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.