Q: My wife is fat. I've been married 21 years, and if I showed you our wedding pictures, you wouldn't know it's the same woman. I'm not talking a few pounds. It's got to be more like 50. I'm just not attracted to her anymore. She knows it, and I know it hurts her. She says she's the same person on the inside, and wishes I could just see past it. Can a guy learn to see past it? -- N.A., Las Vegas

A: I'll answer this, good man, but you should know I'm gonna get grouchy mail.

On the one hand, the cosmetic expectations of our culture -- particularly, but not exclusively, for women -- are unrealistic, cruel and, frankly, shallow. Do you remember the myth of Pygmalian? In our culture, we carve a fixed and narrow image of "desirable woman," and worship it, leaving the vast majority of women straining, obsessing, starving themselves, even mutilating themselves hoping to inch closer to the image they will never attain. The net result is that we teach women to despise themselves as a way of life.

When it comes to psychosexual development, sometimes I think Hugh Hefner practically raised me. Him and Victoria's Secret catalogs. Sports Illustrated swimsuit issues. From as early as I can remember, this world hammered into my brainstem the prototype for "desirable woman." This, this, this, this -- flashing like a neon sign in front of a diner. It was less an education, and more like a trained behavioral response, like teaching a rat to press the lever for cocaine in a college psych experiment.

And Hefner's vision mutates! His first centerfold, Marilyn Monroe, circa 1954, would never today be invited for a test shoot, let alone be chosen as a Playmate. By today's measure, Marilyn would be overweight. A little chunky. The women who hang with Hef today all come from the same cookie cutter. Short. Petite. Maybe 105 pounds. Collagen lips. Inflatable breasts. Straight, platinum blond hair.

There's more diversity in the hamster cage at Petco.

On the other hand ...

Obesity in America is a flat-out health crisis. Pandemic. America is fat. We eat compulsively and badly. Our collective relationship with food is every bit the acculturated immaturity as is our ideas about who is sexually desirable.

You might convince me that my standards for aesthetic preference -- what people look like -- are cultural whimsy. But you will never similarly convince me regarding the deeper issues of fitness and vitality. Vitality is attractive. Sexy. It is Life Force.

Obesity must ultimately cost us some measure of vitality. Fat embalms us. And that is a fair subject for objective, critical inquiry.

And lastly, significant weight gain is virtually never a benign coincidence. It means something. Sometimes, in some cultures, it means prosperity and happiness.

But more often, when people struggling with chronic weight issues seek therapy, they find those issues connected to issues such as self-respect, depression, sexuality. Sometimes weight gain is self-loathing. Others use it as an armor against intimacy. Still others use it as a way to manage childhood issues or to tell their spouse to go to hell.

If the essential message from one spouse to another is, "I no longer care about my own health, vitality and wholeness, but I insist you still desire me," then, ouch, how can that not feel like rejection? Like being discarded. It's not easy to respect someone who doesn't respect herself, let alone desire her.

The same person on the inside? No way. What happens to our bodies happens to our soul. What happens in our soul ultimately will be expressed in our bodies. This is Cosmic Law.

Imagine an alcoholic spouse saying, "Just look past all the hooch I'm slamming down, because I'm still the same person you married on the inside." Oh really? Last time I looked, marriage vows called us to love and honor our spouse, not participate in his or her denial and self-destruction.

Can you learn to see past your wife's weight gain, to eroticize intimacy and find a new and deeper way to desire her? Maybe. Probably. Does the average American male need to do some serious growing up about this? Absolutely.

But a different question is, can you learn to see past what the weight gain means? Depends on what it means. Maybe not. And maybe you shouldn't. Maybe it would be like lying to the kids to cover for an alcoholic.

I'm saying that what your wife is asking you might not be in her own best interest.

Steven Kalas is a behavioral health consultant and counselor at Clear View Counseling and Wellness Center in Las Vegas. His columns appear on Tuesdays and Sundays. Questions for the Asking Human Matters column or comments can be e-mailed to skalas@reviewjournal.com.