hadn’t had sex. It had now been 14 months.
Becoming thinner had affected Jeanne’s self image in many ways. She was healthier and happier with how she looked (“Yay! I’m a small person,” she said). But she was also erupting with fury at the world for the judgment it had passed on her body since she was 17. And she was angry with herself for having always been so accommodating — “a people pleaser,” she called herself.
As a thinner person, she found the ability to say no. The drug reduced her cravings for food and alcohol, but its effects seemed to go way beyond that. At work, she began to assert herself. She set a curfew on the couple’s regular game nights with friends, which tended to be alcohol-lubricated, wee-hours events. Jeanne now drank minimally and insisted on being home by 11 p.m.
In the bedroom, Jeanne withdrew. She hadn’t desired sex for at least five years, she told me. Maybe the culprit was menopause. Or maybe it was the antidepressant she took. But until she started Zepbound, Jeanne had sex with Javier anyway. It “felt like it was my responsibility,” she told me. Somehow the medication, or the confidence its effects inspired in her, allowed her to be honest. And to set limits.
Javier wanted to be patient, but as Jeanne lost weight — 60 pounds in the first year — he found he did not know how to reach her, emotionally. To him, her anger felt “pent up.”
“It’s something that has been bottled up, and all of a sudden, the dam has broken and it’s coming at you,” he said. He missed the Jeanne he fell in love with.
One in eight Americans reports having used a drug like Ozempic, a revolution in the treatment of epidemic obesity and diabetes, as well as in the way people look and feel. But despite the deafening chatter about miracle drugs and the debates over thinness and health, affordability and accessibility, Jeanne and Javier noted that no doctor ever warned them about the dramatic changes that can occur in relationships when one person’s body and self-image undergo a radical transformation. Prescribing clinicians will often warn patients about cost and physical side effects — diarrhea, constipation, nausea, vomiting — but they seldom discuss the personal, psychological or marital consequences.
“There’s such a drive to keep things the same,” said Robyn Pashby, a clinical psychologist who specializes in issues related to weight loss or gain. “When one person changes, it changes the system. It does break that unspoken contract.” Jeanne and Javier had no idea how destabilizing the medication would be to their sense of themselves as a couple. Jeanne told her general practitioner she wanted to try the drug, and he gave it to her.
“It never occurred to me to ask, ‘Well, what does this mean for us?’” Javier said.
When I caught up with Jeanne and Javier in November, they were seated side by side on the video chat, grinning. “I’m not a virgin anymore,” Javier announced, first thing. The long dry spell was over. They had other news, too. Jeanne had undergone a breast lift, an arm lift and a tummy tuck, losing 10 pounds of loose skin, and she felt fantastic. She had a new job, and they were moving to the West Coast, where they would be closer to family.
Over the summer, Jeanne got to thinking about how lucky she was, she told me. She had heard about a woman whose husband continually made degrading comments about her body. “I was just, I think, appreciative that he has been accepting of my body no matter what size,” she said. On a September morning, before the work routine began, Jeanne turned to Javier. “I think we have a little time,” she said.
Javier needed no encouragement. “It was, Boom!” he said. “I got out of bed, locked the door, clothes came off. It was wonderful.” Jeanne smiled.
Jeanne’s thinner body is new to both of them, and Javier misses the warmth and comfort of her former voluptuousness. “I’ve got to really squeeze her tight now to be able to feel anything,” he said. “And then, when I do, it’s —”
“Bony,” Jeanne interjected.
“ — kind of bony,” Javier said.
Lisa Miller is a Times reporter who writes about the personal and cultural struggle to attain good health.
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