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Study results show longer-term impact of weight loss surgery on sexual function

February 20, 2019 – Fargo, North Dakota – Patients who undergo bariatric surgery for obesity may experience positive results in a variety of areas including sexual function. A team of researchers led by Kristine Steffen, PharmD., Ph.D. in North Dakota State University’s College of Health Professions found the positive results of such surgery on sexual function may be longer lasting than previously known.

Approximately half of those participating in the research study reported the post-surgical improvements continued in their satisfaction with sexual life over five years. Results of the study are published in JAMA Surgery. According to the Journal Citation Reports, the journal's 2017 impact factor is 8.498, ranking it second out of 200 journals in the category "Surgery.”

As professor of pharmaceutical sciences in the NDSU School of Pharmacy, and director of biomedical sciences in the Center for Biobehavioral Research at Sanford Research, Steffen led the study. doi:10.1001/jamasurg.2018.1162

“Previously, it was not widely known what the longer-term impact of bariatric surgery may be on sexual function,” said Steffen. “Our longitudinal study results completed with a larger co-hort highlight that for a subset of patients who undergo such surgery, benefits may be longer lasting in specific areas of sexual function.”

After five years post surgery, 50 percent of the 2,215 individuals participating in the study reported that their sexual function and satisfaction remained improved. This result applied to both men and women. For women in the study, more than one-third reported improvements in frequency of sexual desire (41%) and sexual activity (35%) five years after surgery. At least half of men experienced improvements in sexual activity, satisfaction, desire and frequency.

Before the bariatric surgery, 70 percent of females and 74 percent of males in the study were not satisfied with sexual function. A year after surgery, about 56 percent of women experienced improvements in satisfaction with their sexual life and by five years after surgery, this number remained at a similar 52 percent. A similar observation was reported in men, wherein improvement was present in about 50 percent of men at both post-surgical time points.

The type of bariatric surgery performed did not impact study results.

The study was conducted at 10 hospitals in six clinical centers in the U.S. among patients undergoing their first bariatric procedure from 2006 to 2009. Follow up continued through August 2014. Participants completed questionnaires before their procedures and annually after that to the five-year mark.

In addition, study results suggested that patients who experienced greater improvement in depression symptoms after surgery, also experienced greater improvement in several aspects of sexual functioning. This could be a future area of study, according to Steffen.

“These findings provide new evidence to reinforce and extend findings of previous, smaller studies examining sexual functioning in women and men after bariatric surgery which have collectively, although not uniformly, shown improvement in sexual functioning following bariatric surgery,” concluded study authors.

Strengths of the study included its large sample size, 5-year duration of follow-up, and examination of comorbid factors associated with changes in sexual functioning. The study’s limitations include:  lack of a nonsurgical control group, nor did it randomize participants to surgery.

The study’s authors also concluded: “Clinicians should assess patient satisfaction with sexual functioning before and after bariatric surgery. They should also consider interventions targeted to modifiable factors that may influence the likelihood of improvement.”

Co-authors of the research study are:  Wendy King, Ph.D., University of Pittsburgh Graduate School of Public Health; Gretchen White, Ph.D., University of Pittsburgh Graduate School of Public Health and University of Pittsburgh Medical Center; Leslee Subak, M.D., University of California San Francisco now at Stanford University Department of Obstetrics and Gynecology; James Mitchell, M.D., Neuropsychiatric Research Institute, Fargo, ND; Anita Courcoulas, M.D., University of Pittsburgh Medical Center Department of Surgery; David Flum, M.D., University of Washington Department of Surgery; Gladys Strain, Ph.D., Cornell University Medical Center; David Sarwer, Ph.D., Temple University College of Public Health; Ronette Kolotkin, Ph.D., Duke University Medical Center, Faculty of Health Studies – Western Norway University of Applied Sciences, Førde Central Hospital Department of Surgery, Førde, Norway, Førde Hospital Trust, and Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Walter Pories, M.D., East Carolina University Department of Surgery, Greenville, NC; and Alison Huang, M.D., University of California, San Francisco.  

The study was funded by: a cooperative agreement by the National Institute of Diabetes and Digestive and Kidney Diseases (grants U01 DK066557 [Data Coordinating Center], U01-DK66667 [Columbia-Presbyterian], UL1-RR024996 [Columbia-Presbyterian in collaboration with Cornell University Medical Center Clinical and Translational Science Center], U01-DK66568 [University of Washington], M01RR-00037 [University of Washington in collaboration with the Clinical and Translational Research Center], U01-DK66471 [Neuropsychiatric Research Institute], U01-DK66526 [East Carolina University], U01-DK66585 [University of Pittsburgh Medical Center], UL1-RR024153 [University of Pittsburgh Medical Center in collaboration with the Clinical and Translational Research Center]), and U01-DK66555 [Oregon Health & Science University]).

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