Marriage and Weight Loss Surgery: a Narrative Review of Patient and Spousal Outcomes

Abstract

Long-term weight maintenance following weight loss surgery (WLS) may be challenging for patients without supportive spouses. The health behaviors and relationship quality of spouses pre- and post-WLS have rarely been explored, leaving providers with little guidance on how to engage spouses in treatment. The purpose of this review is to synthesize the empirical research on relationship factors and WLS among married couples. The identified articles (N = 13) reported that the amount of weight lost post-WLS tended to be lower for married patients, couples’ relationship quality tended to decline from pre- to post-WLS, and sexual contact increased post-WLS. Future research should explore how the relationship factors and quality of couples may influence patients’ WLS outcomes over time to identify ways that interventions can enhance the couple’s relationship and health.

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References

  1. 1.

    Obesity and Overweight. Center for Disease Control: National Center for Health Statistics. 2013.

  2. 2.

    Longitudinal assessment of bariatric surgery. National Institute of Diabetes and Digestive and Kidney Diseases: Washington, DC; 2010.

  3. 3.

    Melton GB, Steele KE, Schweitzer MA, Lidor AO, Magnuson TH. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes. J Gastrointest Surg. 2008;12(2):250–5.

    Article  PubMed  Google Scholar 

  4. 4.

    Elder KA, Wolfe BM. Bariatric surgery: a review of procedures and outcomes. Gastroenterology. 2007;132(6):2253–71.

    Article  PubMed  Google Scholar 

  5. 5.

    Torquati AL, Lutfi RE, Richards WO. Predictors of early quality of life improvement after laparoscopic gastric bypass surgery. Am J Surg. 2007;193(4):471–5.

    Article  PubMed  Google Scholar 

  6. 6.

    Dixon JB, Dixon ME, O’Brien PE. Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Obes Res. 2001;9(11):713–21.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241:540–5.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Umberson D. Gender, marital status, and the social control of health behavior. Soc Sci Med. 1992;34(8):907–17.

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Nealey-Moore JB, Smith TW, Uchino BN, Hawkins MW, Olson-Cerny C. Cardiovascular reactivity during positive and negative marital interactions. J Behav Med. 2007;30(6):505–19.

    Article  PubMed  Google Scholar 

  10. 10.

    Holt-Lunstad J, Birmingham W, Jones BQ. Is there something unique about marriage? The relative impact of marital status relationship quality, and network social support on ambulatory blood pressure and mental health. Ann Behav Med. 2008;35(2):239–44.

    Article  PubMed  Google Scholar 

  11. 11.

    Trief PM, Ploutz-Snyder R, Britton KD, Weinstock RS. The relationship between marital quality and adherence to the diabetes care regimen. Ann Behav Med. 2004;27(3):148–54.

    Article  PubMed  Google Scholar 

  12. 12.

    Rohrbaugh MJ, Mehl MR, Shoham V, Reilly ES, Ewy GA. Prognostic significance of spouse “we talk” in couples coping with heart failure. J Consult Clin Psychol. 2006;76(5):781–9.

    Article  Google Scholar 

  13. 13.

    Newton TL, Sanford JM. Conflict structure moderates associations between cardiovascular reactivity and negative marital interactions. Health Psychol. 2003;22(3):270–8.

    Article  PubMed  Google Scholar 

  14. 14.

    Brown PC, Smith TW, Benjamin LS. Perceptions of spouse dominance predict blood pressure reactivity during marital interactions. Ann Behav Med. 1998;20(4):286–93.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Baron KG, Smith TW, Czajkowski LA, Gunn HE, Jones CR. Relationship quality and CPAP adherence in patients with obstructive sleep apnea. Behav Sleep Med. 2009;7(1):22–36.

    Article  PubMed  Google Scholar 

  16. 16.

    Smith TW, Uchino BN, Berg CA, Florsheim P, Pearce G, Hawkins M, et al. Associations of self-reports versus spouse ratings of negative affectivity, dominance, and affiliation with coronary artery disease: where should we look and who should we ask when studying personality and health? Psychosom Med. 2007;69(5):441–8.

    Article  PubMed  Google Scholar 

  17. 17.

    Orth-Gomer K, Wamala SP, Horsten M, Schneck-Gustafsson K, Schneiderman N, Mittleman MA. Marital stress worsens prognosis in women with coronary heart disease. J Am Med Assoc. 2000;228(23):3008–14.

    Article  Google Scholar 

  18. 18.

    Kurdek LA. Gender and marital satisfaction early in marriage: a growth curve approach. J Marriage Fam. 2005;67(1):68–84.

    Article  Google Scholar 

  19. 19.

    Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up. Obes Surg. 2000;10(3):233–9.

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S,…Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26)L:2683–93.

  21. 21.

    Brolin RL, Robertson LB, Kenler HA, Cody RP. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg. 1994;220(6):782.

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  22. 22.

    Bond DS, Phelan S, Wolfe LG. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity. 2009;17:78–83.

    Article  PubMed  Google Scholar 

  23. 23.

    Orth WS, Madan AK, Taddeucci RJ, Coday M, Tichansky DS. Support group meeting attendance is associated with better weight loss. Obes Surg. 2008;18(4):391–4.

    Article  PubMed  Google Scholar 

  24. 24.

    McCubin HI, Patterson JM. The family stress process: the double ABCX model of adjustment and adaptation. Marriage Fam Rev. 1983;6(1–2):7–37.

    Article  Google Scholar 

  25. 25.

    Thoits PA. Stress, coping, and social support processes: where are we? What next? J Health Soc Behav. 1995; Spec No: 53–79.

  26. 26.

    Bertalanffy LV. Problems of life. New York: Harper; 1952.

    Google Scholar 

  27. 27.

    Uman LS. Systematic reviews and meta-analyses. J Can Acad Child Adolesc Psychiatry. 2011;20(1):57–9.

    PubMed Central  PubMed  Google Scholar 

  28. 28.

    Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. J Am Med Assoc. 2005;294(15):1909–17.

    CAS  Article  Google Scholar 

  29. 29.

    Hafner RJ, Rogers J, Watts JM. Psychological status before and after gastric restriction as predictors of weight loss in the morbidly obese. J Psychosom Res. 1990;34(3):295–302.

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Sschultz W. The Firo sides manual. Palo Alto: Consulting Psychologists; 1967.

    Google Scholar 

  31. 31.

    Lutfi RT, Torquati A, Sekahr N, Richards WO. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc Interv Tech. 2006;20(6):864–7.

    CAS  Article  Google Scholar 

  32. 32.

    Wheeler E, Prettyman A, Leohard MJ, Tran K. Adherence to outpatient programs postoperative appointments after bariatric surgery. Surg Obes Relat Dis. 2008;4(4):515–20.

    Article  PubMed  Google Scholar 

  33. 33.

    Poblo-Krauze RJ, McCarroll ML, Pasini D, Dan AG, Zografakis JG. The effect of marital status on weight loss after bariatric surgery is moderated by depression. J Obes Weight Loss Ther. 2011;1(104):2.

    Google Scholar 

  34. 34.

    Ray EC, Nickels MW, Sayeed S, Sax HC. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134(4):555–63.

    Article  PubMed  Google Scholar 

  35. 35.

    Canetti L, Berry EM, Elizur Y. Psychosocial predictors of weight loss and psychological adjustment following bariatric surgery and a weight-loss program: the mediating role of emotional eating. Int J Eat Disord. 2009;42(2):109–17.

    Article  PubMed  Google Scholar 

  36. 36.

    Kinzl JF, Trefalt E, Fiala M, Hotter A, Biehl W, Aigner F. Partnership, sexuality, and sexual disorders in morbidly obese women: consequences of weight loss after gastric banding. Obes Surg. 2001;11(4):455–8.

    CAS  Article  PubMed  Google Scholar 

  37. 37.

    Mamplekou E, Komesidou V, Bissias CH, Papakonstantinou A, Melissas J. Psychological condition and quality of life in patients with morbid obesity before and after surgical weight loss. Obes Surg. 2005;15(8):1177–84.

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Derogatis LR. Brief symptom inventory 18. Minneapolis: NCS Pearson; 2000.

    Google Scholar 

  39. 39.

    Hafner RJ, Rogers J. Husbands’ adjustment to wives’ weight loss after gastric restriction for morbid obesity. Int J Obes. 1990;14(12):1069–78.

    CAS  PubMed  Google Scholar 

  40. 40.

    Hafner RJ, Watts JM, Rogers J. Quality of life after gastric bypass for morbid obesity. Int J Obes. 1991;15(8):555–60.

    CAS  PubMed  Google Scholar 

  41. 41.

    Camps MA, Zervos E, Goode S, Rosemurgy AS. Impact of bariatric surgery on body image perception and sexuality in morbidly obese patients and their partners. Obes Surg. 1996;6(4):356–60.

    Article  PubMed  Google Scholar 

  42. 42.

    Hafner RJ. Morbid obesity: effects on the marital system of weight loss after gastric restriction. Psychother Psychosom. 1991;56(3):162–6.

    CAS  Article  PubMed  Google Scholar 

  43. 43.

    Huang CY, Hsu MC, Pan KC, Huang CK, Chi SC. Early health status and health-related quality of life after laparoscopic gastric bypass surgery in morbidly obese patients. Bariatric Nurs Surg Patient Care. 2011;6(4):193–200.

    Article  Google Scholar 

  44. 44.

    Byers ES. Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. J Sex Res. 2005;42(2):113–8.

    Article  PubMed  Google Scholar 

  45. 45.

    Needleman BJ, Happel LC. Bariatric surgery: choosing the optimal procedure. Surg Clin N Am. 2008;88(5):991–1007.

    Article  PubMed  Google Scholar 

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Correspondence to Megan Ferriby.

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Ferriby, M., Pratt, K.J., Balk, E. et al. Marriage and Weight Loss Surgery: a Narrative Review of Patient and Spousal Outcomes. OBES SURG 25, 2436–2442 (2015). https://doi.org/10.1007/s11695-015-1893-2

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Keywords

  • Weight loss surgery
  • Marriage
  • Narrative review