Bariatric Surgery a Boon for Marriage Prospects?July 22, 2022
Many patients cite marriage as a motivator for bariatric surgery, but how does that goal pan out in practice?
In a study seeking to answer how bariatric surgery affects marital status, researchers led by Wendy King, PhD, an epidemiologist at the University of Pittsburgh in Pennsylvania, reported that 18% of 614 unmarried patients wound up getting married within 5 years of their surgery.
Bariatric cohorts have previously cited their desire for romantic partnership or improving relationships as one motivator for undergoing the weight loss procedure, King’s group noted in Annals of Surgery Open.
While the study didn’t include a comparator group, the researchers pointed out that this marriage rate was higher than expected — exceeding that of the general population, which saw a 6.9% rate over a similar time period.
Yet in the study, 13% of the 827 married patients ended up separating from their partner in the 5 years after surgery, 8% of which ended in divorce. The researchers highlighted that this number was likewise higher than the general population’s divorce rate of 3.5%.
“This could indicate that a patient’s changing lifestyle post-surgery put them out of sync with their spouse,” said King in a statement. “It can be really hard when one spouse changes what they eat and how active they are, and desires more sexual activity, while the other doesn’t. That can put significant strain on a marriage.”
She advised that couples consider this and develop strategies to maintain their connection after surgery.
“Our relationships with others — particularly lifelong partners — have been shown to have a profound impact on our health, both physical and mental,” said King. “It will be important for future studies to disentangle the directionality of the various associations between bariatric surgery and relationship status that we uncovered in this study so doctors can best counsel their patients and manage expectations before and after surgery.”
The six-center study included 1,441 adults from the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) cohort, who underwent either Roux-en-Y gastric bypass or sleeve gastrectomy between 2006 and 2009. As expected with a bariatric patient population, 79% were women with a median age of 47.
Prior to surgery, the median body mass index (BMI) was 47 kg/m2. A total of 57% were married at baseline, 5% cohabitating, 4% separated, 15% divorced, 2% widowed, and 17% always single.
There were certain predictors for which patients would be more likely to partner up after bariatric surgery: the top predictor was existing cohabitation with an individual, increasing the chances of marriage by 5.25-fold in an adjusted model. Also, compared with patients who were always single, being previously separated increased one’s chances of marriage post-op (HR 3.03, 95% CI 1.46-6.29).
Other preoperative predictors of marriage after bariatric surgery included being a younger patient (HR 1.69 per 10 years, 95% CI 1.34-2.13), having a college degree versus high school or less education (HR 2.36, 95% CI 1.19-4.71), lower BMI (HR 1.54 per 10 kg/m2, 95% CI 1.11-2.12), and having fewer depressive symptoms (HR 1.47 per 10 Beck Depression Inventory points, 95% CI 1.01-2.16).
For separation or divorce after bariatric surgery, preoperative predictive factors included being female (HR 2.08, 95% CI 1.09-3.96), being younger (HR 1.84 per 10 years, 95% CI 1.46-2.34), having a household income less than $25,000 (HR 2.48 vs $100,000 or more, 95% CI 1.08-5.71), smoking (HR 1.76, 95% CI 0.99-3.11), and having sexual desire once per week or more versus never (HR 2.12, 95% CI 1.05-4.28).
King and colleagues acknowledged that their observational study was unable to account for multiple changes in marital status between assessments.
King and coauthors reported no disclosures.