A mixed-methods’ approach was designed to explore the marital impacts following weight-loss surgery (WLS). In Phase 1, ten individual interviews with spouses of five couples were conducted; two of the couples had the wives preparing for WLS, two of the couples consisted of wives who had WLS, and one couple had both received the surgery. Interviews were transcribed and analyzed using a combination of interpretive phenomenological and grounded theory techniques. Findings demonstrated that WLS does have impacts on marriage regardless of where couples are in their journey. All couples discussed food as a possible source of conflict in their relationship. Interviews also revealed that self-esteem is a major factor contributing to their relationship and support is necessary throughout. In Phase 2 an online survey was developed to quantitatively explore the important constructs deemed important from the participants in Phase 1. Relationships between relationship satisfaction, sexual conflict, self-esteem, depression and body image were examined in 54 participants. Results demonstrate that higher levels of support and self-esteem and lower sexual conflict relate to a more satisfactory relationship in individuals post- WLS.