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Bariatric surgery patients may see benefits to their sex lives

Bariatric surgery may provide sexual benefits in addition to weight loss and diabetes protection, a new study suggests.

Research published on Nov. 4 in JAMA Surgery shows that women who underwent bariatric surgery had better sexual functioning, improvements in levels of reproductive hormones and better health-related and weight-related quality of life after their procedures.

"When we think about extreme obesity and sexual behavior, it's one of these 'don't ask, don't tell' issues," lead researcher David Sarwer, a psychology professor at the University of Pennsylvania's Perelman School of Medicine, told Businessweek. "What this study really shows us is that women experience clinically significant changes within the first year, and sexual behavior is clearly one of these areas."

Bariatric surgery, or weight loss surgery, may bean option for people who are severely obese to lose weight. There are four different types of bariatric surgery, but they often work by restricting the amount of food the person takes in, adjusting how the person absorbs nutrients or manipulating how they digest food.

Researcher examined 106 women who were enrolled in the Longitudinal Assessment of Bariatric Surgery that has tracked them since 2005. They had a median body mass index (BMI) -- a ratio between height and weight used to determine if a person is underweight, normal weight, overweight or obese -- of 44.5, putting them in the obese category (BMI over 30 is considered obese).

Eighty-five of the women underwent a Roux-en-Y gastric bypass, and 21 women had the laparoscopic adjustable gastric banding procedure done.

Roux-en-Y gastric bypass is a surgical procedure that shrinks the size of the stomach by stapling a section of it to make a smaller pouch. The doctors then reattach the small intestine to the smaller pouch. This allows the food to skip the majority of the stomach and the upper part of the small intestine.

Laparoscopic adjustable gastric banding is when a doctor places a band around the upper part of the stomach to separate it from the lower part. The upper portion becomes a smaller bag that has a narrow opening that leads to the lower portion. The size of the pouch can be can be adjusted by increasing or decreasing the amount of saline solution stored inside a reservoir connected to the band. The procedure does not involve any cutting or stapling inside of abdomen.

New Jersey governor Chris Christine underwent the procedure in February.

The women in the study lost an average of 32.7 percent of their body weight in the first year following surgery, and kept up the weight loss by losing about 33.5 percent of their initial body weight during the second postoperative year.

They were asked to complete surveys on their sex lives, and their hormone levels were measured through blood samples. Another questionnaire recorded their quality of life, body image, depressive symptoms and marital life quality.

Two years after the surgery, women said they had improvements in their overall sexual functioning, and improvements in arousal, lubrication, desires and satisfaction.

They also said they had better quality of life in most categories, better body image and fewer depressive symptoms just one year out of surgery, with the positive changes persisting through the second year.

Women also had changes in levels of all the sexual hormones that the researchers looked at by two years after surgery.

"These results suggest that improvements in sexual health may be added to the list of benefits associated with large weight losses seen with bariatric surgery," the study authors wrote. "Future studies should investigate if these changes endure over longer periods of time, and they should investigate changes in sexual functioning in men who undergo bariatric surgery."

Alison Field, an epidemiologist at Children's Hospital Boston, pointed out in an accompanying editorial that the study cohort selected which type of bariatric surgery they wanted, so this may have affected the results. She called for more studies to look at the effects of different methods of bariatric surgery on weight loss and other health benefits.

"We don't think all breast cancer should be treated the same -- not at all," Field told NPR. "We need to start thinking the same way with obesity."

"If you look at Weight Watchers, it's focused on education and navigating social situations," she added. "It works very well for some people, but not others. We need to figure who the subgroups are and how to match the best treatment to them. We have a ways to go to get there."

Other studies have shown that bariatric surgery can help mothers pass on healthier genes to their children, as well as improve heart health for patients.

Bariatric surgery has also been linked to preventing Type 2 diabetes and reversing some obesity-related health conditions.

However, another study showed that while the bariatric surgery group did have an improvement in lowering their Type 2 diabetes risk, they had more nutritional problems than those who just used lifestyle management to control their weight. Gastric bypass patients have also been linked to an increased risk for alcoholism.

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