Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Bariatric Surgery

Changes in relationship status following bariatric surgery

Abstract

Background and objective

Bariatric surgery is a major event associated with psychological changes such as improvements in self-esteem, increased autonomy, and better self-value. Such changes could affect the patient’s interpersonal relationships; however, little is known about the impact of bariatric surgery on changes in relationship status. In this paper, we aim to test the hypothesis that bariatric surgery is associated with changes in interpersonal relationships such as becoming single for those who were in a relationship or entering a relationship among those who were single before surgery.

Methods

This register-based cohort study consisted of 12,493 patients undergoing bariatric surgery (95% gastric bypass) from 2005 to 2013 and a reference group of 15,101 individuals with obesity between the age of 18–63 with a body mass index between 32 and 60 kg/m2. Transitions between married, divorced, widowed, never-married single, and living with a partner without being married were analyzed by Poisson regression. Additionally, the outcome was dichotomized, and transitions between being single and being in a relationship were also analyzed. All analyses were weighted using inverse probability of treatment weighting based on propensity scores.

Results

The overall incidence rate ratio (IRR) of changing status from being single to in a relationship was 2.03 (95% CI: 1.18–2.28), and the overall IRR of changing status from being in a relationship to single was 1.66 (95% CI: 1.50–1.83).

Conclusion

Bariatric surgery is associated with a higher chance of finding a partner among single individuals, and a higher risk of separating from a partner among individuals in a relationship.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Balance of covariates.
Fig. 2: The effects of age and education on chances of entering a new relationship.
Fig. 3: The effects of age and education on the risk of becoming single.

References

  1. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.

    Article  CAS  Google Scholar 

  2. Herring LY, Stevinson C, Davies MJ, Biddle SJ, Sutton C, Bowrey D, et al. Changes in physical activity behaviour and physical function after bariatric surgery: a systematic review and meta‐analysis. Obesity Rev. 2016;17:250–61.

    Article  CAS  Google Scholar 

  3. Coulman KD, MacKichan F, Blazeby JM, Owen‐Smith A. Patient experiences of outcomes of bariatric surgery: a systematic review and qualitative synthesis. Obesity Rev. 2017;18:547–59.

    Article  Google Scholar 

  4. Kalarchian MA, Marcus MD. Psychosocial concerns following bariatric surgery: current status. Current Obesity Rep. 2019;8:1–9.

    Article  Google Scholar 

  5. Hult M, Bonn SE, Brandt L, Wirén M, Lagerros YT. Women’s satisfaction with and reasons to seek bariatric surgery—a prospective study in Sweden with 1-year follow-up. Obes Surg. 2019;29:2059–70.

    Article  Google Scholar 

  6. Pearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: factors motivating the decision to seek bariatric surgery. Surg Obesity Rel Dis. 2019;15:636–42.

    Article  Google Scholar 

  7. Sharman MJ, Venn AJ, Hensher M, Wilkinson S, Palmer AJ, Williams D, et al. Motivations for seeking bariatric surgery: the importance of health professionals and social networks. Bariatric Surg Pract Patient Care. 2016;11:104–9.

    Article  Google Scholar 

  8. Lier HØ, Aastrom S, Rørtveit K. Patients’ daily life experiences five years after gastric bypass surgery–a qualitative study. J Clin Nurs. 2016;25:322–31.

    Article  Google Scholar 

  9. Bruze G, Holmin TE, Peltonen M, Ottosson J, Sjöholm K, Näslund I, et al. Associations of bariatric surgery with changes in interpersonal relationship status: results from 2 Swedish cohort studies. JAMA Surg. 2018;153:654–61.

    Article  Google Scholar 

  10. Carr D, Friedman MA. Body weight and the quality of interpersonal relationships. Soc Psychol Q. 2006;69:127–49.

    Article  Google Scholar 

  11. Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity. 2006;14:1802–15.

    Article  Google Scholar 

  12. Dush CMK, Amato PR. Consequences of relationship status and quality for subjective well-being. J Soc Pers Relatsh. 2005;22:607–27.

    Article  Google Scholar 

  13. Sarwer DB, Wadden TA, Moore RH, Eisenberg MH, Raper SE, Williams NN. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis. 2010;6:608–14.

    Article  Google Scholar 

  14. Burgmer R, Legenbauer T, Müller A, de Zwaan M, Fischer C, Herpertz S. Psychological outcome 4 years after restrictive bariatric surgery. Obes Surg. 2014;24:1670–8.

    Article  Google Scholar 

  15. Wallwork A, Tremblay L, Chi M, Sockalingam S. Exploring partners’ experiences in living with patients who undergo bariatric surgery. Obes Surg. 2017;27:1973–81.

    Article  Google Scholar 

  16. Lynge E, Sandegaard JL, Rebolj M. The Danish National Patient Register. Scand J Public Health. 2011;39:30–3.

    Article  Google Scholar 

  17. Christensen AI, Ekholm O, Glumer C, Andreasen AH, Hvidberg MF, Kristensen PL, et al. The Danish National Health Survey 2010. Study design and respondent characteristics. Scand J Public Health. 2012;40:391–7.

    Article  Google Scholar 

  18. Ekholm O, Hesse U, Davidsen M, Kjoller M. The study design and characteristics of the Danish national health interview surveys. Scand J Public Health. 2009;37:758–65.

    Article  Google Scholar 

  19. Eriksen L, Gronbaek M, Helge JW, Tolstrup JS, Curtis T. The Danish Health Examination Survey 2007–2008 (DANHES 2007–2008). Scand J Public Health. 2011;39:203–11.

    Article  Google Scholar 

  20. Pedersen CB. The Danish Civil Registration System. Scand J Public Health. 2011;39:22–5.

    Article  Google Scholar 

  21. Jensen VM, Rasmussen AW. Danish Education Registers. Scand J Public Health. 2011;39:91–4.

    Article  Google Scholar 

  22. Baadsgaard M, Quitzau J. Danish registers on personal income and transfer payments. Scand J Public Health. 2011;39:103–5.

    Article  Google Scholar 

  23. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.

    Article  CAS  Google Scholar 

  24. Sturmer T, Rothman KJ, Avorn J, Glynn RJ. Treatment effects in the presence of unmeasured confounding: dealing with observations in the tails of the propensity score distribution–a simulation study. Am J Epidemiol. 2010;172:843–54.

    Article  Google Scholar 

  25. Hachem A, Brennan L. Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 2016;26:395–409.

    Article  Google Scholar 

  26. Sogg S, Gorman MJ. Interpersonal changes and challenges after weight-loss surgery. Primary Psychiatry. 2008;15:61–6.

    Google Scholar 

  27. Moore DD, Cooper CE. Life after bariatric surgery: perceptions of male patients and their intimate relationships. J Marital Family Therapy. 2016;42:495–508.

    Article  Google Scholar 

  28. Szmulewicz A, Wanis KN, Gripper A, Angriman F, Hawel J, Elnahas A, et al. Mental health quality of life after bariatric surgery: a systematic review and meta-analysis of randomized clinical trials. Clin Obes. 2019;9:e12290.

    Article  Google Scholar 

  29. Canetti L, Bachar E, Bonne O. Deterioration of mental health in bariatric surgery after 10 years despite successful weight loss. Eur J Clin Nutr. 2016;70:17–22.

    Article  CAS  Google Scholar 

  30. Bocchieri LE, Meana M, Fisher BL. Perceived psychosocial outcomes of gastric bypass surgery: a qualitative study. Obes Surg. 2002;12:781–8.

    Article  Google Scholar 

  31. Pories ML, Hodgson J, Rose MA, Pender J, Sira N, Swanson M. Following bariatric surgery: an exploration of the couples’ experience. Obes Surg. 2016;26:54–60.

    Article  Google Scholar 

  32. Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.

    Article  Google Scholar 

  33. Lazzati A, Chatellier G, Katsahian S. Readmissions after bariatric surgery in France, 2013–2016: a Nationwide Study on Administrative Data. Obes Surg. 2019;29:3680–9.

    Article  Google Scholar 

  34. Bramming M, Becker U, Jørgensen MB, Neermark S, Bisgaard T, Tolstrup JS. Bariatric surgery and risk of alcohol use disorder: a register-based cohort study. Int J Epidemiol. 2020;49:1826–35.

    Article  Google Scholar 

  35. Kitzinger HB, Abayev S, Pittermann A, Karle B, Bohdjalian A, Langer FB, et al. After massive weight loss: patients’ expectations of body contouring surgery. Obes Surg. 2012;22:544–8.

    Article  Google Scholar 

  36. Müller A, Hase C, Pommnitz M, de Zwaan M. Depression and suicide after bariatric surgery. Curr Psychiatry Rep. 2019;21:84.

    Article  Google Scholar 

  37. Peterhänsel C, Petroff D, Klinitzke G, Kersting A, Wagner B. Risk of completed suicide after bariatric surgery: a systematic review. Obes Rev. 2013;14:369–82.

    Article  Google Scholar 

  38. Somers AR. Marital status, health, and use of health services: an old relationship revisited. JAMA. 1979;241:1818–22.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

MB and JST designed the study. JST performed analysis. MB and JST interpreted data and MB, SSH, and JST drafted the article. All authors actively contributed to the final manuscript by revising it critically for important intellectual content and approved the final version to be published. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Corresponding author

Correspondence to Janne S. Tolstrup.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Ethical approval

The study was approved by the Danish Data Protection Agency reference number 2015-57-0008. Manual chart review with data collection was performed with the approval of Danish Patient Safety Authority (former National Board of Health) with reference number 3-3013-770/1.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Bramming, M., Hviid, S.S., Becker, U. et al. Changes in relationship status following bariatric surgery. Int J Obes 45, 1599–1606 (2021). https://doi.org/10.1038/s41366-021-00825-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-021-00825-2

Search

Quick links