This seems like such a happy ending. Appearance and weight gain can be so tricky - many people stare in the mirror wondering if people can see their imperfections. Others are busy running after kids and careers and don't notice. Still more relax on the couch after a long day and don't notice the 2 extra pounds every months until 5 years means it's 50 extra pounds.

I accidentally gained weight myself, from 135 to 175, while going to school and working full time. By husband gained even more. Then he had a heart problem. We worked out together, lost much of the weight together. I'm down to my high school 130. Ultimately we parted ways, but that wake-up call makes me more GGG for my current guy, the man of my dreams.

We all need a wake-up call, about every 5 years. We can't get complacent. We have to reinvent ourselves throughout our lifetimes.

Dan, your sizeist advice to HARD is appalling. It's the partner's responsibility to be attractive to the other? Really?

Is that true if it was reversed. What if HARD fell for her when she weighed 400 pounds, and has since dropped to 140, and no longer finds her attractive. Would you still tell HARD that he has "a right to expect that your partner will maintain some base level of attractiveness"?

What if his wife was black, and her skin has darkened with age, and now he no longer finds her attractive. Is it still her responsibility to lighten her skin or it's disrespectful to her partner?

Now, you're probably thinking "This is totally different. Being fat is unhealthy, so if she lost weight she should stay that way. But if she gained it, she should lose it."
Well, that's untrue.
Being fat is actually more healthy: (This will download a PDF) http://www.nejm.org/doi/pdf/10.1056/NEJM…
And the idea that being fat kills you has been disproven: http://jama.ama-assn.org/content/293/15/…

You might also be thinking "Way to pull the race card, but unlike race and skin color you can change how much you weigh. Being fat is just a sign of being lazy or overeating."
But that's wrong too:
http://journals.lww.com/smajournalonline…
There is no proof that diet can result in long term weight change, and any changes over about 5 bls go away after 6 months to 2 years (and you'll note they've been married for 10, so unless she gained this weight in the last 6 months when this was written, it's not because of diet or excercise):
http://www.ncbi.nlm.nih.gov/pubmed/17054…

Ultimately, the human body packs on more weight as we go through middle age, and then loses it as it breaks down and heads towards the grave. There's nothing we can do about it.

You should not be advising people to change.

The advice should have been for HARD and his wife to go see therapists. HARD should see one to explore his emotional and intimacy issues. And it seems possible that his wife has an eating disorder given that she's eating food that's wrecking her skin and giving her digestive issues, especially given that a) she's a woman in America and b) she's living with a man who hates the way she looks and she clearly knows it, but even if not, going to a therapist would help her deal with her feelings about her superficial husband and anything else going on. And finally, they should see one together, because they've clearly got a lot to work out between the two.

Even with your fatphobic advice, not suggesting a therapist in your advice to investigate her potential for having an eating disorder is shocking. I mean, if you're going to attack the marginalized woman, at least send her to someone qualified instead of just having the husband, the man she's suppose to trust the most of unconditional support and love, tear her down.

Super late to the game here, but hey, hair growth, lethargy, weight gain, all of these things sound a lot like PCOS- which can increase testosterone in a woman and make her grow hair in weird places and make her get apple fat. I know, I had it too.

Exercise and eating low-glycemic index foods has helped lower my testosterone levels, and so has some medications, but I'll probably always be a larger lady, albeit a pretty damn fit one since I exercise every day and watch my diet. The problem here is when your endocrine system decides to kick your ass, there's very little you can do about some of the appearance factors. You can mitigate the symptoms, but you'll never go back to how you were before until the doctors figure out what the hell PCOS is beyond just the group of symptoms that show up to give you the diagnosis.

I'm luckier than a friend of mine, though. She has such bad PCOS that she has a freaking BEARD.

As far as the husband is concerned, if he really isn't sexually attracted to her, he should tell her. I know I'd want my husband to tell me, so I could divorce his ass and go find someone who actually likes my body sexually. Seriously. I would much rather get it out in the open immediately (even though it would suck and hurt), than to find out later that he had infected me with HIV because he was sleeping around with skinny heroin addicts or something. Hell, I'd be pretty happy with just staying in a marriage and finding an exclusive sex partner out there somewhere and then not being sexual with one another. I need my sex at least once a day if possible. I would very much rather find someone with a similar sex drive who I can fluid bond with.

We're not so weak that we can't handle a simple "I would like you to lose weight", and men have to be able to accept being told the same. Not letting yourself go is an important responsibility for both partners, and also includes maintaining proper hygiene, wearing appropriate clothing and keeping up with whatever was your approach to body hair.