In recent years, bariatric surgery has emerged as a popular weight-loss solution, offering hope and improved health for individuals struggling with obesity. This surge in popularity has led to increased curiosity and concern, prompting researchers to investigate the intricate effects of significant weight loss on relationships. Studies have revealed a concerning trend: the divorce rate after bariatric surgery is nearly double that of the general population. However, it's important to note that even with an increase in the divorce rate, most marriages in the study were unchanged, said epidemiologist and lead author Wendy King, PhD. In fact, 81% of couples were still married 5 years after surgery.
The Impact of Transformation
One prevalent theme in these studies is the significant impact of the transformation following bariatric surgery. The partner who undergoes surgery may experience newfound attention and validation, leading to a shift in the balance of power within the relationship. This transformation can be both physical and emotional, affecting not only the individual but also the dynamics of their relationships.
Emotional Rollercoaster
The emotional rollercoaster that accompanies weight loss is not limited to the individual undergoing surgery. Both partners may experience a range of emotions, including joy, anxiety, and insecurity. These emotional shifts can create tension and strain on the relationship, particularly if communication is lacking.
Physical Intimacy
Physical intimacy is a crucial component of many romantic relationships. However, issues such as mismatched libidos, body image concerns, or performance anxiety may arise after bariatric surgery, causing strain on the relationship. Open communication and a willingness to address these issues are essential for maintaining a healthy physical connection.
The Importance of Support Systems
The success of bariatric surgery often hinges on robust support systems. This includes not only medical professionals but also family and friends. A supportive partner can play a crucial role in helping the individual navigate the challenges of weight loss and lifestyle changes.
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Predictors of Marriage and Divorce
Certain studies have identified predictors linked to both marriage and divorce after bariatric surgery. Younger participants and those living with a partner before surgery were more likely to get married throughout the following five years. Conversely, factors such as poor family relations before surgery, a high sexual desire after surgery, and a history of previous divorce/separation were associated with an increased risk of divorce.
Personal Stories
Steven Jason Williams, a successful YouTuber known as Boogie2988, underwent gastric bypass in August 2017. Before the surgery, he attended group sessions where he learned that many married patients divorce within years of the procedure. Williams, who weighed 587lbs (266kg) at his heaviest and relied on his wife, Desiree, for care, knew their marriage was already strained. Two months after the surgery, Desiree left. Despite the personal cost, Williams believes the surgery was the right choice, stating, "I would do it again just to give her that freedom and the option to end our codependent relationship, because it wasn’t working. I just wanted her to be happy."
Gary Cupid, a facilities manager from Hackney, east London, had a mini gastric bypass in June 2017 and lost 108lb (49kg). As he lost weight, he started working out and making friends, leading to increased confidence. However, his engagement ended two months after the surgery. Cupid believes his fiancee "didn’t feel comfortable with the friendships I’d gained … she felt that I’d become a different person."
Chloe, a therapist from Shropshire, had a gastric sleeve fitted and went from a size 28 to a 14. She realized how differently she was treated after the surgery, stating, "I didn’t realise how differently I was treated to everyone else until I was treated like everyone else. I thought it was me personally that repelled people, and that’s why strangers wouldn’t make eye contact with me." Chloe, who married young, is now separated and believes she shouldn't have gotten married in the first place, stating, "I got married because - there’s no other way of putting this - he was willing."
Kelly Graham, a team leader from Bedfordshire, had a gastric sleeve fitted in June 2018. Afterwards, Graham realized her marriage had been floundering for years. “I was too busy being miserable about my weight - that took over my life, more so than dealing with my relationship. But once I had the surgery and I started losing weight and feeling better about myself, I addressed the relationship.” They separated this year, after three years of marriage.
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Aisha Walker, from Kent, had a mini gastric bypass in March 2017. Within a month, Walker, who runs the Gastric Guru support group, had lost some of her best friends. “I wasn’t the friend who just sat in the corner and said yes all the time. I gained my own spirit, and that made them feel uncomfortable.”
The Role of Self-Esteem
Many pre-surgical patients suffer from low self-esteem, often stemming from weight-related issues experienced since childhood. Bariatric surgery can rebalance self-esteem, leading patients to recognize their self-worth. As Dr. Goldman recalled a patient who, before surgery, had very low self-worth. She wasn’t satisfied with her relationship but admitted to staying because she didn’t believe she could do any better than her current partner. After surgery, her perspective radically changed. She started to get healthier, invested in her education, and changed jobs. And when her partner refused to join her in making changes, she left.
Statistical Insights
A 2018 study found that, of nearly 1,000 obese patients in relationships who had had bariatric surgery, 9% had divorced or separated within four years of their surgery, compared with 6% in a control group. Patients who were single prior to their surgery were more likely to find love afterwards. Out of nearly 1,000 single patients, 21% got married or started a relationship within four years, compared with 11% of those who didn’t have the procedure.
Changes in relationship status after bariatric surgery were examined in 2 cohorts: (1) the prospective Swedish Obese Subjects (SOS) study and (2) participants from the Scandinavian Obesity Surgery Registry (SOReg). In the SOS study, bariatric surgery was associated with increased incidence of divorce/separation compared with controls for those in a relationship (adjusted hazard ratio [aHR] = 1.28; 95% CI, 1.03-1.60; P = .03) and increased incidence of marriage or new relationship (aHR = 2.03; 95% CI, 1.52-2.71; P < .001) in those who were unmarried or single at baseline. In the SOReg and general population cohort, gastric bypass was associated with increased incidence of divorce compared with married control participants (aHR = 1.41; 95% CI, 1.33-1.49; P < .001) and increased incidence of marriage in those who were unmarried at baseline (aHR = 1.35; 95% CI, 1.28-1.42; P < .001).
New research from the University of Pittsburgh found that people who have bariatric surgery double their chances of marriage or divorce. data follows two Scandinavian studies from 2018 and 2020 that found similar relationship changes after bariatric surgery. But the postsurgery divorce rate in the United States was only about half that found in the Danish and Swedish studies, according to the new study published in Annals of Surgery.
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population has a divorce rate of 3.5%, bariatric patients in the study had an 8% divorce rate. population.
The Importance of Counseling
It’s critical that patients receive more counseling on how choosing to have bariatric surgery can impact their relationship before and after their weight loss procedure, Dr. King said. It should be the standard of care.
Currently, relationship-specific counseling isn’t required, Dr. Goldman said. Most programs do require a psychosocial evaluation before surgery, “but they are quite varied.” And even in programs where relationships are mentioned, there often isn’t a psychologist or licensed mental health professional on the team.
Navigating the Challenges
Changes, even those that are positive and healthy, create a kind of crisis for relationships, Dr. Cole said. It’s not just bariatric surgery. Bringing a baby into the home, infertility treatments, and substance abuse recovery are all considered positive changes that are also predictors of relationship dissatisfaction and divorce, he said.
He advises creating a new “ritual of connection: moments in time when you plan to turn toward one another.”That could be a daily walk, where you intentionally talk about the surgery-related changes that both of you have had.