From Folie-a-Deux to La Diete-a-Deux

Shahar Madjar, MD

Angelina was seeking a companion. She responded to a personal ad in a single’s magazine. She was 23, Angelo was 27, love bloomed, and within a week the couple got married.

At age 8 Angelo was diagnosed with paranoid schizophrenia. He had delusions and hallucinations. He was often visited by three ‘demons’ – imaginary figures he named Romanoff, The Baron, and La Bella.

On their wedding night, Angelina saw Angelo become possessed by Romanoff. Angelo told Angelina that he was the god of the ocean and that he had known her throughout her childhood. She was initially scared, but over the next two years, when Angelo was visited by Romanoff and his other demons at increasing frequency, she became accustomed to Angelo’s delusions and integrated them into her own world.

In the world they had built, there was Romanoff, “the fallen angel with greyish-black wings” who held “a sword with gems upon it.” There was LaBelle, the “tall beautiful lady dressed in silver with long silver hair … who carried a chalice full of blood” drawn from Angelo’s enemies. And there was The Baron — a tall gentlemen dressed in black who carried a sword.

Angelina and Angelo were socially isolated. They experienced financial difficulties. They had to move from one state to another in search of a steady job for Angelo.

The couple continued to hear voices — that of Romanoff, for example, told them that Angelo would soon die, and Angelina would be raped.

The couple bought a gun.

One night, while dining in a restaurant, Angelo saw two strangers laughing. He thought they were laughing at him. Angelina and Angelo left the restaurant and returned to their home where Angelo was visited again by Romanoff. “The enemies were laughing at us. You must kill them or they will kill you,” Angelo, possessed by Romanoff, told Angelina.

The couple returned to the restaurant where Angelo shot and killed the two strangers. Romanoff then told the couple that they ought to kill themselves. Angelina swallowed vaginal suppositories, perfume and allergy pills. She did not die. The police traced the couple to their apartment. They were arrested and admitted to a psychiatric hospital.

The case of Angelo and Angelina was described in the Jefferson Journal of Psychiatry (January 1993), by Ryan M. Nishihara and Craig T. Nakamura from John A. Burns School of Medicine in Honolulu, Hawaii. It is one of dozens cases of Folie-a-Deux, French for madness-of-two, a rare psychiatric syndrome in which delusional beliefs and sometimes hallucinations are transferred from one individual to another.

The case of Angelina and Angelo is an extreme example of how your spouse can influence the way you think and behave. A recent article in Obesity brings about another example – a milder, more benign one. Here, your spouse’s way of thinking and behavior will not end with a murder. Instead, it may result in a mild weight loss. I call it La Diete-a-Deux:

Amy A. Gorin from the Department of Psychological Sciences at the University of Connecticut and her colleagues sought to answer the question: If one spouse participates in weight loss treatment, does the other spouse lose weight?

The authors of the study call this phenomenon — where non-dieting spouses lose weight while their spouses go on a diet — a ripple effect. The study was supported by Weight Watchers International, Inc.

Some 130 couples participated in Gorin’s study. The researchers randomly assigned one member of each couple into two groups: 65 participants were assigned to Weight Watchers diet (WW) — these participants received 6 months of free access to WW meetings and online tools. The other 65 participants received a 4-page weight loss handout with basic information regarding healthy eating and physical activity. They did not participate in meetings and did not have access to Weight Watchers’ online tools.

The spouses of the 130 participants received no treatment at all: no Weight Watchers meeting, no online tools, not even a 4-page weight loss handout.

Most of the couples were married (93.1 percent), the other couples just lived together.

At 6 months after they embarked on their diet, the participants who were on WW diet lost more weight than those on the self-guided diet. WW dieters lost 4.31 kgs while self-guided dieters lost only 3.08 kgs.

Surprisingly, the spouses of the participants also lost weight. At 6 months, spouses of participants on the WW diet lost 2.16 kgs, while spouses on the self-guided diet lost 1.88 kgs. Overall, 32 percent of the untreated spouses lost 3 percent or more of their initial body weight.

The study, the authors say, shows that a ripple effect does exist and that “weight loss can spread within couples.”

From Folie-a-Deux to La Diete-a-Deux: your spouse’s thinking and behavior may have ripple-effect on your health. As to tips on how to choose the right spouse, I will update you as soon as these become available. Please don’t hold your breath.

Editor’s note: Dr. Shahar Madjar is a urologist working in several locations in the Upper Peninsula. Contact him at or at