A study shows that bariatric surgery doubles the likelihood of getting married or getting divorced.
Adults who have weight-loss surgery are more than twice as likely to get married within five years as the overall U.S. population. Similarly, the recent study led by epidemiologists at the University of Pittsburgh School of Public Health found that adults who are married and have bariatric surgery are more than twice as likely to be divorced.
The study, which was published in Wolters Kluwer’s Annals of Surgery Open, is the first to characterize the marital outcomes of American adults who underwent weight-loss surgery, providing patients and medical professionals with concrete data on how romantic relationships change after the procedure.
“Weight loss is generally the goal of bariatric surgery, but people have a variety of motivators for wanting to lose weight – for example, remission of Type 2 diabetes and improvement in joint pain,” stated lead author Wendy King, Ph.D., associate professor of epidemiology at Pitt Public Health. “Patients have also described the desire for romantic partnership or improving relationships as important motivators. Before this study, we had no quantitative data in the U.S. on how marital status changes after bariatric surgery – are patients more likely to get married, divorced, find romantic stability?”
King and her colleagues analyzed data on 1,441 U.S. individuals who received Roux-en-Y gastric bypass or sleeve gastrectomy between 2006 and 2009, the two most frequent and effective surgical procedures for severe obesity. The participants varied in age from 19 to 75 years old, with 79% of them being female. 62% were married or living with a partner at the time of surgery, while the remainder were separated, divorced, widowed, or had always been single.
The patients were part of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study, a prospective, cohort study of patients undergoing weight-loss surgery in the U.S financed by the National Institutes of Health.
Consistent with prior Scandinavian research, the great majority of LABS-2 individuals maintained their relationship status for the five years following surgery, with 81% of married participants remaining married and 70% of always-single people remaining single. However, 18% of unmarried participants married, compared to 7% of the total U.S. population, and 8% of married participants divorced, compared to 4% of the general population. A further 5% of married individuals who did not divorce separated.
According to King, there were a number of factors that enhanced the likelihood of a participant changing their relationship status after surgery. Some were anticipated: Younger individuals and those who lived with a spouse prior to surgery were more likely to marry during the next five years. Some, though, were more surprising. For example, the amount of weight lost was not associated with whether someone got married but improved physical health was associated.
However, when it came to separation and divorce, those who dropped more weight, as well as those who reported an increase in sexual desire post-surgery, were more likely to become separated or divorced.
“This could indicate that a patient’s changing lifestyle post-surgery put them out of sync with their spouse,” King said. “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. It may be important for couples to consider this and have strategies to maintain their connection after surgery.”
King noted that the LABS-2 study did not ask participants whether a desire to change their romantic relationship status was among their motivations for getting bariatric surgery, so the team could not determine if the participants who got married or divorced went into surgery hoping for a change.
“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.”
Reference: “Changes in Marital Status Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: A US Multicenter Prospective Cohort Study” by Wendy C. King, Ph.D., Amanda S. Hinerman, Ph.D. and Gretchen E. White, Ph.D., 20 July 2022, Annals of Surgery Open.
No additional funding was provided for this study, but LABS-2 was funded through a cooperative agreement by the National Institute of Diabetes and Digestive Kidney Diseases.