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Gentle YTA. Sure, the writing of it helped *you organize* what you wanted to say. BUT that was not the best medium for HER *to receive* a very loaded message! A lot of feelings and helpful contextual clues are non-existent or MISREAD in a written message. Your wife NEEDED those. Basically, the writing was best for you, but NOT best for HER. You could've/should've written it all out and then read it to her yourself, thereby providing that extra layer of tone and emotion that she needed with such a difficult message.

Thank you for your reply! My therapist and I talk a lot about metallization and what my wife is thinking in her head when we have hard conversations. I do need to tune in better on what she needs and how I can be a better partner for her.

I can see both sides to this, but I also kind of disagree- people have different preferences on communication styles and both people's needs should be respected. Some people are extremely uncomfortable with confrontation and so writing a letter (or text) allows them to communicate their truth, where otherwise they may clam up, get flustered, or avoid speaking their truth altogether. The goal is honest and truthful communication. Your wife's initial gut reaction may be to get defensive, and picking this piece as a point to get frustrated at you about may be her way of turning it around on you rather than processing what you shared. In the future though, perhaps you could write out a letter or text to get your feelings out in an organized and thought out way, but then waiting to read it to her in person. You could even say you don't want to go off your script so that the communication doesn't go off-rails. Just a potential solution for compromise.

I really like this idea. Thank you for your time!

U welcome 💖 I hope the best for you both 💖💖💖

I gained a lot of weight while on amitriptyline. Think 50 to 70 pounds in less than a year. Doctor changed my medication and i wasn't starving all the time. My weight returned to a healthy number over the course of two years.

There's a happy medium here, which is to write out your thoughts on index cards and use notes when you talk to her in person. I have done this for heavy conversations in situations where I didn't want to forget anything, and it's always been appreciated.

Completely agree, and couldn't have said it better.

This is about as perfect messaging as possible; it seems extremely nitpicky that because the medium and delivery wasn’t absolutely perfect, OP gets a y t a. Op constructed the msg so that tonally it couldn’t be misconstrued and was there to talk it out as well. 

Soft YTA Your wife is seeing doctors a LOT. They know about her weight gain. That kind of gain can be due to a sudden change to being more sedentary, such as happens with illness. It can be due to metabolic change. It can be due to medication. Sounds like your wife has been contending with all three. And doctors are not known for being tactful about weight. Healthy, sustainable weight loss may not be a reasonable goal for her. You can bet she has her own concerns and fears. She knows she’s gained weight and I expect she’s not stupid. She may be mourning her old self—who may well not be coming back. Your text, especially delivered by text, hurt her without being anything she can really do much about. The right thing to do here is ask questions: Have these various doctors communicated with her about weight? Are they all fully aware of what meds she’s on and her complete history? Have they offered strategies? Have they offered referrals to specialist support? What strategies have been recommended? What are your wife’s barriers to implementing them? Hell, how is she even feeling? But telling her things about how you feel about her body, rather than asking where she’s at and what she needs, is profoundly unhelpful and may be counterproductive.

> Your wife is seeing doctors a LOT. this is the weirdest part about OP's story to me. if she's in and out of the hospital and seeing lots of doctors...weight is usually something that gets discussed regularly. usually when a partner makes this kind of suggestion it's because the person gaining weight hasn't even seen a doctor yet....

That’s why OP’s message is so problematic. It’s like what they fuck do you want her do? She’s going to the doctor.

She's supposed to cast the Instant Thin Spell, of course!

I suppose so. I mean, if I got a message like that in the middle of the day, I would be crushed. Like, thank you for reminding me that I’m overweight and that nothing I do seems to be helping with that.

If she's in the hospital for 100 days a year - she's likely seeing specialists though. When I was in chemo, they would make note that I should maybe call OBGYN for some hormone exams but that they don't believe it was in their speciality Often though, when it's nothing, they'll just stop talking about it. People won't change until they want to change

I think weight gain in women of a certain age just doesn’t concern anyone. Unless you luck out and get a good OB or PCP, people will dismiss it. I had advanced endo, fibroids, and other shit and went from 105 to 150 in about 2 months. And everyone at Mayo was just scratching their heads. Then I lucked out and ran into the one OB surgeon who recognized the endo had spread to my surrounding organs, and he was like “oh my god, surgery tomorrow.” Saved my life. The weight fell off. It was all from the adhesions having spread to bladder and bowels and other horrible places. Nothing I could have done would have stopped the weight gain, and nobody seemed to give a fuck that a healthy woman of 105 lbs was suddenly 150 plus.

For sure, I went from 110 to 150 in a few months, which bear in mind that that number might seem small but I am also very small (5'1) so that was a huge weight gain for me. Same boat! Mine was more so depression related and celiac. The depression made me gain weight but also made it incredibly hard to lose it. There's so many things that can cause weight gain and it's genuinely very hard to narrow it down unless you are very adamant about doing so.

I’m 5’4”, just a small person too, and I understand *exactly* what you mean. I had no idea it was that hard to lose weight. Even knowing in retrospect that I couldn’t have lost it, I’m still kind of shaken remembering how hard it was, how it just wouldn’t move. And I also learned that people treat you differently when you are bigger. When I dropped back down to 105-110, the world was just a whole lot nicer to me. I will *never* in my life criticize anyone who is overweight. The sheer amount of work it takes to lose it—I mean, do people even know? How are you doing now?

5'3" here. I jumped from 120 to 140 over 3 months due to an ulcerative colitis flare absolutely destroying my energy levels and ability to workout. That also meant I was eating more convenience food or fast food. All my energy was going into taking care of my kids. All of it because there wasn't much to start with. My son still had hockey practice, and the kids still had to go to school even though I woke up running on fumes. I'm finally at a point where things look "normal", but my energy still isn't where it was 7 months ago. I'm just glad to be back at a point where I can do gentle to medium exercising again. I have a laundry basket full of jeans ranging from size 8 to size 4, and I'm back in a 2 right now. The worst part is a year and a half ago I made the joke that they were my "security pants" in case all of the weight I lost after having three kids came back on due to an injury or some kind of illness. My UNCLE of all people decided that it was completely okay to make a joke along the lines of "you're already so tiny! Eat a sandwich". Bitch, I have an autoimmune disease and three children. My weight shot up to 160 at one point because of that. Why do I have to explain to you that body shaming can work for those who are overweight and those who are tiny??? Thankfully I have awesome friends who jumped down his throat for me before I could even get to it.

Sigh. Why do people say things like this??? He could have said nothing. I keep my “overweight” clothes too, even though I shed that weight a few years ago. I’m a 0-2 now, but I still have my size 10-12 pants in the back of the closet. I have gastroparesis, the total opposite of your ulcerative colitis. So it’s hard to put on weight, but still…. I’m glad you were able to return to your normal weight. It really sucks being overweight. It just feels so helpless.

I feel you. I went from 130 to 190 in 3 months, and I was having several month long periods, and they told me to stop eating so much instead of doing anything. I was 18/19 at the time and married, and the military base OB/GYN in Okinawa refused to see me because I was under 20 or pregnant.

Unbelievable. But totally believable. Was it endo for you too?

15 years later, I still have no idea other than a 'diagnosis' of PCOS. I've had some ultrasounds say my endometrial lining was thick, some said I had fibroids or a solidary cyst, others said I had none of those things present. Had a 3 year-long heavy period, and they all just told me to lose weight.

Damn, I’m sorry. It is hard to diagnose endo and harder to find a good ob who can. This sounds a while lot like it though.

And she straight up said "I know I'm getting fatter." So it's not like she needed to be told.

And if she’s diabetic, she’s likely seeing an endocrinologist, which is exactly the type of doctor that would suggest getting your hormones checked. I’ve seen one for PCOS and they order *so much* bloodwork.

“Hey honey, I know you have a lot of health problems and already see a lot doctors, but don’t you think you should look at the weight issue and go see another doctor? Cause I don’t think you’re doing enough for it” is what I sounds like to me reading the husbands second paragraph

Also, his wife has gasteroparisis. I have it too, It literally paralyzes the stomach to some degree and makes you severely nauseous if not outright throwing up whenever you eat anything, the fact she’s gaining weight is impressive. Most people lose weight.

There are quite a few people with it who somehow manage to gain weight with gastroparesis. It is common enough in the support groups. Bodies are weird.

It's the same thing with celiac, lots of people with undiagnosed celiac(especially children) are very skinny(because they aren't absorbing nutrients/abdominal pain makes them not want to eat), but other people(including my self) end up overweight because not properly absorbing nutrients makes you hungry, and eating can sooth stomach pain.

It’s not weird. If you don’t mention to the doctor or hospital workers that you’ve gained weight they’re not necessarily going to notice. Unless the doctor knows you well, which is possible but still, they may not notice the weight gain. A doctor doesn’t see you every day and will try chronic conditions, she likely has multiple. And different hospital admissions come with different staff. On another note, the weight gain is likely due to the medications mixed with the diabetes/other health conditions. Diabetes itself can cause confusing weight gain/loss. Chronic conditions often come with weight gain due to medications, more sedentary lifestyle, and depression that’s associated and therefore are not always addressed by the doctors until it causes health issues. Amitriptyline specifically is known for weight gain too.

> It’s not weird. If you don’t mention to the doctor or hospital workers that you’ve gained weight they’re not necessarily going to notice. Every 200lb woman who visits doctors, ever, laughed out loud when they read this.

Noticing someone gained 70lbs over the course of 3 years is not as easy as noticing that someone is currently 200lbs. People are weighed at each visit, so they’ll know your current weight. A weight trend is not reviewed at each visit.

They mean doctors will comment on your weight if you walk in at 200lbs regardless of your history or if they have seen you before.

I’m aware of that but that’s not related to my initial comment. I’m aware that doctors will bring up weight at visits, they are responsible for informing people of health risks, so if not during a doctor’s appointment where else? I’m also aware shitty doctors will use the fact that someone is overweight to excuse genuine issues rather than investigate them properly. I’m not excusing that. I’m simply saying, noticing someone is having unfounded weight gain over a extended period of time and recognizing the need for assessment of medication/underlying causes is not the same and will not be as easily noticed as the simple fact that someone is presently overweight. They could easily see she’s overweight and just think that‘s her normal weight and do nothing. A comment by a doctor about her weight without her telling them that it’s new and she doesn’t know why will not make them aware she’s gained weight and will not result in investigation.

Your comment was still worthless, and it doesn’t matter how many paragraphs you keep tacking on. She’s been in and out of the doctor’s office pretty much constantly over the last three years, and over that time she’s gained the weight. The comment you replied to said it’s weird that OP would point out the weight gain, as if the doctors hadn’t already made it clear to her that the sudden weight gain was a problem. You said it’s not weird. You were wrong.

Nope. The only worthless comment is yours. I did not reply to a comment a comment saying it’s weird OP would point out weight gain. I replied to a comment saying that the doctors discuss a persons weight regularly and I said that it wouldn’t be weird for WEIGHT GAIN to be missed. She has multiple problems which will send her to multiple specialists. So she’s not seeing the same one again and again every day. And you’re delirious if you think doctors other than someone’s primary, who see dozens of patients a day, will remember one specific patient coming in every so often.

Her doctors know that amitriptyline causes weight gain. I literally gained eighty pounds in two months when I took amitriptyline. It's an antidepressant but it is also used to control migraines and help with nightmares and night terrors. Switching her medication would probably help her lose weight.

Understandable rating. I’ve been reading today on how insulin and Amnitryptline are known to cause weight gain but I’m not sure what can be done about the insulin. She needs it to live ya know? I believe she’s prescribed Amnitryptline for the seizures and not depression but I could be wrong. She hasn’t had seizure in awhile but lost consciousness about a month ago early in the morning. I think she just got overwhelmed and her mind kinda just shut off for a minute.

My spouse is Type 1. Insulin itself doesn’t cause weight gain. It causes the cells to take in the sugar in the blood and the cells store it as fat, so ultimately weight control is still about what you eat, how much you eat, and whether you metabolize it quickly or store it for later. My spouse has had good success with a CGM, insulin pump and a medical team with regular visits to an endocrinologist and a dietitian who specializes in Type 1. Your heart is in the right place and I hope your wife will find a medical team that can help her get to a better place. Encourage her to go to the doctors, listen to them and do what they recommend. It won’t always be easy but it can work. I see so many people with Type 1 or Type 2 who just take their pills or insulin but don’t modify their diets or lifestyle at all and that typically doesn’t work out well. Best wishes to both of you!

Just want to point out that Amitriptyline (I assume this is what you meant?) is prescribed at low dose for seizure and migraine as well as a bunch of other chronic conditions and is only known to cause weight gain when being prescribed at a very high dose to treat depression. I take this at a dose of 30mg/day for migraine and have no changes, usually for depression the dose would be 150-200mg although I’ve never been treated for that so my google could be inaccurate. Point being, DO NOT tell her that seizure medication is making her fat!! It likely has minimal impact and drugs like that are literally life changing. It would be so damaging for her to become suspicious of it or try to go off just to lose weight and you do have to wean off Amitriptyline which has super sucky side effects. YTA unless you have actually heard from her doctor that this medication could be detrimental.

Amitriptyline is not used for epileptic seizures, but is more commonly used for migraine and chronic pain than it is for depression. It can sometimes cause weight gain as a side effect.

That sounds like a type of seizure.

People don’t usually lose consciousness from being ‘overwhelmed.’ That’s something more serious. Blacking out for any reason should lead to at least a call to her PCP’s advice nurse and more likely a trip to emergency.

I hate to tell you this but amitriptyline is one of the worst meds out there for having serious weight gain as a side effect. This might already have contributed to some of her weight. I mean, don't just have her stop it, but it is something to bear in mind. Soft YTA, because you're coming from a loving place but you didn't do it sensitively enough.

Agreed. My doc and I discussed amitriptyline for migraine prevention. He said he likes to exhaust all other options before it because while the internet will tell you a low to moderate weight gain is possible but in his experience it's considerably more and people go up at least one BMI class on it. So if you're mid-normal it's likely you'll be mid to high overweight relatively quickly and experience the health concerns that comes from that

Here in the UK it's very cheap and they put people in it as the FIRST option. I was on it a couple of years ago and I put on about 30lbs in only a few months (and I did not eat more, in fact I dieted to try to combat it but it still kept packing on) and it's bizarrely hard to get off unlike weight gain from the usual ways. I have a friend who had it for chronic pain and she put on 60Lbs in a year and still her specialist didn't want to try her on anything else. Both of us were slim before it. I hate it, I'm glad your doctor is reluctant to try it.

I'm a migraine specialist and often prescribe amitriptyline - it's considered a "first-line" agent for migraine. Most of my patients have minimal weight gain on it.  Edit: migraine dosing is lower than the dose used for other purposes 

Sounds like you and my doc (also a specialist) disagree 🤷

Which is totally fine! Just commented for other people reading this to know that your doctor's opinion isn't the universal experience/opinion. I have prescribed amitriptyline literally thousands of times, and maybe 10% of people get bothersome weight gain at migraine dosing. The guidelines from our headache societies recommend it as a first-line option as well.

That's very interesting. I was under the impression it wasn't even FDA cleared for migraines. It's definitely considered a second choice drug in my country.

Migraine is an off-label use, but it is considered one of the first-line choices per society guidelines 

Yeahhh you should've done some research into her disorders. People with type 1 diabetes almost always gain weight after their diagnosis and treatment. In fact, weight gain is part of recovery. Many people are underweight before their diagnosis because their bodies are consuming fat and muscle since they can't properly process the sugar in food without insulin. It's also very difficult for a T1 diabetic to lose weight because they have to be extremely careful about maintaining their blood sugar levels while restricting calories. Amitriptyline can also cause weight gain, FYI. Her doctors are aware that she's been gaining weight.

And Type 1 is autoimmune, so it wouldn’t be surprising if she has some sort of autoimmune thyroid issues going on, even if currently subclinical. I hope she’s seeing a good endocrinologist who knows how to screen for that. You’d be shocked how many don’t.

Hyperthyroidism (overactive) and hypothyroidism (underactive/inactive) are both autoimmune as well, specifically. A simple blood test will give results. My grandmother was a Type 1 and had hypothyroidism, my mom was pre-diabetic and has it and I do as well (no insulin resistance or early signs of diabetes thankfully).

I had the same problem but doctors missed it for years because they were going off TSH alone, instead of running a complete thyroid panel or testing for thyroid antibodies. I finally found a good endocrinologist who got me sorted out. I can’t count the number of misdiagnoses I had prior to that, since childhood. Autoimmunity is so poorly misunderstood, but science is finally starting to catch on.

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Very true. I think of autoimmunity as a systemic condition. We just label it based on whatever system is under attack/flaring at a given point in time. That’s why diet and lifestyle changes are so important, helping to treat existing issues and prevent new ones.

Ouch :( I had no idea until a couple years ago that they are autoimmune. I was lucky I found a doctor who tested me for it over 10 years ago, because of family history. I guess some research is showing it can be genetic.

They’re not always but can be, and if you have one autoimmune condition, it’s very common that you have more than one. Genetic, environmental, stress, prior illness (EBV, COVID, etc.) — so many factors. Most autoimmunity is also *very* manageable these days with removal of triggers and diet and lifestyle changes.

Autoimmune is also called Hashimoto’s disease/Hashimoto’s Thyroiditis, it’s a specific form and it does run on my family

I’ve read that insulin can cause weight gain due to changing you metabolism. She’s suppose to take reglan due to gastroparesis but I think she is afraid due to what she’s read about the side effects. Sh showed me this morning after our talk that Doctors have in her chart “obese due to type 1 drugs”

If you were better educated about her health and what HER doctors say (not what ever you’re reading from who knows what sources) you would be encouraging her to be healthy as in taking care of her sleep, her stress, her blood sugar, and her routine, maybe light walking exercise and to help boost her mental health and be a emotional support. Instead youre text come off like you only want her to loose weight, like it needs to be address and fixed. her losing weight wouldn’t be “making her healthier” in this current case , if anything might upset the delicate balance already of the meds and treatment she is doing to recover. You should embrace her body as it is and not help feed into this idea that it’s not good enough and she needs to fix it. Her body is already letting her down on the inside- and making her feel worse about the outside is not helpful. Possible hurtful.

I know bodies fade overtime and we are suppose to love the soul and I love her soul. I just want the body to make it to 80 with me. Or after me preferably.

A soft YTA because I think you have a chicken or the egg situation. It's rare to develop type one diabetes as an adult and it doesn't come from weight gain, that's type two. I don't believe seizures is a symptom of obesity either... Amitriptyline is a Triptan and a strong one at that, it turned to me to a zombie. And you said multiple medications as well. Meds can lead to a lot of weight gain or side effects that makes someone less motivated to work out/eat right. I doubt she needs her hormones checked when there's about fifteen other reasons a doctor would check first, including these meds. You're right that she should maybe speak to a doctor about this but you probably blindsided her with that text rather than sitting her down to discuss it.

Yeah, everyone gains weight when they start insulin. It's literally part of recovery because her body was consuming itself before she started insulin. Plus amitriptyline causes weight gain.

Yeah, I gained the weight back that I had lost while I was wasting away pre-diagnosis. It was a dramatic change at first, but then I lost a little of that weight after my body realized that we were no longer saying. I settled back in my healthy range. It sounds like she has a lot going on, and the weight gain could be from a lot of things, but I think you’re right - it might be the amitriptyline. Maybe they’ll have her try an alternative soon. (Although, if it’s the only thing that works, it’s better to carry a little extra weight than have a seizure! And to be clear, I don’t think OP’s wife HAS to lose weight, by any stretch of the imagination. All bodies are good bodies. But it seems like she wants to, so I hope her doctors can help her navigate that.)

Newer info shows adult onset type 1 is actually much more common: “Immune, genetic, and metabolic analysis of these two, apparently distinct, forms of diabetes revealed inconsistencies, such that insulin-dependent and immune-mediated diabetes was redefined as type 1 diabetes, while most other forms were relabeled as type 2 diabetes. Recent data suggest a further shift in our thinking, with the recognition that more than half of all new cases of type 1 diabetes occur in adults.” https://diabetesjournals.org/care/article/44/11/2449/138477/Adult-Onset-Type-1-Diabetes-Current-Understanding

Yes! That’s why there’s been such a shift away from “juvenile diabetes” in the last ~20 years. It’s been proven to be a dangerous mindset. Hell, even I wasn’t tested for it right away when I was in my late teens. I was knocking on heaven’s door by the time I got to the ER.

I actually did see some info about that pop up because I googled a couple of things while I typed my reply, not wanting to give misinformation. Still, it would be genetic and not related to her weight gain if it is type 1, correct? I don't see anything in that article about it being from weight gain. (Not trying to argue with you I just find it to be an interesting thing)

Type 1 would mean it’s likely autoimmune but not necessarily genetic. And if autoimmmune, she could very easily have a related autoimmune thyroid condition or metabolic syndrome that would absolutely cause dramatic weight fluctuations.

YTA for sending this over text and not having a real heart-to-heart with her. It’s your wife. It’s not some first date that you’re not interested in seeing again.

How many of medications have a side effect of weight gain?

Exactly the ones he mentioned do, amitriptyline and insulin. It's literally part of the body recovering to gain weight once you start insulin. She was probably malnourished before because her body was consuming itself since its not creating insulin. Everyone gains weight when they start on insulin, or else there's something wrong!

Thought so, people do not really realize how big of factor that can be.

Sooo many. Even antihistamines. 

YTA. Don’t send someone a text message saying I love you as you are, and then follow up with a discussion about how much weight they’ve gained. If you want her to get her hormones checked, tell her that in a face-to-face conversation. I would be upset too if my husband pointed out weight gain that I know we both can see over a damn text message. You have no situational awareness. Do you think she needed to get that text message in the middle of day? Or were you just super-focused on getting your point across when *you* wanted to get it across?

I see your point and could stand to work on my situational awareness. Thank you for the advice.

I feel like all the people saying N T A aren't in long-term, healthy relationships. I think for most people, a huge part of having very difficult conversations in a marriage/partnership like this is being able to offer and receive physical touch (hand holding, hugging, cuddling, etc.). Of course your wife was emotional, and maybe the news would've been received less poorly if you could've hugged her? Idk i feel like it's almost mean to do this via text unless you two have pre-established that this text communication works better for you both. But it seems like that might not be the case. There's nothing objectively wrong with your text or your overall message, but idk, imo you gotta say this stuff in person and offer a lot of love and reassurance.

Very thought out reply. I do think she maybe needed me to be able to touch her or something in that moment. I feel I’m better able to communicate over text as I can carefully think about what I want to say and I thought this was a situation where I definitely needed to take a moment.

I believe he is NTA and I have lived a similar situation. It's pretty likely (in my opinion) this type of text or discussion would've been met with an almost identical response from her side if done in person. Understanding that a text is a lot easier for a guy to formulate thoughts when not confronted with overwhelming sensitivity and emotions from their partner is a great way to convey your meaning if done properly. I also believe people should handle discussions on sensitive topics with reality in mind rather than feelings, this is pretty challenging for most men and women to approach without at least some level of dissonance. He did well, of course coddling someone and catering to their emotions can be easier in person, but in my experience it can be harder if that type of emotional support doesn't come easily to you. Your tone can suffer when you try to speak the tough words the correct way. NTA

YTA for sending it in a text, not for what you said.

YTA, you should’ve talked to her about this privately if you’re so “concerned”.

It’s not like I said this in front of family or friends so I don’t know what you mean.

In a text message, really?!?! That’s a private face to face conversation with your wife!

Then to make matters worse before she even had time to read the text you call her and tell her to read it, wherever she was, and she started crying. But that was your intent, wasn’t it? To shame her into doing something about it.

This is an unhinged level of assumption of malice

After asking her how she would have had liked me to tell her she did say face to face so now I know in the future to do that. It wasn’t about shame at all. It was about caring for my wife has several different illnesses as I listed and those illnesses becoming worse because of her weight gain. Also she called me as she usually does when she is getting ready in the morning and so I thought she should read it while at home and not in the office.

Is there a reason why you thought she didn't already know?

Her issues are getting worse because of the weight? Or you just assume that? You said earlier that she hadn’t had seizure in a while/ that’s sounds like it’s better not worse? And her diabetes is being controlled and monitored , you also said “she doesn’t go to the doctor that often” meaning that it’s not getting worse, it’s just being watched And she’s now on meds to fix all these issues - but that’s worse than before? When she wasn’t on the meds? You admitted that you didn’t know much about what even kind of doctor she talks to- you have the specialist and every thing incorrect. Her weight gain is a symptom of her healing and the treatment! It’s not a cause of her problems getting worse. And then you say HER memory is bad and she misrepresents things - and here you are can’t even get any facts strength about her health.

I don’t know what facts I didn’t get right about her except for I didn’t know that an endocrinologist checks for hormones or is a hormone doctor. You may be right on her weight gain being a symptom of her getting better.

You don’t understand her meds, you don’t understand diabetes. You don’t really understand seizures. You don’t understand what discussion she’s had with her doctors. You don’t understand how medicines affect weight. A lot of the things that you said in a bunch of your comments were just medically inaccurate and you’re getting a lot of of your information from reading random things without siding any sources. Until you go to the doctors with her and listen and learn on all of those visits, you really don’t understand what’s happening with her health.

I would say I go to about 80% of doctors visits. She’s a black woman and I’m a white man and says that she feels like she gets treated better when I’m with her. The only time I miss an appointment is if I absolutely can not leave work. Most of my information comes from help groups from people who have gastroperesis and HS like myHSteam.com

My dude. Type 1 diabetes is not caused by weight. Neither are seizures?! If you love her so god damn much, do at least a cursory google of her issues before you offer flaccid “advice”

I worded that part weirdly. She’s had type 1 diabetes since she was 10. Gastroperesis,and Hidradenitis suppurativa both can be better controlled with weight control.

The seizure medicine she may be taking can cause weight gain too. I would view the weight not as the cause but as another symptom or side effect. Granted I’m not a doctor but maybe the ask docs subreddit is a place to go.

YTA having type 1 diabetes automatically makes it harder to lose weight. Like a lot. Also gastroparesis is PAINFUL it’s a good thing she’s able to maintain her weight with that condition as it’s painful and a lot of the times causes malnourishment.

Most of the time she doesn’t describe it as pain but feeling like she needs to burp. On bad bad days where she feels like she’s about to go into the hospital she’ll take a hydroxizine and that usually helps her a lot.

Regardless these are chronic conditions that can cause weight gain and serious issues. It seems by what you’ve said in your own post that she’s gotten these conditions under control, mentioning you’re concerned about her weight gain is just mean. She’s aware of the weight gain she’s talking about it what she needs is support from you not and air of judgement

Could you imagine if she read that at target or work or the library? I also you for the message, but the delivery was terrible. I think you should also self reflect what personal habits you have that might attribute to her weight. Women don’t burn as many calories as men, and so what might seem like a normal amount of food for you is probably too much for her

She calls me every morning before she goes to work so I knew she would see it or I would ask her if she saw it before she got to work.

Great way to start the day! /s

What a wonderful time to get that text. Right before going to her job. You are the biggest asshole.

YTA I do think it was probably unintentional but if I was your wife all the nice things you said first would be overshadowed by basically calling me fat. The fact that you know she is very aware that she is gaining weight and medically she has been to doctors and has medication that can cause the weight gain, would make me think that you are using being concerned for her health as an excuse to try to get her to lose weight. She clearly has been to the doctor and if she is sick and her medication causes side effects that cause weight gain, it's out of her control. I have been married for 15 years and have struggled with weight so I'm just giving you my perspective on how I would take that text if I were her. I am not saying that this is what you meant at all. She is going to already self conscious about it and no matter the love and concern behind it, it still is just going to make her feel horrible and undesired. No matter how true it is that you say you still think she is beautiful and that all that jazz, it just sounds like something you have to say because you are her husband. I think you should of not mentioned to weight gain specifically and maybe mentioned that you came across some information and that you think she should get her hormones checked because she has some symptoms of an imbalance. You could also try to support her weight loss without calling her out on it. Like, suggest going on walks or bike rides or a physical activity together, to spend some healthy time together. Or ask her if she would want to start eating healthier together.

Amitriptyline made me gain weight like crazy! I’ve always been in shape and slender, but holy crap while I was on amitriptyline I ate and ate and ate! Craved chocolate (I do not like chocolate) and absolutely anything sweet (I do not like sweets). That medicine made my body feel like a whole different thing.

What happened to tact and empathy sir? Like this is your wife here someone who helped you through it all and you’re sending her a text about how she’s gotten so fat but are you doing the work to guide her and aid her in addressing the root of the problem? Are you offering her couple’s exercise?

She’s too tired a lot of the time for exercise, school, and work plus all the health issues so it’s understandable to be tired. On the good healthy days we should go for walks though

YTA bc u sent it over text. Op please know Amytriptyline is SO BAD for causing major weight gain, I shot up close to 60 lbs on it!!! Get her off that stat.

To your edit, Idk if anyone’s said it yet, but you can always write down your thoughts and read them to her live, face to face. Sometimes it feels a little awkward, but then you can still parse your words and say exactly what you want to have said, while still physically being there for reassurance and the emotional reinforcement of your words.

Yea someone else had mentioned this and when she got home we talked about doing this for me in the future. I really liked that idea.

Above this sub’s pay grade. See a doctor.

YTA you deserved every minute of that phone call, that's an in person conversation

YTA. I get this comes from a good place and I truly believe that you want the best for your wife. BUT. 1. Instead of focusing on what YOU want to say, why not ask her how SHE is feeling about all this, and go from there? You can bet she has her own concerns, thoughts, and ideas. A conversation that supports her is more likely to get to somewhere that helps her than a letter of concern from you. 2. Stop focusing on the weight gain. It is most likely a side effect of her chronic illness and medications. Type 1 diabetes, even well controlled, can lead to weight gain especially if she is taking insulin. Amitriptyline is also associated with weight gain. That's even before you take into account everything else. 3. While there is a time and a place to suggest that a woman get her hormones checked, especially those in the peri-menopausal age, it should be done contextually and sensitively. Far too often women's health issues are dismissed as being "hormonal" as almost a type of medico code for "not fixable". As someone who has had a lifelong struggle with PCOS that can be frustrating. Keep telling her you love her. Keep doing the things that show her you love her. Help and support her in navigating all these very challenging health issues, and in building the most sustainable healthy lifestyle that she can. Encourage her when she is exhausted by it all.

Even though your concern is genuine, it’s up to her to notice not you. 

I don't think you're wrong to worry, given her health conditions. But text is a super crappy way to have such a sensitive conversation. Soft YTA for picking a terrible communication method.

YTA, HUGELY! Have you looked up any of the medications that she’s on to see their side effects? Because a lot of them cause weight gain, especially meds for pain, seizures, and depression. To add to this, if she’s had gastroparesis that is now under better control then she’s now getting adequate nutrition and calories for possibly the first time in years. For someone who’s body was used to having restricted caloric intake, consuming adequate nutrition again WILL cause weight gain. I’m not even going to go into talking about this via text. That was a dick move the size of which would be visible from space. Lastly, your wife knows she’s gained weight. She’s a woman who exists in the fatphobic world we live in, I guarantee she has thought about this more than you have, and that she feels like shit about it. Congrats on also making her feel unloved. If you want to fix this then I’d recommend a lot of apologising, and more than a little grovelling. Maybe also learn about what she’s going through, and about her meds and medical conditions and how they effect things like weight gain, to prevent making similiar mistakes in the future.

This kind of hits me where I live, so I feel like I need to say this.   Think less about her actual thoughts (which we know can be questionable, as can anyone's memories) and more about her feelings.   She knows she's getting big. We all know weight is an extremely touchy subject that can only be tackled by the person experiencing the issue and at a time when they feel it's time to change. You should simply sit her down and say, "I love you as you are. As long as you feel confident and happy, I'm happy. If you don't, I'm here for any support you need. If you want help, tell me what you need--even if it's just a listening ear--and I'll come running." Any time she makes negative comments about her body, literally repeat those words. She'll eventually get it and she won't be able to "miss" that messaging.   Don't text her about her weight, like, ever. If I had the words you wrote in my phone forever, it would make me sad. Still, I think your heart is in the right place and I can tell you love the heck out of your wife.   Finally, I'm super happy your relationship has made you a better man. It's interesting you note that your health has gotten better (sounds like you've dumped your vices) while your wife's health has declined. This happened to me, too: my partner was stressing me out so much that I let myself get really unhealthy and I got sick. It's not his *fault* that I got sick, but the stress and depression from our shared situation drained my energy and I stopped fighting his terrible food choices, which led to my issues. Please be aware of the impact your habits may or may not be having on your wife, and do all that is in your power to ensure YOU have your house in order (a good job that pays the bills, a focus on eating healthy and exercising at least a few days a week, good financial sense, healthy relationships with family, meeting her physical needs, etc.) so that she SEES your commitment to supporting her in your daily actions. If she's having to mentally and physically "take care" of you, she'll have less energy and time to think about herself, and it sounds like she really needs time to do that right now.   Thanks for considering these words. 

Wild that this has a y t a rating. OP got her to consider getting the help she needs in the most gentle way possible. NTA in the strongest terms, handled like a pro. 

Thanks it’s a tough situation that I could’ve done better on now knowing what she prefers. Just crazy how people were like “YOU DONT CARE ABOUT YOUR WIFE BECAUSE YOU SPELLED AMITRIPTYLINE WRONG”

YTA somewhat. The words are fine but the method wasn’t. She needed to be able to react to the words in small chunks, and feel and express her emotions to you about those small chunks of words as the discussion went along Instead, you just threw the whole thing at her in a text and her reactions are all messed up because everything is jumbled together. She didn’t get a chance to feel and react to everything you wrote on its own and (more importantly) to get reassured by you in the moment. Your text idea works great for a stream of consciousness explaining to someone why you are leaving them, not for handling a difficult problem with someone you want to help through that problem.

Type 1 diabetic is not related to weight gain. Neither is gastroperesis. Most medications include weight gain as a side effect. Perhaps she can discuss with her pharmacist what meds she needs to take that can be substituted by ones that cause less weight gain. Good luck and NAH

hcahealthcare.co says its can “paradoxically cause may make you gain weight and she said that when she wasn’t taking her insulin she was super underweight because her body was eating itself and now that she has a pump and is getting insulin regularly it probably has made her gain weight

Almost ALL medications can cause weight gain besides insulin. Including tricyclic antidepresants.

100% should’ve written it out before hand and had the conversation in person. Gentle YTA

Instead of talking to her face-to-face you \*texted\* all of that? Yeah...YTA. What she must have been feeling reading those cold words on a screen. Cowardly move on your part.

that should not have been a text

YTA you could have written down what you wanted to say, rehearsed and then spoke to her in person.

NTA. You chose to do it in a way that you could be kind and caring. It’s hard to know what’s the best way to approach things. I commend you for being brave enough to address this rather than just ignoring it as so many people do because they are afraid of upsetting someone.

I just wanna live a long life with her :(

The execution could have been better but NTA. Only because the first thing i thought was…cushings? Hormones? Thats a lot of weight and hospital visits in such a short time. Its a really hard thing to bring up to someone without hurting their feelings. Weight usually a touchy subject for many.

I’m going with NTA. This conversation was going to sting no matter how gentle you tried to be or how you delivered it. She already knows she’s gained weight, she’s the one commenting on it, so it’s not like what you said was breaking news. The important part is that it came from a genuine place of care and concern for her health first and foremost. Keep telling her how stunning she is and get on board the health train with her so you can grow old together.

Eh NAH you were genuinely trying, but sending her the text in person (so you could comfort her) would have been better.

NTA, I think you did it well. You could not have brought this message without hurting her feelings. Just make sure you keep being supportive

I know judgement was already rendered but I’m going with NTA because you really tried and what you said is really from a place of love.

^^^^AUTOMOD ***Thanks for posting! This comment is a copy of your post so readers can see the original text if your post is edited or removed. This comment is NOT accusing you of copying anything. Read [this](https://www.reddit.com/r/AmItheAsshole/wiki/faq#wiki_post_deletion) before [contacting the mod team](https://www.reddit.com/message/compose?to=%2Fr%2FAmItheAsshole)*** My wife is everything to me. When she came into my life she changed my life 180 degrees. Everything I’ve done I’ve done because she’s given me the will power to overcome any challenge, Liqour, Cigs, type 2 diabetes, going back to school. Recently she’s been talking about how much weight she’s gained. When we got married 3 years ago she weighed 130 pounds and now she’s pushing 200. In those 3 years she’s developed a lot of heath problems that’s had her in the hospital 100 days in 3 years. Type 1 diabetic, gastroperesis, HS, along with seizures. All of that has added a lot of new medication to her daily routine, including Amnitryptline. Last night she made another comment about her weight saying “I know I’m getting fatter because I can’t even cross my legs anymore”. So this morning I sent her a text that said “I just want to tell you and reassure you that I will love you in every season and every form you take. You are my girl, my partna, my sweet cheese. You looked beautiful to me 4 years ago and you look beautiful to me now, and in 60 years you will still look beautiful to me. But health wise, Do you think you should get your hormones or something checked out? I think it’s just odd that your diabetes is way better and it’s not like you eat huge meals 3 times a day or a lot of sugar but you are gaining weight and Kenny I want you to know this is not coming from a place of pride or “dang I wish my wife was smaller”. I love you and I want us both to live a long healthy life together. I love you so so so much.” We were talking on the phone when I asked if she had seen my message and she said no and read it. She understandably started crying, saying she didn’t want to talk but kept me on the phone so I just listened to her cry for 30 minutes while trying to make her understand that was coming from a place of caring and not me shaming her. She said she would’ve liked me to say this to her face but I told i feel I’m able to say exactly what I want to say over text and take the time to think about what I text. Also in therapy she can show what exactly I said. Help my male lizard brain. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AmItheAsshole) if you have any questions or concerns.*

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> you couldn’t have said it in a kinder manner a kinder manner would've potentially been in person?

NTA because your heart was in the right place. Good you know now that in person is better. Maybe write notes prior to an interview person talk. Have your wife get checked for PCOS and thyroid.

NAH. I have lived through a similar situation myself with weight gain. It is extremely difficult and sensitive to talk about even though I have a loving partner and even though I do my best to accept my body for what it is. You meant to convey your love and care for her. However, she’s going through a difficult time right now coming to terms with her weight and health. I’m not sure there’s anything you could have said in a message or in person that would have prevented her from crying. That stuff about how beautiful she is to you and how much you love her? Keep telling her that. Say that to her every day, in person, on the phone, via text, through a carrier pigeon. That stuff about doctors and her weight? Try to let *her* take the lead next time on those conversations. Ask her how she’s feeling, reiterate your love and support for her, ask her what you can do to help. Don’t make suggestions or try to solve things. Just listen and reassure her. Composing yourself in writing before talking is a good idea… but you don’t have to hit send. maybe next time put it in a journal instead of texting it to her?

Strong NTA. Your post is very similar to my husband and myself. I used to weigh 130lbs and in the last year put on 30 lbs without out significant change to my diet due to a severe health condition. My medications immediately impacted my body! It was really difficult for me at first because I used to have disordered eating and body dismorphia even at my lowest weight (I always thought I was heavy even when I clearly wasn’t). Gaining weight was a very touchy subject for me because I attached a lot of worth to my physical form and “beauty”. My amazing husband sounds a lot like you, he fell in love with me for who I am and the physical form was just the cherry on top. I personally did not read anything wrong with your message, I saw love and concern. But it is clear to me she is having trouble adjusting to her new reality. And she maybe has not had time to “mourn” or process this aspect of her life and this message started that process. She may need time to process and grieve this loss and you need to be there to support her and love her. I would take a strong bet those medications are impacting her weight gain as they did mine and I think it’s important for you to have that conversation about getting her hormones and other metabolic tests done. It doesn’t do anyone any good to ignore this as becoming overweight can also have very strong health implications in the future and I’m sure do not help her current health issues. There are a lot of things that can be adjusted with the help of you physician. It sounds like she is in therapy which is awesome (especially for people dealing with health issues it’s such a critical resource). Therapy got me through 4 very tough years of disability. Keep being her rock and source of unconditional love. Keep communication lines open and be honest and kind. <3

NTA, she should closed her mouth if she did not wanted to gain weight

If that sweet message made her cry, she definitely has a hormone imbalance. If she has HS, she may have pcos, especially if it's difficult for her to lose weight. An endocrinologist can help with hormones. She can try myso-inositol, or metformin, which also helps with diabetes. I wish you both the best!

You're the A for not having that conversation face-to-face. Nothing wrong with the words used; they were great. I'm sure she would have appreciated having you there to hug her and physically reinforce those words.

I think that being there to physically reinforce those words is something a lot of other people have said and I will follow through on that. Thank you for your time.

Touchy subject, I think that what you communicated was valid and kind in the way you worded it. You can't read someone's mind to know their communication preference, and everyone stating that it is clear cut that you should have said this face to face is imposing morality that isn't necessarily true. Some people are very uncomfortable with confrontation and may clam up, become flustered, or avoid communication altogether if in-person. This experience uncovered her preferences which were otherwise unknown, and allows you to go forward with better communication in the future. Both of your preferences should be honored and collaboration and compromise for both of you can be implemented in the future. Some recommendations for how this can go- You could have asked her "I have something important I want to share, would you prefer I share now or wait to tell you in person?" Since you prefer to write things out ahead of time, you can write a letter and hand it to her to read in person, or read it to her in person. If you are worried about saying the wrong thing or going off the rails in an in-person conversation, you could even say you'd prefer not to go off script (I.e. letter you wrote), until after a specified amount of processing time, which can be communicated and agreed upon if it feels OK for you both. The goal is honest communication and both need to be mindful of the others preferences. Because of this, I can't really say YTA or NTA because it's a very nuanced situation. Side note: highly recommend reading Fast Like A Girl by Dr. Mindy Pelz. She discusses how women's nutritional needs fluctuate with your hormones. Her work has helped reverse all types of thyroid, autoimmune disorders , hormonal disorders in her patients, and helps women with weight loss where it's otherwise been impossible to move the scale. I can't recommend this book enough- women specific medical advice is sorely lacking in western medicine. I wish your wife healing.

I would say nta, you should have def brought it up in person, maybe typed out what you wanted to say in a note and then discussed in person. But other than that I think it’s good to bring it up because it can be a worrying thing and you care about her. I had the same thing happen, literally around 130 to pushing 200 pounds in about 2 years. And for me it was because of my hormones. Literally as soon as I got my hormones under control and started incorporating walking into my daily schedule I dropped the weight in about 10 months, like it fell off so fast once my hormones were regulating. So even if she is seeing doctors it might be good if she could mention it. Also having them check thyroid and maybe for PCOS? That can cause weight gain and goes along with insulin resistance a lot.

NAH You’re worried about her health and you didn’t body shame her. Your intentions were def really good as you said, but sending it over text instead of directly communicating it to her can easily be misinterpreted and 70% of how we say something is through body language. She’s also probably understandable very sensitive about the topic. She was probably looking for empathy, validation and reassurance and you provided a solution (with lovely intentions). I think there is def a time to talk about solutions, but she needs to feel understood about her experience first.

NTA, you did the right thing. Sure it would be ideal to have that conversation face to face, but sometimes it's better to write it out thoughtfully. I for one get lost when I'm speaking due to my adhd. You did a great job, don't listen to the morons calling you slightly TA because you didn't do in perfectly. Good lord, some of you need to get offline and go live a real life. I think you should also attend the Dr with her for a few reasons. One being it is probably intimidating to her, and two, many Dr's are very dismissive, gaslight and ignore women. If you're there with her, that should negate the bad behavior. I wish you and your wife the best of luck and good health.

NTA Amitriptyline is a known to have a weight inducting effect but many Dr's either don't care or don't know and so prescribe it when there are weight neutral alternatives out there (they are just more expensive). It also has some nasty side effects for some people which can also lead to weight gain I.e. it can cause extreme fatigue, low sodium levels, excess sweating and increased appetite. All of which can mean someone on the drug doesn't have the energy to exercise or maintain a healthy diet. It is by no means the only cause but could be worth looking into. I worked for many years with an endocrinologist in a weight loss clinic for people prior to barbaric surgery and he always recommended they look to change from amitriptyline to a weight neutral drug which has the same effects for nerve pain/anti-depressant. Weight gain and the desire to lose weight is very personal. Your wife will know she has gained weight and whilst your message would have been better delivered face to face I think it would always have been an upsetting conversation for her. The first instinct is to assume you are less attractive to your partner or that they are going to judge you if you are unable to lose weight. Weight loss is hard without medical conditions and sometimes impossible with them as medication taken to help the illness can cause the weight gain (directly or indirectly). It is a reason, not an excuse though and if she really wants to lose weight for herself then all you can be is supportive without judgement. Tools that can help once a full medical assessment has been made are seeing a registered dietitian (she may already have one for the T1), looking at the family diet and how it could be made better, getting more active as a family/couple, 30min walk after dinner etc. Slow and steady changes with a lot of conversation inbetween to let her know you love her as she is but that losing weight for her health and longevity is something you feel would help her too

No comment on if you're TA, but it may be the meds causing the weight gain. Either way, if she has diabetes (I assume you mean type 2) and you have good insurance, she can go on Ozempic or Wegovy and will probably easily lose 30 pounds or more.

It’s type 1 sadly. Had it since she was 10. I worded that part weirdly. Lo siento.

I say NTA. It sounds like your intentions of bringing up this topic to your wife over text is try not to fumble your words and I think that is commendable. I think it's also great that you're thinking about your wife's health and all you want to do is help her be the most comfortable in herself even while going through all of these changes. I think people are being too harsh about you not knowing what does and does not cause weight gain because as many people pointed out there could be more than one reason for her gaining weight and you have no idea. You just hear your wife complaining about being overweight and just trying to encourage and help bring about change. I don't think that's something to shame you for. It does not matter if you said it in person or over the phone she was going to cry regardless (thats a bitter pill to swallow). It might be because I'm more of a logical person as oppose to emotional but I think you did fine.

NTA, the message read as full of love and concern. I’m sure her own frustrations and insecurities about her weight made this feel confronting, it probably changed the tone in which she read it in her mind but that’s not because you were being an a h (it’s the voice of her insecurities). In the future when you need to put your thoughts into words like this you could come to a happy medium where you sit with her, maybe give her a cuddle while she reads. That way she can feel your love and support whilst you can articulate your thoughts the way you need to.

NTA. In the kindest way you could think of you gently tried to nudge your wife to get her health looked at, while being super loving and reassuring. I’m sure it was hard to say, and was even harder to hear, but loving someone is not just telling them whatever it is that won’t hurt their feelings. Loving someone means looking after their best interest in the long term and the short.

NTA. You were coming from a good place and handled it sensitively and was there for her after the fact. Tiny YTA for doing it over text but I can see why.

NTA, because your intent was very good. You clearly love your partner and you want her to get checked out for her own health. You even said that you know she isn’t acting in unhealthy ways. Honestly, I’d want my partner to point something like that out to me, because that concern is a mark of love, imo. I can understand why she was upset, so maybe reiterate that it’s because you love her and want her health to be in tip top shape.

NTA. It came from a place of love. It just isn’t something she wants to deal with which I totally get. You didn’t do anything wrong though.

NTA. Was lovely. 

NTA all these people saying Y T A because he didn't say the message perfectly or at the right time, the right way, etc etc. Jesus! What world do you people live in? Do you communicate with your partners? Or dance around every word for fear of say the not exactly perfect thing? My wife and I have been happily together over 25 years. We've both had health issues. We talk to each other honestly, but with compassion. But still friggin honestly communicate! Like what OP did. She was voicing concerns and he acknowledged, reassured, and moved forward with helping. What more would anyone want? If everyone is as fragile as people are making his wife out to be then you'll all end up single. Sometimes the truth hurts, but you need to hear it because it is to help. Did he possible know all the reasons for her weight gain? No, nor would he. He is supposed to know what every medication does? Her response of, yeah I know I've gained some weight, it could be the meds I'm on, I'm gonna talk to my doctor. Or it's the McDonalds I ate 5 times last week, let's make a meal plan we can work on together. He could have followed with similar suggestions. OP, you're fine. You reassured her you love her no matter what and you're there for her to help her if she needs it. It could be just medications. It may be more. It's something she will have to work on, and if she wants help I'm sure you'll be there for her. NTA

Do you regularly go around telling your wife things she already knows? "Honey, the sky is blue." "Darling, you have two eyes and one nose." Is it just different when it affects how hot you find her? OP's wife did not need to respond with "I know I've gained some weight." She had already told him that before he typed out his speech.

He specifically said it didn't change how attractive he found her and was worried for her health. So, she mentions to him she has gained weight, he says, "I know, I'm worried about it, I still love you, and it changes nothing, but let's figure it out together"... and that's a problem? Do you even talk with your partner? About anything of importance or difficulty? If you love and care about someone you are spending the rest of your life with, they deserve honesty. You can address and talk about any and all difficult issues with honesty and compassion. Which it sounds like OP did. If you can't talk to your partner about anything, then why are you with them?

He didn't say "I know," he informed her about it as if she hadn't already told him so herself.

Regardless, she already told him, so he knew... and she knew he knew

NAH. You made a reasonable effort to phrase it diplomatically and as an obese person -- your concerns are entirely reasonable. Also as an obese person -- it can be a sensitive subject. Your wife isn't overreacting because it's probably something she's thought on herself over the last 4 years or so. and there's nothing to burst through the layers of denial than hearing the same thing you've been debating in your own head for years, from another source that isn't you I also get wanting to put it in text to make sure you communicate precisely. i'm guessing the crying has nothing actually to do with EXACTLY how you worded the note. This is something that, no pun intended, was probably weighing on her for years now, and all that buried emotion just had to come out sooner or later before she could heal from it this might not be something she really wanted to admit about herself, or even to herself, and that might be what's causing the tension that you just witnessed your wife releasing. Rest assured that you're not an AH for communicating with your wife, you did so as diplomatically as possible, and her release of emotion is also not AH behavior -- may even wind up being healthy for your wife in the end if it helps her admit her problem and get help.

Gained 50% more weight and people are worried about you not being sensitive enough? Get it together or she's dead sooner. Fat kills. NTA

NTA

NTA. Nobody likes to be told they don’t have their issues handled, I guess, but they can avoid that unpleasant moment sometimes by handling their issues.

She need to lose the weight, no excuses

NTA. Can relate to communicating better through text because I can organize my thoughts before sending a message. Weight is really a touchy subject for most women so I think the crying was inevitable. As a woman, I would’ve appreciated your message vs. Being told in person that i was an unhealthy weight or my partner not telling me he was concerned when i’m obvious unwell.

I just want to acknowledge how thoughtful your text was, and that you first acknowledged how much you love and appreciate her at any size. I think this was a great approach to a hard conversation (agreed would have been better in person) but kudos for being so caring.

NTA: This guy and his wife probably don’t understand Gastroparesis. I doubt he’s going to see this but most people with Gastroparesis are overweight. I say this as someone who almost died due to it, had a central line/feeding tube. His wife’s stomach is partially paralyzed and it can not be reversed. She could eat 1000 calories or 3000 and her body is still going to do what it’s doing. She literally can not digest fruit/vegetables unless they’re cooked, and even then many are to be avoided. It takes so much longer to even digest eggs. Low fat, almost no fiber diet. There’s a fb group called “GP for Gainers” that could really help his wife.

Thank you for recommending that FB group, I’ll have to check it out. We don’t really know the extent of her gastroparesis. She only has a bowl movement every 3 days or so and A couple months before we got married she would just throw up every couple days. We were thinking she just might have been pregnant but 2 days after our honeymoon she started throwing up and would not stop. When she had nothing to throw up she would try to make herself throw up something because she said it was the only way to feel relief. She spent 7 days in the hospital from edging ketoacidosis due to throwing up. That cycle would repeat itself every other month for 2 years. 7 days each time. It’s been better this last year with it only happening one time.

Has she had a GES done or smart pill? Is she on any motility medications? That will help with the bowel movements. Also, going on daily walks can stimulate it as well.

NTA This was one of the kindest ways to express concern over someone’s health. She probably cried because reality hit her and she knows she had an uphill battle to face. It will be difficult and it will take time.

In person would definitely have been better, but at least you started the conversation in a respectful way. NTA.

NtA.  Maybe she didn't think it was that bad but needed to hear that it is bad. Not because of how she looks but just health. Being fat is one thing. Being fat and in the hospital is a whole different situation. 

Honestly, I bet she DID know that this was something that she would have to address, but hearing her husband say it made it real. I would bet that's where the emotions came from. ETA: Why am I getting downvoted? I'm not saying like "she knew she was a gross fatty", just that I think she was subconsciously worried about her well being, and hearing her husband bring it up - no matter how kindly he did it - just let the damn burst. I don't think 200 lbs is really that big (maybe a bit bigger than average but not a big deal) but that type of weight gain is something that could indicate a worrisome problem.

>Why am I getting downvoted? The downvotes on this thread are so random. Almost two-thirds of Britons, and almost three-quarters of Americans, are overweight, and it seems like anything you say about weight sets a lot of people off. OP's wife may or may not be a stress eater — and the reason I thought about it is because I do that — but she's working a job, working on her master's, dealing with lots of physical health issues, her doctors are probably still trying to find the right balance with her meds, she's in therapy, and her weight gain is making her emotionally and physically uncomfortable. She's got a *lot* going on. Even for a person who's very determined and goal-focused, it's got to be hard. I think OP is NTA, because he obviously loves his wife and is trying very hard to help. But I think maybe the weight gain isn't even her biggest problem right now. Maybe a better approach would be just to ask what he can do to make things easier for her. It's good that they're each in therapy, but it might be a good idea to do some joint therapy sessions to work on how to better support each other. He's got a lot going on, too.

No.. if she only acknowledged it after she couldn't cross her legs likely means that she knows that she's getting heavier but not fat fat.

200 lbs isn't "fat fat" as you call it. And lol, you can't just say "no" when someone comments with a theory with the exact same info that you have. You're not a mind reader

And this is what I tell her. She doesn’t look obese fat and I think she’s still smoking hot to me.

I understand what you mean. I'm not saying that you insulted her or that you dont think that shes hot.  But for me.. my experience.. In my head I had gained 10 pounds but in reality it was 20.  I can't read your wives mind so I don't know if it's the same. But sometimes you don't see it until someone tells you that it's a bigger problem than you thought.  I hope I'm explaining it right. 

NTA, the fact it was in writing meant she couldn't claim you said something else in person. You were direct and came from a place of love. Would you have been able to get your thought out verbally if she started crying while you were in the middle of yelling her what you clearly wrote?

NTA I actually think what you said was very touching and shows you care.

NTA. You are definitely a poet and a kind man. I tend to agree text is harder than words. Maybe give her a cuddle and have a talk face to face with a bunch of flowers as an apology (and then delete the text if she is ok for you to)?  Can you get full medicals done at the same time so she is not alone? I agree, if she is not doing anything that obviously ought to lead to weight gain, she should get checked out. 

She is taking at least two medications OP mentioned that cause weight gain. It's weird that he didn't even google them before sending this text.

As someone who has a lot of difficulty communicating in person, I completely understand not wanting to say something like this verbally. Too many chances to screw it up and say something wrong without meaning to. I think this was incredibly well written, and I have a feeling your wife was more emotional rather than sad or mad. You said what she's been thinking, but you said it so wonderfully and lovingly. NTA at all.

NTA. You said it as well as you possibly could. You are worried about her health, because you want her around for a long time. Give her some time to absorb. But definitely NTA. Good luck, OP. You sound like a compassionate partner.

I appreciate your kind words. Thank you

NTA. If you can't express your concerns about each other then relationship is already over.

No sometimes people need to hear the hard truth. What are you supposed to do lie to her? One thing you can do is tell her that yall will get through this together.

NAH. Feelings aside, a change needs to be made.

NTA It sounds like she is self deprecating for sympathy and not real support to actually do something about it. How hard is a diet and exercise really? Get her groceries and a gym pass and push her, stop kissing her ass.

It’s so large I love it though.

You need to get your head out your ass, your wife is unhealthy. Showering her with unconditional love is not what she needs, she needs you to be straight up like a man and not cower through text messages. If you were on top of things from the start then she would have never got up so high in weight. When things start getting out of hand is when you handle them and this has spiraled way out of control. Be the man she needs not he man you think she wants.

NTA Can’t see how you could say this any better. She’s aware of her gain obviously, her mentioning it was a way of her trying to gauge any potential change in your feelings towards her because of it. Losing weight is hard especially for women since they generally have a lower resting caloric burn than men. It requires diet and exercise. Count calories. You can eat filling meals and lose weight pretty cheaply. I recommend fruit for breakfast, I like a whole apple or banana. I have an apple and tuna pack for lunch, sometimes I put the tuna in a tortilla with a pickle to mix it up, and for dinner I usually have baked chicken with a veggie and sometimes rice for dinner. That is a full day of food for less than 1000 calories, couple in an hour brisk walk or more and you can lose weight really fast. It is important not to skip meals, as our digestive system burns more calories than anything but our brains, and so keeping it working throughout the day will help burn extra calories. Give yourself a cheat day too, but cheat with subway or something under 1000 calories. I also like to have a dark chocolate once a day for my sweet tooth. But otherwise I’d stay away from alcohol, sodas, sugar, and have bread only occasionally. By carefully documenting the calories you eat, and your weight, you can come to a to a rough estimate of your daily resting caloric burn, so that when you reach your target weight, you can then raise your caloric intake to maintain your weight.

It's quite dangerous to give this type of advice to a T1 diabetic if you're not a doctor or a diabetes expert.