The study’s findings show that bariatric surgery can actually spur sexual improvements. How? Why?
Understanding That Obesity’s Psychological And Physical Effects Can Alter A Person’s Sex Life
Considering almost 40 percent of adults in America now fall under the category of obesity, which is defined by any body mass index (BMI) over 29, bariatric surgery has become a more and more popular topic of interest.
In fact, the American Society for Metabolic and Bariatric Surgery’s data shows a 70,000 increase in the number of Americans electing one of the various types of weight loss surgery, such as a sleeve gastrectomy, gastric bypass, or adjustable gastric bands, between 2011 and 2017.
Historically, one of the main reasons people have shown interest in bariatric surgery is the weight loss and resulting improved physical health benefits it offers. Many surgeons perform the surgery to prevent or treat disease processes like sleep apnea, heart disease, diabetes, or osteoarthritis. The new study in JAMA Surgery, however, is shedding a new light on a different benefit, and it’s one that many people have difficulty discussing – sex.
The study found long-lasting improvements when it comes to the sexuality and sex life of post-bariatric surgery patients. Improvement in sexual desire was reported by over 40 percent of the female subjects, and at least half of the male subjects reported improved sexual activity. It’s both evidence that a problem exists and can be improved.
It’s the long-term aspect of improvement that particularly makes this study so unique. There have been previous studies connecting improved sexual function with bariatric surgery , but the viewpoint of such studies were all from short-term improvements. The JAMA study, however, showed higher sex drives and frequency of sex over a much more prolonged five-year period.
Another unique feature of this study is that it directly addresses the often overlooked aspect of how changes in sexual function and gratification correspond to both obesity and weight loss.
Co-author of the study and University of California in San Francisco internist Allison J. Huang pointed out in a recent podcast that the physical and psychological effects of obesity on a person’s sexual function doesn’t get as much hype as the disease counterpart aspects like diabetes and heart disease. The doctor went on to say that, despite little research existing, such long-term quality of life improvements are of particular interest to patients.
According to Dr. Samer Mattar, medical director of Seattle’s Swedish Weight Loss and Bariatric Surgery, obesity and sexual dysfunction are often interlinked. And, it’s often not just a simple fix since there can be multiple factors involved.
Psychologically, morbidly obese persons can suffer with discouragement and low self-esteem, which is then compounded as society views obesity as a lack of motivation or willpower on the obese person’s part.
The above can hinder relationships as the obese person misses opportunities to create meaningful relationships as they become less outgoing and less inclined to socialize. According to Mattar, 50% of morbidly obese patients also suffer from depression, which is known to lower libido.
From a physical standpoint, the mere presence of the extra weight can create sexual limitations. The presence of obesity-related disease processes may further place limitations and create physiological sexual dysfunction.
Plus, Mattar points out that those disease processes and the medications used to treat them have their own set of effects on sexual functioning, such as lethargy, decreased libido, and anatomical impairments.
From gallstones to infection, research doesn’t ignore a wide range of potential risks with bariatric surgery. However, research also points to a plethora of improved health markers, including weigh loss, lower cholesterol, lower blood pressure, higher self-esteem, and overall better quality of life.
What To Takeaway From The Sex And Bariatric Surgery Study?
The JAMA study involved a survey of over 2,200 bariatric surgery patients from 2006 to 2009 at 10 different American hospitals. Each patient completed a questionnaire before their bariatric surgery and then every year thereafter for five years.
Prior to surgery, 74 percent of male participants and 70 percent of female participants said they were dissatisfied with their sexual function. The one-year follow-up survey after surgery showed 50 percent of males and 56 percent of females responded with greater satisfaction concerning their sex life.
With 41 percent, females showed the greatest improvement in frequency of sexual desire experienced. Half of all the men experienced sexual frequency, desire, and activity improvements. Five years post-surgery, and 35 percent of females still responded with improved sexual activity. Almost half of all the respondents reported that sexual satisfaction and performance remained improved on the five-year follow-up survey.
According to Huang, the data is reassuring that bariatric weight loss surgery patients dissatisfied with the sexual lifestyles may experience long-term and vast sexual improvement in the years following bariatric weight loss surgery. The hope is that the study will enable bariatric surgeons to more fully counsel and discuss the wide scope of benefits offered by bariatric weight loss surgery, including how their sex life may evolve in the years following surgery.
Associate professor of surgery at the University of Michigan Dana A. Telem co-authored an editorial accompanying the study, in which she expressed the importance of considering sexual function in bariatric surgery.
According to Telem, the sexual function benefits for post-bariatric surgery patients likely stems from a combination of psychological, biological, and physical changes. The person may feel more energetic as they lose weight and therefore see improvement in obesity-related disease processes, gain a healthier body image, and experience more positivity around themselves. Telem points out that it’s only reasonable that the above effects may lead to improved sexual function.
While the study’s findings have been noted for the research’s long-term considerations and multi-centered facets, Telem says that it still leaves room to be bolstered by succeeding research since it had such a high number of female participants in comparison to males.
Yet, Telem’s editorial also pointed out that the research had many clues concerning how the sexual function of various subsets might be altered. An example was the fact younger respondents and marriage seemed to correlate with positive sexual function improvements post-bariatric weight loss surgery.
On the other hand, lower probabilities of improvement were noted amongst subsets, such as antidepressant users, menopausal women, and younger respondents with urinary incontinence.
Despite the epidemic of obesity in America, only about one percent of the population has utilized a bariatric weight loss surgery. Telem suggests that the lack of utilization may be due to people either assuming they’re not a candidate or feeling the thorns of the social stigma that the surgery is an easy alternative to other weight loss methods.
In the editorial piece, Telem expresses hope that the study may help people see that bariatric surgery goes beyond just weight loss to improve multiple aspects of a person’s well-being, including their sex lives.
The importance of recognizing that sexual function is an important and desired area of care for obese patients is a thought Mattar stresses from the study’s findings. Mattar places an importance on clinicians assessing, asking sexual function questions both before and after weight loss surgery, and then tracking outcomes.
According to Mattar, the study’s findings also point out the need for physicians to discuss the other potential interventions that may have an impact on their patient’s sexual function post-bariatric surgery.