Carlos Romero's apartment is marked with remnants from his former life: a giant television from his days playing World of Warcraft and a pair of jeans the width of an easy chair. Remnants of that time — when he weighed 437 pounds — mark his body too: loose, hanging skin and stretch marks.

"I lift weights and work out and work hard, but there's lasting damage," says Romero.

Yet for all the troubles he had dating when he was obese — all those unanswered requests on dating websites — shedding weight left him uneasy about how much to reveal. "If you were to say to someone on the first date, 'I lost 220 pounds,' you're indicating that you had a very serious issue at one point and that you may still have that issue," he says. "So it's not something I put on a dating profile because I don't want people to judge me for it."

A photograph of Carlos Romero with his sisters in high school sits on the counter in Romero's apartment in Seattle.

A photograph of Carlos Romero with his sisters in high school sits on the counter in Romero's apartment in Seattle.

Mike Kane for NPR

The stigma of obesity is so strong that it can remain even after the weight is lost. Holly Fee, a sociologist at Bowling Green State University, has conducted some of the only research on dating attitudes toward the formerly obese. In 2012, Fee published her findings in the journal Sociological Inquiry.

She found that potential suitors said they would hesitate to form a romantic relationship with someone who used to be heavy. The biggest fear, Fee says, is "they believed these formerly obese individuals would regain their weight."

The prevailing belief is that people who have never been obese can control their weight, and those who've been heavy have less willpower, says David Sarwer, a psychology professor and the director of clinical services at the Center for Weight and Eating Disorders at University of Pennsylvania's Perelman School of Medicine. Physicians and the general public tend to think that obesity is "a moral failing, and that they can't push away from the table, " Sarwer says.

For men and women who have lost a significant amount of weight, excess, hanging skin can hold them back from dating and being intimate. Health insurance almost never pays for costly plastic surgery to correct the problem, which can be uncomfortable and embarrassing.

"I think they can be particularly self-conscious about this issue and be worried about the first time the partner sees them undressed," Sarwer says. "How are they going to respond? Are they going to be grossed out?"

It wasn't sex or romance that sparked the big change in Carlos Romero two years ago. That's when, at age 28, he was diagnosed with muscular dystrophy. Romero knew if he didn't lose weight, his condition could worsen quickly. He stopped eating pizza and ramen noodles and drinking soda and began exercising. Then, a year ago, after he had dropped a number of jeans sizes, he tried Internet dating again. Romero updated his old profiles and pictures and started sending out messages.

"It was amazing at the time," he says. He got responses from girls he never thought he would hear back from. "I was like, 'Holy crap! This is so different.' It felt like a whole other world had opened up."

Now, Romero spends many nights on dates with his new girlfriend, Kate Rowe. They met on OkCupid.com after he sent her a message. He looked "smoldering and broody" in his profile picture, Rowe says, "and I was like, 'Why not?' "

Their third date was on Romero's 30th birthday, and he decided to tell Rowe about his weight loss, which he thought could be "a potential deal-breaker."

"I don't want to like this girl any more than I already do without having her know," he remembers thinking. "I said, 'I have to tell you this thing. Please don't judge me.' "

Romero knew the risk he was taking. He thought, "What if she doesn't want to be anywhere near me?" Instead of being repulsed, though, Rowe says she was inspired by his hard work and commitment to good health.

If she had seen Romero's old profile back when he was bigger, she probably would not have responded, she says. But now he is into rock climbing and being active, and they have things in common.

For Carlos, there are still physical and psychological hurdles to being in love. It's difficult for him to be intimate. He says shyly, "She's seen everything." And when he looks in the mirror, he still sees a 400-pound man. His mind hasn't quite caught up to his body.

This story is drawn from reporter Sarah Varney's new book "XL Love: How the Obesity Crisis Is Complicating America's Love Life."

Copyright 2015 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

Transcript

RACHEL MARTIN, HOST:

And for people who struggle with their weight, dating can be daunting. When researchers analyzed tens of thousands of online daters, they found a strong preference for what they call healthy weight partners. As Sarah Varney reports, even men and women who've lost weight run into resistance.

SARAH VARNEY, BYLINE: Carlos Romero's apartment in Seattle is marked with remnants from his former life - a giant television from his days playing "World Of Warcraft," a pair of jeans the width of an easy chair. The remnants of that time when he weighed 437 pounds mark his body, too.

CARLOS ROMERO: I lift weights, and I work out. And I work out very hard, but there's just lasting damage.

VARNEY: Like loose, hanging skin and stretch marks. But for all the troubles Carlos had dating when he was obese, all those unanswered requests on dating websites, shedding weight left him uneasy about how much to reveal.

ROMERO: If you were to say to someone on a first date that I lost 220 pounds, you're indicating that you had a very serious issue at one point and that you may still have that issue. So it's not something that I put on a dating profile because I don't want people to judge me for it.

VARNEY: The stigma of obesity is so strong, in fact, that it can remain even after the weight is lost. Holly Fee is a sociologist at Bowling Green State University, and she's conducted some of the only research on dating attitudes toward the formerly obese. She's found that potential suitors say they would hesitate to form a romantic relationship with someone who used to be heavy.

HOLLY FEE: A big driving factor in why they have this hesitation of forming this romantic relationship was that they believed that these formerly obese individuals would regain their weight.

VARNEY: Fee says the prevailing belief is that people who've never been obese can control their weight and those who've been heavy have less willpower. David Sarwer is a psychology professor at the University of Pennsylvania and the director of clinical services at Penn's Center for Weight and Eating Disorders.

DAVID SARWER: The general public still thinks that this is an issue of willpower, still thinks that people who are struggling to control their weight are really - it's a moral failing. They can't push away from the table. It's an issue of self-esteem or depression. And I think it's important that we realize it was only in 2013 where the American Medical Association finally came out and said, yeah, obesity is a disease.

VARNEY: For men and women who've lost a significant amount of weight, fears about excess, hanging skin can hold them back from dating and being intimate. Health insurance almost never pays for costly plastic surgery to correct the problem, which can be uncomfortable and embarrassing for the formerly obese.

SARWER: I think they can be particularly self-conscious about this issue and be worried about the first time that the new partner sees them undressed. How are they going to respond? Are they going to be grossed out? Are they not going to want to have sexual intimacy with them a second time?

VARNEY: But it wasn't sex or romance that sparked the big change in Carlos two years ago. That's when, at age 28, he was diagnosed with muscular dystrophy. Carlos knew if he didn't lose weight, his condition could worsen quickly. He stopped eating pizza, Ramen noodles and Dr. Pepper and begin exercising. Then a year ago, after he dropped a number of jean sizes, he tried Internet dating again. Carlos updated his profile and started sending out messages.

ROMERO: It was amazing at the time. Like, girls that I was, like, never going hear back from this girl, like, and then I would hear back from them and then be like holy crap. Like, this is so different. Like, it felt like a whole other world had opened up.

KATE ROWE: Cheers, baby.

ROMERO: I love you.

ROWE: I love you, too.

VARNEY: On a recent night, Carlos and his new girlfriend, Kate Rowe, were out for margaritas and tacos in downtown Seattle.

ROMERO: Do you know what you're getting?

ROWE: Carnisata tacos, like last night.

VARNEY: They met on OkCupid after he messaged her.

ROWE: I just, like, saw, like, you know, Carlos sent you a message. And I was like, oh, and he's into climbing and, you know, he wants to take me out for a date. And I read his profile, and then I was like, why not? I have nothing to lose.

VARNEY: Kate says Carlos looked hot in his picture - smoldering and broody. He waited until their third date to tell her about his massive weight loss.

ROMERO: I don't want to like this girl any more than I already do without having her, like, know that this might be a potential deal breaker. So that's when I told her, and I remember just being like, I have to tell you this thing. Please don't judge me. But, yeah, I used to have a very serious weight problem, and I've lost, like, 200 pounds.

VARNEY: Carlos knew the risk he was taking. What if she doesn't want to be anywhere near me, he thought. But that's not what happened.

ROMERO: She took it really well and was kind of inspired by it.

VARNEY: For Carlos, there are still physical and psychological hurtles to being in love. It's difficult for him to be intimate, he says shyly. She's seen everything. And when he looks in the mirror, he still sees a 400-pound man. His mind hasn't quite caught up to his body. For NPR News, I'm Sarah Varney.

MARTIN: Sarah Varney comes to us through a partnership with Kaiser Health News, a non-profit news service.

MARTIN: This is MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.

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