Previous research has suggested bariatric surgery can lead to short-term improvements in sexual function, but authors of the new study, published in February 2019 in the journal JAMA Surgery, found that one-half of participants who underwent the operation saw better sexual function, including a boosted libido and more frequent sex, for at least five years afterward. The study is also noteworthy because it shines more light on an overlooked aspect of obesity and subsequent weight loss: changes in sexual satisfaction and sexual function. With almost 40 percent of U.S. adults categorized as obese, according to the Centers for Disease Control and Prevention (CDC), interest in bariatric surgery has grown. Obesity is defined as having a body mass index (BMI) of 30 or more. Data from the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests about 228,000 Americans underwent some type of bariatric surgery in 2017, up from 158,000 in 2011. There are several types of weight loss surgery, including gastric bypass, sleeve gastrectomy, and adjustable gastric band procedures, according to ASMBS. Surgeons often perform the operation to help people prevent or treat obesity-related diseases, such as diabetes, heart disease, osteoarthritis, and sleep apnea, according to ASMBS. But sexual dysfunction is a feature that often does not receive as much attention, said Alison J. Huang, MD, study coauthor and internist and primary care doctor at the University of California in San Francisco, in a JAMA Surgery podcast. Dr. Huang was not available for direct comment. “We’ve known for a long time that bariatric surgery improves many aspects of health in obese adults, at least in the short term,” Huang said. “But relatively little research on bariatric surgery has focused on quality-of-life outcomes that have interested patients even more than clinicians.” RELATED: 7 Healthy Reasons You Should Have Sex — Right Now!
How the Physical and Psychological Tolls of Obesity Can Hinder a Person’s Sex Life
Sexual dysfunction is often linked to obesity, says Samer Mattar, MD, immediate past president of ASMBS and medical director of Swedish Weight Loss and Bariatric Surgery in Seattle. Dr. Mattar wasn’t involved in the study. “The reasons for this are multifactorial,” he says. “Obesity itself, the mere physical presence of the extra weight, can result in physical limitations. Second, there are psychological aspects to it. Unfortunately, a lot of our patients who suffer the ravages of morbid obesity become discouraged; they have self-esteem issues that stem from our society misinterpreting that obesity involves a lack of willpower or motivation. These patients become a little less social, less outgoing, and the opportunities to create relationships are hindered.” RELATED: Bariatric Surgery May Change Your Relationship Status for Better or Worse Obesity-related diseases, such as diabetes, sleep apnea, cardiovascular disease, and depression, further interfere with physiological sexual function, Mattar says. “All these have side effects, such as decreased energy and decreased libido, or patients take medication for the diseases that may have the side effect of decreasing sexual function. Plus depression itself, which is present in more than 50 percent of our patients, has a major impact on libido.” Bariatric surgery carries risks as wide-ranging as infections to gallstones, notes the Mayo Clinic. But most patients who undergo the procedure experience weight loss and corresponding improvements in various health markers, such as cholesterol and blood pressure, along with improved self-image and a better quality of life, according to numerous studies. RELATED: For Diabetes Control, Gastric Bypass Surgery Trumps Lifestyle Changes
What to Know About the New Study on Sex and Bariatric Surgery
To understand the impact of obesity and subsequent weight loss on sexual function, Huang and her colleagues conducted a survey of 2,215 individuals who underwent bariatric surgery at 1 of 10 hospitals around the United States from 2006 to 2009. The subjects were followed, completing questionnaires before surgery and annually thereafter for five years. The study showed that before surgery, 70 percent of females and 74 of males expressed dissatisfaction with sexual function. But one year following surgery, about 56 percent of women and about one-half of the men experienced improvements in satisfaction with their sexual life. RELATED: 10 Things Your Doctor Won’t Tell You About Bariatric Surgery Among women, 41 percent reported improvements in the frequency of sexual desire and 35 percent reported improvements in sexual activity five years after surgery. At least one-half of the men experienced improvements in sexual activity, satisfaction, desire, and frequency. Sexual satisfaction remained high even five years after surgery, with about one-half of the patients reporting that their sexual function and satisfaction remained improved. “We hope these findings will allow bariatric surgeons to counsel patients more effectively about the way their sexual activity and function is likely to evolve in the years after surgery,” Huang says. “This data provides reassuring evidence that in the majority of patients who start out with some degree of dissatisfaction with their sexual lives presurgery, the post-surgical years will show benefit, not decline in sexual function.” RELATED: Bariatric Surgery Significantly Lowers Heart Risks for Obese People With Diabetes The beneficial impact on sexual function is likely the result of many physical and psychological changes, says Dana A. Telem, MD, MPH, an associate professor of surgery at the University of Michigan who coauthored an editorial accompanying the study. “I’m sure it’s a combination of everything, as most things are — biological mechanisms and psychological factors,” she said. “As you lose weight, several things happen: People feel more energetic. There are improvements in several weight-related medical conditions, and they have an overall better image and positivity around themselves, which you can see might lead to improved sexual function.” The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funded the research, and the study was large, multicentered, and long-term, which bolsters the findings, Dr. Telem adds. However, there were far more female participants in the study. More research is needed on sexual function in men undergoing bariatric surgery, she says. RELATED: Sexual Activity Boosts Well-Being in Older Adults, Study Shows The study provided other clues about which patients may experience improvements in sexual function following bariatric surgery. For example, younger age and getting married had a positive association with improvements in sexual function, while urinary incontinence, menopause, and antidepressant use were associated with a lower probability of experiencing improvements. The findings demonstrate that sexual function is an important consideration in bariatric surgery, Telem says. “We have a big problem in this country with obesity, yet only about 1 percent of people utilize surgery,” she says. “I think that has a lot to do with stigma about the procedure being an easy way out, or people feeling like they are not candidates for it. But studies like this say surgery isn’t just about weight loss. It’s about other aspects of well-being, too.” Doctors should assess their patients’ sexual function before and following surgery, Mattar says. Moreover, physicians should discuss other interventions that influence the improvement of sexual function following surgery. “We have to recognize that sexual function is an important component” in the care of the obese patient, Mattar says. “I think we need to place more importance on asking questions relative to these areas, and then track the patient and monitor outcomes. If the improvements in sexual function begin to fall off, we can intervene and address the issue.”
title: “Bariatric Surgery May Improve Your Sex Life Study Says” ShowToc: true date: “2022-12-08” author: “Janice Forgey”
Previous research has suggested bariatric surgery can lead to short-term improvements in sexual function, but authors of the new study, published in February 2019 in the journal JAMA Surgery, found that one-half of participants who underwent the operation saw better sexual function, including a boosted libido and more frequent sex, for at least five years afterward. The study is also noteworthy because it shines more light on an overlooked aspect of obesity and subsequent weight loss: changes in sexual satisfaction and sexual function. With almost 40 percent of U.S. adults categorized as obese, according to the Centers for Disease Control and Prevention (CDC), interest in bariatric surgery has grown. Obesity is defined as having a body mass index (BMI) of 30 or more. Data from the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests about 228,000 Americans underwent some type of bariatric surgery in 2017, up from 158,000 in 2011. There are several types of weight loss surgery, including gastric bypass, sleeve gastrectomy, and adjustable gastric band procedures, according to ASMBS. Surgeons often perform the operation to help people prevent or treat obesity-related diseases, such as diabetes, heart disease, osteoarthritis, and sleep apnea, according to ASMBS. But sexual dysfunction is a feature that often does not receive as much attention, said Alison J. Huang, MD, study coauthor and internist and primary care doctor at the University of California in San Francisco, in a JAMA Surgery podcast. Dr. Huang was not available for direct comment. “We’ve known for a long time that bariatric surgery improves many aspects of health in obese adults, at least in the short term,” Huang said. “But relatively little research on bariatric surgery has focused on quality-of-life outcomes that have interested patients even more than clinicians.” RELATED: 7 Healthy Reasons You Should Have Sex — Right Now!
How the Physical and Psychological Tolls of Obesity Can Hinder a Person’s Sex Life
Sexual dysfunction is often linked to obesity, says Samer Mattar, MD, immediate past president of ASMBS and medical director of Swedish Weight Loss and Bariatric Surgery in Seattle. Dr. Mattar wasn’t involved in the study. “The reasons for this are multifactorial,” he says. “Obesity itself, the mere physical presence of the extra weight, can result in physical limitations. Second, there are psychological aspects to it. Unfortunately, a lot of our patients who suffer the ravages of morbid obesity become discouraged; they have self-esteem issues that stem from our society misinterpreting that obesity involves a lack of willpower or motivation. These patients become a little less social, less outgoing, and the opportunities to create relationships are hindered.” RELATED: Bariatric Surgery May Change Your Relationship Status for Better or Worse Obesity-related diseases, such as diabetes, sleep apnea, cardiovascular disease, and depression, further interfere with physiological sexual function, Mattar says. “All these have side effects, such as decreased energy and decreased libido, or patients take medication for the diseases that may have the side effect of decreasing sexual function. Plus depression itself, which is present in more than 50 percent of our patients, has a major impact on libido.” Bariatric surgery carries risks as wide-ranging as infections to gallstones, notes the Mayo Clinic. But most patients who undergo the procedure experience weight loss and corresponding improvements in various health markers, such as cholesterol and blood pressure, along with improved self-image and a better quality of life, according to numerous studies. RELATED: For Diabetes Control, Gastric Bypass Surgery Trumps Lifestyle Changes
What to Know About the New Study on Sex and Bariatric Surgery
To understand the impact of obesity and subsequent weight loss on sexual function, Huang and her colleagues conducted a survey of 2,215 individuals who underwent bariatric surgery at 1 of 10 hospitals around the United States from 2006 to 2009. The subjects were followed, completing questionnaires before surgery and annually thereafter for five years. The study showed that before surgery, 70 percent of females and 74 of males expressed dissatisfaction with sexual function. But one year following surgery, about 56 percent of women and about one-half of the men experienced improvements in satisfaction with their sexual life. RELATED: 10 Things Your Doctor Won’t Tell You About Bariatric Surgery Among women, 41 percent reported improvements in the frequency of sexual desire and 35 percent reported improvements in sexual activity five years after surgery. At least one-half of the men experienced improvements in sexual activity, satisfaction, desire, and frequency. Sexual satisfaction remained high even five years after surgery, with about one-half of the patients reporting that their sexual function and satisfaction remained improved. “We hope these findings will allow bariatric surgeons to counsel patients more effectively about the way their sexual activity and function is likely to evolve in the years after surgery,” Huang says. “This data provides reassuring evidence that in the majority of patients who start out with some degree of dissatisfaction with their sexual lives presurgery, the post-surgical years will show benefit, not decline in sexual function.” RELATED: Bariatric Surgery Significantly Lowers Heart Risks for Obese People With Diabetes The beneficial impact on sexual function is likely the result of many physical and psychological changes, says Dana A. Telem, MD, MPH, an associate professor of surgery at the University of Michigan who coauthored an editorial accompanying the study. “I’m sure it’s a combination of everything, as most things are — biological mechanisms and psychological factors,” she said. “As you lose weight, several things happen: People feel more energetic. There are improvements in several weight-related medical conditions, and they have an overall better image and positivity around themselves, which you can see might lead to improved sexual function.” The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funded the research, and the study was large, multicentered, and long-term, which bolsters the findings, Dr. Telem adds. However, there were far more female participants in the study. More research is needed on sexual function in men undergoing bariatric surgery, she says. RELATED: Sexual Activity Boosts Well-Being in Older Adults, Study Shows The study provided other clues about which patients may experience improvements in sexual function following bariatric surgery. For example, younger age and getting married had a positive association with improvements in sexual function, while urinary incontinence, menopause, and antidepressant use were associated with a lower probability of experiencing improvements. The findings demonstrate that sexual function is an important consideration in bariatric surgery, Telem says. “We have a big problem in this country with obesity, yet only about 1 percent of people utilize surgery,” she says. “I think that has a lot to do with stigma about the procedure being an easy way out, or people feeling like they are not candidates for it. But studies like this say surgery isn’t just about weight loss. It’s about other aspects of well-being, too.” Doctors should assess their patients’ sexual function before and following surgery, Mattar says. Moreover, physicians should discuss other interventions that influence the improvement of sexual function following surgery. “We have to recognize that sexual function is an important component” in the care of the obese patient, Mattar says. “I think we need to place more importance on asking questions relative to these areas, and then track the patient and monitor outcomes. If the improvements in sexual function begin to fall off, we can intervene and address the issue.”
