Weight loss surgery doubles chance of marriage or divorce, study reveals

Pennsylvania, USA: A new cohort study in the Annals of Surgery Open found that adults who are not married and get bariatric surgery are more than twice as likely to get married within 5 years compared to the general US population. Also, adults who are married and get weight loss surgery are more than twice as likely to get divorced. 

Globally, approximately 13% of adults are obese (men: 11%, women: 15%). They are at increased risk for many serious diseases and health conditions. Bariatric surgery such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), have become standard modalities for treating severe obesity and generally lead to sustainable improvements in weight, glycemic control, and other aspects of physical health. These procedures may also lead to improvements in mental health, self-esteem, body image, sexual desire, and comfort with physical intimacy.

Health issues dominate the motivation, but spousal encouragement and finding a life partner are self-reported motivators for seeking surgery. Qualitative studies examining the effect of bariatric surgery on interpersonal relationships note both improvements and declines in existing relationships, as well as increased romantic interest from others. However, there is a lack of research quantifying changes in the relationship or marital status, or examining factors related to changes in the relationship or marital status.

Wendy King, University of Pittsburgh, PA and her research team conducted a study to evaluate changes in marital status following Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).

Researchers included 1441 adults who underwent RYGB or SG in the study. Participants self-reported marital status preoperatively and annually postoperatively for ≤5 years. Time to change in marital status was analyzed with Kaplan–Meier estimates of cumulative incidence and Cox proportional-hazard models. In preoperative, 57% of participants (79% female, median age 47 years, median BMI- 47 kg/m2) were married, 5% cohabitating, 4% separated, 15% divorced, 2% widowed, and 17% always single.

Key findings of the study,

• The 5-year cumulative incidence of marriage among unmarried participants (N = 614) was 18%.

• Cohabitating (HR = 5.25) or being separated (HR = 3.03) versus always single, younger age (HR = 1.69/10 years), having a college degree versus ≤high school (HR = 2.36), lower BMI (HR = 1.54/10kg/m2), and fewer depressive symptoms (HR = 1.47/10 Beck Depression Inventory points) preoperative independently predicted higher chance of marriage.

• The 5-year cumulative incidence of separation/divorce among married participants (N = 827) was 13%

• Female sex (HR = 2.08), younger age (HR = 1.84/10 years), household income <$25,000 versus ≥$100,000 (HR = 2.48), smoking (HR = 1.76), and sexual desire ≥once/week versus never (HR = 2.12) preoperative independently predicted separation/divorce.

The authors conclude that undergoing RYGB or SG did not change marital status in the majority of the adults within 5 years of the surgery. However, approximately18% of unmarried participants got married and 14% of married participants got separated or divorced after surgery.

Several preoperative predictors of marriage and separation or divorce, usually seen in the general population were identified during the study. The study also showed that greater weight loss was related to a higher chance of postoperative separation or divorce but not marriage.

Reference:

King, Wendy C PhD*; Hinerman, Amanda S PhD*; White, Gretchen E PhD† Changes in Marital Status Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: A US Multicenter Prospective Cohort Study, Annals of Surgery Open: September 2022 - Volume 3 - Issue 3 - p e182 doi: 10.1097/AS9.0000000000000182