Sexual life after weight loss surgery.

BACKGROUND: Previous research revealed a relationship between higher body mass index (BMI) and lower sexual functioning. However, the role of psychosocial variables, such as body image, in this relationship has been understudied. OBJECTIVE: To assess sexual life before and after weight loss surgery (WLS) and examine the role of body image and BMI in these changes. SETTING: WLS center at a major urban community hospital. METHODS: 327 participants (275 women and 52 men) who underwent either laparoscopic Roux-en-Y gastric bypass surgery (n = 225) or laparoscopic adjustable gastric band (n = 102) were assessed on measures of sexual life preoperatively and at 1, 3, 6, 12, and 24 months after surgery. The number of completers were n = 126 at 1-month follow-up, n = 84 at 3 months, n = 86 at 6 months, n = 84 at 12 months, and n = 55 at 24 months. RESULTS: There was a significant increase in quality of sexual life over time, F(5,479.5) = 24.3, P<.001. Greater body image dissatisfaction predicted lower quality of sexual life when controlling for BMI, F(1,580.3) = 36.9, P<.001, but BMI did not predict quality of sexual life when controlling for body dissatisfaction, F(1,566.6)<.01, P = .94. A mediation analysis revealed that the relationship BMI had with sexual life was through its influence on body dissatisfaction. CONCLUSION: Participants experienced improvements in quality of sexual life over time after WLS, and decrease in body image dissatisfaction was the strongest predictor of these improvements. These results underscore the importance of body image, independent of weight loss, in postsurgical sexual life.

Weight-based rejection sensitivity: Scale development and implications for well-being.

We integrated theories of social stigma and rejection sensitivity to develop a new construct for understanding the effects of day-to-day experiences of interpersonal weight stigma: weight-based rejection sensitivity (W-RS), or a tendency to anxiously expect weight-based rejection. We created a new scale to measure W-RS. Studies 1 and 2 together established the scale as valid and reliable in a college student population. Study 3 examined the outcomes and predictive validity of W-RS by testing the effects of W-RS longitudinally across college students' first semester. Those who were high in W-RS were found to be at additional risk for compromised psychological and physical well-being over time. W-RS also predicted poorer adjustment to college. Overall, W-RS could help to explain individual reactions to stigma and to predict when weight stigmatization may have a greater likelihood of impacting a target.

Examining a ripple effect: do spouses' behavior changes predict each other's weight loss?

BACKGROUND: Including spouses in obesity treatment has been found to promote weight loss. We assessed whether spouses' diet and activity changes impacted each other's weight loss when both members attended an active weight loss program (TOGETHER) or only the primary participant attended treatment (ALONE). METHODS: Heterosexual couples (N = 132) enrolled in an 18-month randomized controlled weight loss trial were weighed and completed measures of dietary intake and physical activity at baseline and 6 months. We conducted dyadic data analyses using the Actor-Partner Interdependence Model. RESULTS: Participants' weight loss was not predicted by their partners' behavior changes. However, partners' weight loss was predicted by their participants' changes in calorie and fat intake. When partners were coupled with a participant who did not reduce their own calorie and fat intake as much, these partners had higher weight loss when treated in the TOGETHER group but lower weight loss when they were untreated in the ALONE group. There were no reciprocal effects found with physical activity changes. CONCLUSIONS: Direct treatment had the greatest impact on participants and partners who were treated. Untreated partners' weight losses were positively impacted by their spouses' dietary changes, suggesting a ripple effect from treated spouses to their untreated partners.