Study Figure 1 – Cumulative incidence of postoperative changes in marital status among all participants.
The first research paper Dr. Wendy King talked about:
Weight loss is usually the main goal of these procedures, but some are concerned with relieving type 2 diabetes and improving joint pain, and some patients describe ‘the desire to improve their relationship’ as an important motivator for them.
Before this study, however, there was no such quantitative reference data in the United States—that is, are patients more likely to end up in a divorce, or have a secure relationship?
Study Figure 2 – Cumulative incidence of postoperative marriage among unmarried participants.
With this in mind, Wendy King and colleaguesAnalysis of 1441 Americans who underwent Roux-en-Y gastric bypass, or sleeve gastrectomy, between 2006 and 2009data — also the two most common and effective shell surgeries used to treat severe obesity.
Participants ranged in age from 19 to 75, and 79 percent were women. It found that 62% of patients were married or living with a partner at the time of surgery, while the rest were separated, divorced, widowed, or remained single.
Study Figure 3 – Cumulative incidence of postoperative separation or divorce among married/cohabiting participants.
It is reported that as part of the LABS-2 longitudinal assessment,The National Institutes of Health (NIH) funded this prospective cohort study of patients undergoing bariatric surgery in the United States.
Similar to previous studies in Scandinavia, the vast majority of LABS-2 patients maintained their partner relationships for five years after surgery.
Of those, 81 percent remained married, with as many as 70 percent of those who remained single unchanged, and 18 percent of those who were never married got married.
For reference, this rate is 7% for the general U.S. population, and the divorce rate for married participants is 8%. The figure for the general population is 4%, and 5% of non-divorced married people are separated.
Table 1 – Patient statistics during surgery, overall and marital status.
Wendy King noted that there are a number of factors that increase a patient’s relationship changes after surgery.
Some factors were to be expected, such as patients living together before surgery were more likely to marry their spouses in the next five years.
Other unexpected factors, such as weight loss, were not related to whether some people were married, but only to an overall improvement in their physical condition.
Table 2 – Number of “risk events” for U.S. adults by preoperative marital status.
However, among the separated and divorced groups, those who lost more weight and had increased sexual desire after surgery were more likely to be separated or divorced.
This may indicate that patients’ lifestyle changes after surgery have not been synchronized with those of their spouses.
When one partner changes their eating habits and activity levels and desires more sexual activity, it can put considerable stress on the marriage if the other partner doesn’t change in sync.
It may become even more important for couples to weigh these factors when developing a surgical strategy.
Table 3 – Postoperative marital hazard ratios for U.S. adults by preoperative characteristics.
However, Wendy King also emphasized that the LABS-2 study did not ask participants whether “expectations for changes in the partnership” were one of their motivations for choosing surgery, so they could not determine whether married or divorced participants wanted surgical changes. .
Table 4 – Risk-Adjusted Ratios for Postoperative Separation or Divorce for Adults Married at the Time of Surgery.
Wendy King concludes: “Our relationships with others – especially lifelong partners – have been shown to have a profound impact on physical and mental health”.
Dr. Wendy King (Photo: University of Pittsburgh)
Going forward, she hopes to further clarify “the various bidirectional associations of bariatric surgery and relationship status” so that physicians can provide patients with better preoperative counseling and management of postoperative expectations.