Losing excess weight isn’t the only potential benefit of bariatric surgery – those who undergo the procedure may also enjoy long-term improvements between sheets.
Previous research suggested that bariatric surgery could lead to short-term improvements in sexual function, but the authors of the new A study published in February 2019 in the journal JAMA Surgeryfound that half of the participants who underwent the procedure experienced better sexual function, including increased libido and frequent sex for at least five years afterward.
The study is also noteworthy because it sheds more light on an overlooked aspect of obesity and subsequent weight loss: changes in sexual gratification and sexual function. With nearly 40 percent of adults in the United States classified as obese, According to the Centers for Disease Control and Prevention (CDC)Interest in obesity surgery has grown.
Obesity is defined as having a body mass index (BMI) of 30 or more. Data from the American Society for Bariatric and Metabolic Surgery (ASMBS) It is suggested that 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 surgery, sleeve gastrectomy, and adjustable gastric banding procedures, according to the ASMBS.
Surgeons often perform the procedure to help people prevent or treat obesity-related diseases, such as diabetes, heart disease, osteoporosis, and sleep apnea, according to ASMBS. But sexual dysfunction is a trait that often doesn’t get the same amount of attention, he said Alison J. Huang, MDco-author of the study and an internist and primary care physician at the University of California, San Francisco, in JAMA Surgery audio notation. 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 concerned patients more than physicians.”
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How the physical and psychological toll of obesity can hinder a person’s sexual life
Impotence is often linked to obesity, he says Samer Matar, MD, former president of the ASMBS and medical director of the Swedish Surgery for Weight Loss and Bariatric Surgery in Seattle. Dr. Matar was not involved in the study.
“The reasons for this are multifactorial,” he says. Obesity itself, just the physical presence of excess weight, can lead to physical limitations. Second, there are psychological aspects to it. Unfortunately, many of our patients who suffer from the ravages of obesity are frustrated; They have self-esteem issues that stem from our society misinterpreting that obesity involves a lack of will or motivation. These patients become somewhat less social, less open, and opportunities to form relationships are hampered.”
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Matar says obesity-related diseases, such as diabetes, sleep apnea, cardiovascular disease and depression, further interfere with physiological sexual function. “All of these have side effects, such as decreased energy and decreased libido, or patients taking medications for illnesses that may have side effects to reduce sexual function. In addition to depression itself, which is present in more than 50 percent of our patients, it has a significant impact on libido. “.
Bariatric surgery carries extensive risks such as gallstone infections, Mayo Clinic notes. But most patients who undergo this procedure experience weight loss and corresponding improvements in various health indicators, such as cholesterol and blood pressure, along with improved self-image and improved quality of life, according to many studies.
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What you need to know about the new study on sex and bariatric surgery
To understand the effect of obesity and subsequent weight loss on sexual function, Huang and her colleagues surveyed 2,215 individuals who underwent bariatric surgery at 1 of 10 hospitals across the United States from 2006 to 2009. Subjects were followed, and questionnaires completed before and after surgery annually. for five years.
The study showed that before surgery, 70 percent of females and 74 percent of males expressed dissatisfaction with sexual function. But a year after surgery, about 56 percent of women and about half of men saw an improvement in satisfaction with their sex lives.
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Among the women, 41 percent reported an improvement in the frequency of sexual desire and 35 percent reported improvements in sexual activity five years after surgery. At least half of the men experienced an improvement in sexual activity, satisfaction, desire, and frequency.
Sexual satisfaction remained high even five years after surgery, with about half of patients reporting improved sexual function and satisfaction.
“We hope that these findings will allow bariatric surgeons to more effectively advise patients about the way their sexual activities and function are likely to develop in the years after surgery,” Huang says. “These data provide reassuring evidence that in the majority of patients who begin with some degree of dissatisfaction with their sexual life before surgery, the postoperative years will show a benefit, not a decline in sexual function.”
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The beneficial effect on sexual function is likely to be the result of many physical and psychological changes Dana A. Tellem, MD, MPHan assistant professor of surgery at the University of Michigan and co-author of Introduction to the study.
“I’m sure it’s a combination of everything, as in most things – biological mechanisms and psychological factors,” she said. When you lose weight, several things happen: People feel more energetic. There are improvements in many medical conditions related to weight, and they have a better overall image and positivity about themselves, which you can see may lead to improved sexual function.”
The research was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the study was large, multicenter, and long-term, strengthening the results, Dr. Tellem adds. However, there were significantly more female participants in the study. She says more research is needed on sexual function in men undergoing bariatric surgery.
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The study provided further evidence about patients who may experience improvements in sexual function after bariatric surgery. For example, younger age and marriage had a positive association with improvements in sexual function, while enuresis, menopause and antidepressant use were associated with a lower likelihood of improvement.
The findings suggest that sexual function is an important consideration in bariatric surgery, Tellem says.
“We have a huge problem in this country with obesity, and yet only about 1 percent of people use surgery,” she says. “I think this has a lot to do with the stigma around the procedure being an easy way out, or that people feel they are not good candidates for it. But studies like this say that surgery isn’t just about weight loss. It’s about other aspects of well-being as well.”
Matar says doctors should evaluate their patients’ sexual function before and after surgery. Furthermore, clinicians should discuss other interventions that affect the improvement of sexual function after surgery.
“We have to realize that sexual function is an important component” of obese care, Matar says. “I think we need to give more importance to asking questions about these areas, and then tracking the patient and monitoring the results. If improvements in sexual function start to decline, we can intervene and address the problem.”
