Changes in relationship status following bariatric surgery

Associations between marital status and weight loss trajectories entering into early adulthood: a Teen-LABS study

BACKGROUND

Among adolescents who underwent metabolic and bariatric surgery (MBS), it is unclear how relationships and specifically marital status (MS) may be associated with long-term weight loss.

OBJECTIVE

In this analysis, we tested for associations between the MS of adolescents who underwent MBS and the MS of their primary caregiver and weight loss trajectory over 8 years.

SETTING

Teen-LABS participating sites.

METHODS

This sample included 231 participants (75.3% female, 71.4% White, 68.0% Roux-en-Y gastric bypass, 27.7% vertical sleeve gastrectomy, 4.3% laparoscopic adjustable gastric band). A linear mixed model was conducted with the dependent variable percent body mass index (BMI) change from preoperatively through 8 years with between-participant factors (1) participant MS, (2) caregiver MS, and (3) interaction between caregiver and participant MS.

RESULTS

One third of participants and 87% of caregivers were ever married (EM). Compared with never-married (NM) participants and caregivers (-14.6%), EM participants and caregivers (-20.6%), EM participants and NM caregivers (-25.9%), and NM participants and EM caregivers (-19.8%), each had significantly greater BMI loss at 8 years (each P < .05). No other group comparisons achieved statistical significance.

CONCLUSIONS

NM participants with NM caregivers had less favorable long-term BMI. Additional research is needed to better understand how relationships affect behavior change and weight loss after MBS.

Sexuality and self-concept of morbidly obese women who are sexually attracted to men after bariatric surgery: a phenomenological study

BACKGROUND

Morbid Obesity (MO) is a public health problem that affects a person's physical, psychological and sexual well-being. Women with MO are affected by their body image and self-concept, and obesity stigma may affect women in social and sexual relationships.

OBJECTIVE

To describe and understand the experiences of morbidly obese heterosexual women (who are sexually attracted to men) in relation to their body image and sexuality after bariatric surgery.

METHODOLOGY

Qualitative study using Merleau-Ponty's hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached.

RESULTS

Two main themes were identified: (1) "Escaping from a cruel environment": weight loss to increase self-esteem; with the sub-themes: 'I love myself now', and 'Body image and social relationships; a vicious circle; (2) "Now, I am truly me": accepting my body to reclaim my sexuality, with the sub-themes: 'The body as the focal point of sexuality', and 'When regaining your sex drive reignites your sex life and relationship'.

CONCLUSION

Weight loss and body acceptance radically change morbidly obese women's sex lives after bariatric surgery. They rediscover their bodies, have increased self-esteem, and see improvements in their social relationships and sexuality. These women feel seen, loved and desired, and now value their body image and femininity. As they go through continuous improvements following bariatric surgery, they gradually regain self-esteem, acceptance of their bodies and control over their sex life. Even though the women's partners benefit from these improvements, they seem to be afraid of being left.

On power and its corrupting effects: the effects of power on human behavior and the limits of accountability systems

Power is an all-pervasive, and fundamental force in human relationships and plays a valuable role in social, political, and economic interactions. Power differences are important in social groups in enhancing group functioning. Most people want to have power and there are many benefits to having power. However, power is a corrupting force and this has been a topic of interest for centuries to scholars from Plato to Lord Acton. Even with increased knowledge of power's corrupting effect and safeguards put in place to counteract such tendencies, power abuse remains rampant in society suggesting that the full extent of this effect is not well understood. In this paper, an effort is made to improve understanding of power's corrupting effects on human behavior through an integrated and comprehensive synthesis of the neurological, sociological, physiological, and psychological literature on power. The structural limits of justice systems' capability to hold powerful people accountable are also discussed.

Examining spousal and family support as predictors of long-term weight loss and remission of type 2 diabetes following bariatric surgery in Singapore: a retrospective cohort study

OBJECTIVES

Postoperative outcomes vary considerably across bariatric patients and may be related to psychosocial factors. In this study, we examined whether a patient's family support predicts postsurgical weight loss and the remission of type 2 diabetes mellitus (T2DM).

DESIGN

Retrospective cohort study in Singapore.

SETTING

Participants were recruited from a public hospital in Singapore.

PARTICIPANTS

Between 2008 and 2018, 359 patients completed a presurgical questionnaire before undergoing gastric bypass or sleeve gastrectomy.

OUTCOME MEASURES

As part of the questionnaire, patients described their family support in terms of structure (marital status, number of family members in the household) and function (marriage satisfaction, family emotional support, family practical support). Linear mixed-effects and Cox proportional-hazard models were used to examine whether these family support variables predicted percent total weight loss or T2DM remission up to 5 years postsurgery. T2DM remission was defined as glycated haemoglobin (HbA1c) <6.0% without medications.

RESULTS

Participants had a mean preoperative body mass index of 42.6±7.7 kg/m² and HbA1c (%) of 6.82±1.67. Marital satisfaction was found to be a significant predictor of postsurgical weight trajectories. Namely, patients who reported higher marital satisfaction were more likely to sustain weight loss than patients who reported lower marital satisfaction (β=0.92, SE=0.37, p=0.02). Family support did not significantly predict T2DM remission.

CONCLUSIONS

Given the link between marital support and long-term weight outcomes, providers could consider asking patients about their spousal relationships during presurgical counselling.

TRIAL REGISTRATION NUMBER

NCT04303611.

Changes in Marital Status Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: A US Multicenter Prospective Cohort Study

Among a US cohort followed 5 years after Roux-en-Y gastric bypass or sleeve gastrectomy, cumulative incidence of marriage and separation/divorce were 18% among unmarried (N=614) and 13% among married (N=827) participants, respectively. Preoperative predictors of marriage included younger age, college degree, lower BMI and cohabitating or being separated (versus single).

Estado nutricional e clínico de pacientes submetidos à cirurgia bariátrica

Objetivo: analisar o estado clínico e nutricional de pacientes submetidos à cirurgia bariátrica. Métodos: trata-se de um estudo epidemiológico observacional, com delineamento transversal, norteado pela ferramenta STROBE. Foi realizado entre 2015 e 2016, com dados de pacientes submetidos à cirurgia bariátrica em Y de Roux nos anos de 2012 a 2014, em um hospital privado de Minas Gerais. A coleta de dados ocorreu por meio de questionário semi-estruturado, elaborado pelos pesquisadores. Para verificar a existência da associação entre as variáveis do estado nutricional e clínico com o tempo pós-cirúrgico, utilizou-se o teste Qui-quadrado de Pearson ou Exato de Fisher para as variáveis categóricas e, para as contínuas, os testes Kruskal-Wallis ou Mann-Whitney. Resultados: verificou-se significância estatística para as variáveis: “enfraquecimento de unhas” (p=0,002), “êmese” (p=0,018), “frequência de consumo alcoólico” (p=0,018) e “número de refeições diárias” (p=0,028) no grupo feminino. Conclusão: este estudo evidenciou alterações no componente clínico e nutricional das pacientes submetidos à cirurgia bariátrica. Observou-se associações estatisticamente significativas no grupo feminino, incluindo mudanças no perfil clínico de maior episódio de êmese e maior frequência no consumo de álcool. Em relação ao perfil nutricional, pacientes do sexo feminino apresentaram maiores proporções no número de refeições e maior enfraquecimento nas unhas após o procedimento cirúrgico. Reforça-se a importância do acompanhamento e orientação nutricional e psicológica contínuas, pré e pós cirúrgicas, minimizando os impactos negativos deste resultado na saúde dos indivíduos.