The decision to undergo bariatric surgery is not one that patients take lightly. It’s important to look at all the health factors when deciding on this procedure, but new research shows that some aspects of patients lives, like relationships and other personal factors, should also be considered before deciding on surgery.
It’s not a quick fix, and it’s not an easy process post-surgery, and the research shows that many patients will have a higher risk of divorce, separation or marriage after their surgery and those issues should be part of the decision-making process.
The medical concerns surrounding weight loss surgery have been studied extensively. Risk and reward should be evaluated for each patient and their situation, but up until now, there hasn’t been much attention to paid to how a patient’s life will change socially and emotionally after the surgery.
The study was conducted in Sweden and was observational, using data from two specific groups. Patients undergoing bariatric surgery who were enrolled in the Swedish Obese Subjects (SOS) study were recruited and matched to obese patients in the general population who were not having surgery. The other cohort was comprised of patients from the Scandinavian Obesity Surgery Registry (SOReg) who were also matched to similarly aged obese patients who were not opting for surgery.
In the participants who underwent the surgery, there was an increased likelihood of patients separating or divorcing their partners or, alternately, meeting someone and getting married compared to those who did not have surgery. Some of that could be the result of the increased social activity many patients reported after surgery. With the operation resulting in better quality of life, including better fitness, less reliance on medications for health problems like high blood pressure, anxiety or depression, an increased social life is prevalent after surgery. Many patients regard it as a clean slate, where they can go out again and meet new people. There was also an association between the amount of weight loss and the odds of finding a new partner.
While meeting new people is easily understood as an aftereffect of weight loss surgery, the association between the procedure and an increased divorce rate is less clear. It could be that the operation improves the self-esteem and self-image of patients and they feel more able to leave an unhealthy or unsatisfying relationship. While it’s to be expected that much will change in a patient’s life after this kind of surgery, the study authors point out that it’s important for healthcare providers to advise their patients of more than just the medical factors. Informing patients that they may see significant life changes as well is recommended.
The study authors, in their conclusion, wrote “Our data suggest that bariatric surgery-induced weight loss influences interpersonal relationships. For persons with obesity who are single, a better chance of finding a partner might be added as yet another positive association of bariatric surgery-induced weight loss. Increased incidence of divorce and separation after bariatric surgery might be associated with increased tension in already vulnerable relationships or to improvements that empower patients to leave unhealthy relationships.”
There are some limitations to the study. It only included people living in Sweden, so it’s unclear if the results would be different in a different cultural environment. It was also observational, with participants answering questionnaires, which is not the same as randomized controlled clinical studies. In the SOS study, there were approximately 2,000 participants who had surgery that were compared to the same number of obese patients who did not have the surgery. In the SOReg study, the data was collected via an electronic database and included about 29,000 patients who had surgery and an equal-sized group of obese patients who did not have surgery. Factors like income, education, and family history were not taken into account, so that limits conclusions that can be drawn from the work. Check out the video below that features patients from the weight loss reality series “My 600 Pound Life” who have gone through relationship changes after their surgery.
Sources: JAMA Surgery, ABC News
