Dawn once weighed more than 300 pounds. Through gastric bypass surgery, she was able to lose the weight. And then she met Paul, the man she hopes to marry. He agrees that "sparks flew " until he saw her in a bathing suit. Two years later, he admits that he loves Dawn, but he's not in love with her.
Paul says that he knows that his vantage point is offensive to Dawn, but she understands, because other men have told her that they , too, find the excessive skin left over from her extreme weight loss unsightly.
"I'm frustrated," Dawn says. "It sucks, plain and simple. He's my best friend, and I've never connected to anyone more than him. He's not the only person who's told me this. I was just hoping that when we had such a good connection, we could work through the physical."
[AD]"What you could say is, 'You're worth shooting the dice for 15 or 20 grand,'" Dr. Phil tells Paul.
Dawn explains that the two of them have worked out a plan where he will front her the money to have the surgery, but he always backs down in fear. "He's afraid," she says. "The reward is not worth the risk."
Paul says that although the plan is for him to be reimbursed, he's shy about rushing into loaning anybody thousands of dollars.
Dawn says that Paul keeps his ex-girlfriends in his life because he's afraid to let go of other possibilities. "I wish Paul would grow up!" she says.
"I'm still at the point where I want to be with attractive women," Paul says, in defense. "And, I find Dawn physically unattractive."
"Let me ask you something: If someone could wave a magic wand, and this was all gone from her, would you be pursuing her [for marriage]?" Dr. Phil asks Paul.
Paul is hesitant to agree to marriage, but he says if that were the case, the two would definitely be involved in a romantic relationship. "There are a lot of things that I love about Dawn," Paul says. "I know looks aren't everything, but without that physical attraction, how can you get the romance going?"
Dawn understands Paul's position. "I hate looking at it too!" she says. "How can I expect somebody to be physically attracted to me when I can't stand looking at myself in the mirror?"
Dr. Phil tells Dawn that her wish to improve her body image is a valid and healthy one; it's the situation with Paul that's troubling. "What I can't understand is why it's OK with you to be with somebody who tells you, in every way he knows how, 'You are not good enough. Furthermore, you're not worth the gamble to get good enough,'" he says. "That says two things to me: One, it tells me that your self-esteem is really compromised, if you're willing to take that from somebody." Directing his focus at Paul, he says, "It tells me that you're not in love with this woman. If you were in love with her, you would be part of the solution, not a part of the problem."
[AD]Dawn agrees that her self-esteem is compromised as a result of Paul and the multiple men in her past who have all had a problem with the way that she looks. This time, she says it's different. "Why lose my best friend, when no matter whom I date, they will have the same problem?" she adds.
"There are right reasons and wrong reasons to have plastic surgery," Dr. Phil tells her. "This is a right reason. You have had a major body reconfiguration. It has left you with excess tissue that you don't need, and you don't want. But, here's your problem: When a woman gets something like this done, [their partner] says, 'Now that you've lost the weight, now that you've had the surgery, now that you've made these changes, now I lust after you.' At that point, your body image will have been improved, your self-image will probably have been improved, then you're at a real risk of looking at him and saying, 'I wasn't good enough for you before, you aren't good enough for me now.'"
Dawn says she's thought about that a lot, but adds that if she didn't have the connection and the history with Paul, it would be much easier to leave. She maintains that she wants the surgery for herself and no one else. "I want to be sexy for whomever I'm with," she says. "I want to look sexy for me."
"Best friends don't hurt best friends," Dr. Phil says.
Dawn claims that she would agree if she didn't feel the same way about her body as Paul.
Paul says he's showing respect for Dawn by not having sex with her before marriage, a statement that doesn't ring true for Dr. Phil.
"So, you're married to these other girls that you're having sex with?" Dr. Phil asks him.
"I'm not saying that I'm sleeping with these other girls," Paul answers. "I might have romantic dates with these other girls, but who says that I'm actually sleeping with [them]?"
"Are you?" Dr. Phil asks.
"I'm not!" he says.
[AD]Confused, Dr. Phil tries to clarify the fact that Paul is having romantic dates with other women that he's unwilling to have with Dawn. "What are you doing with them that you are unwilling to do with her?"
"I'm not saying that I've never had sex before," Paul says. "But, with Dawn, I want to do it right. And with the excess skin, it's hard for me to get romantic."
Paul says he's unwilling to take the gamble on Dawn at this point. "We're not married. We don't live together."
"But see, that's just it," Dawn says. "We're not married, and we don't live together, so he won't take the gamble. But then we can't get married or live together until we get it fixed; it's a catch 22. What do I do?"
"I'm in a dilemma about this," Dr. Phil tells the couple. "I can help you get this done, and I want to do that, but I feel like by doing that, I'm feeding into the toxic nature of this relationship."
Dawn expresses confusion to Dr. Phil. "Why is it toxic that he's being honest with me?"
"If he loved you, he would love you through it," Dr. Phil says. "He would say, 'I love you, and you are good enough for me. We can work together to do this for both of us.' But, that's not what he's saying."
Dawn says that a man has to be attracted to his partner, or he will be looking at other women.
Dr. Phil again expresses that he's torn with his decision whether to provide surgery for Dawn. "I feel that this falls below the standard," he tells her. "If he really loved you, this wouldn't matter. This would be one thing that went on the to-do list. I think you're doing this to please him."
"Absolutely not!" Dawn pleads. "I want to get this done for me." She says she's embarrassed in a swimsuit and while shopping at the mall. She adds that all of her clothes pinch her, and she gets uncomfortable rashes. "I feel like a candle that's been sitting too close to the fire, and it's just melting. I'm disfigured, and it's disgusting. It's an ugly reminder of being 300 pounds.
"I don't want to be alone for the rest of my life, but I know men are not going to accept me," she says. "When I weighed 300 pounds, I felt like a big blob. I worked hard to lose 150 pounds!" she says, tearfully.
[AD]Dr. Phil debates whether to help Dawn by asking himself aloud: "The question is, is it reasonable and healthy to help Dawn get a body makeover, or is that just playing into an unhealthy relationship dynamic that will hurt her in the future?"
Dr. Phil ultimately decides to help Dawn get the surgery that she wants, by providing her with a doctor in her hometown. She breaks down in tears with relief.
"I have concerns," Dr. Phil continues. "I don't think this is a good dynamic here," he says of her relationship with Paul. "I don't think there is a great future. But, I simply don't think that I should penalize [Dawn] because of [Paul]. I'm doing this in spite of your relationship."