Why would an otherwise loving spouse refuse to assist his morbidly obese wife in getting healthy? TLC's "My 600-lb Life" explores this conundrum. Bedridden, 605-lb Tracey Matthews has life-threatening cellulitis and lymphedema. Her husband, who is so willing to enable her obesity, refuses to support bariatric surgery. Why does Anthony balk at helping with weight-loss -- the one thing that could save her life? It could be the baffling, cunning relationship between addiction and codependency.

Obesity enabler bails at the worst time

Tracey Matthews of "My 600-lb Life" felt supported when she was helpless.

But now that she is getting help, her husband is unsupportive. Anthony says she needs to do this alone and quit relying on other people. If Matthews was further along in her treatment, that advice would make sense. Former TLC star of "Here Comes Honey Boo Boo" (Mama June Shannon) had gastric bypass surgery a few years ago. Her new reality television show "From Not to Hot" chronicles her weight-loss. In order to get plastic surgery, she must lose more weight. She's ready for that but Matthews is nowhere near ready for independence yet.

Obese woman's husband shows codependency

The problem on "My 600-lb Life" seems to be that Matthews is a food addict and her husband is codependent on her addiction.

He might simply be tired of caring for her, period. That burnout is common in spouses and very few relationships can sustain the pressure morbid obesity brings. Those that do are usually based on unhealthy codependence. Reality television Dr. Younan Nowzaradan sees this all the time. Partners need their loved ones to be overweight and incapacitated to feel a sense of purpose.

TLC patients lose weight and relationships

A heart-breaking but common outcome on the TLC show "My 600-lb Life" is that with the obesity goes the relationship. Enablers and codependent caregivers feel unneeded when their partners get healthy. It's very like alcoholism and the 12-step program Alcoholics Anonymous (and Alanon) express this dilemma.

In addiction, the partner knew and understood the roles. As the addict moves to recovery, the codependent must either get healthy or get out. Tracey Matthews' husband is correct that if she wants to lose weight, she will have to work her program, but she will also need help initially if she's going to heal killer obesity, cellulitis and lymphedema.