Could weight-loss surgery hurt a marriage?

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After weight-loss surgery, married people tended to lose less weight than singles, and some reported a negative impact on their relationships, a recent study notes.

A research team from Ohio State University reviewed 13 studies on weight-loss surgery, published between 1990 and 2014. Four of those specifically focused on romantic relationships and how they were affected by the procedures, and six others included that data as part of their research.

One study found that married patients were 2.6 times less likely to reach their target weight a year after surgery. Another noted that single patients were 2.7 times more likely to stick to diet and exercise goals. In terms of relationship quality, three studies reported that participants had a higher interest in sex after the surgery, but that some marriages still ran into trouble.

Patients may experience physical discomfort that affects intimacy, or they may feel disconnected on a deeper level, while trying to change eating habits and physical activity levels.

Writing in a blog post for Obesity Action Coalition, weight-loss surgeon Dr. Walter Medlin noted, “Relationships change in many ways, as you change after surgery. Even though life may have been hard in many ways before surgery, leaving familiar old ways behind can be stressful.”

He added that this stress can be a threat, especially for a spouse who might feel that he or she is “losing” some version of the person who had surgery. “Some spouses have gotten away with taking advantage of power if you have had to rely on them, and may fear you will retaliate with increased freedom and power after obesity no longer limits your financial and relationship prospects,” Dr. Medlin wrote.

About 65 percent of people seeking weight-loss surgery are married. In the recent study, researchers suggested that health care teams could capitalize on the potentially positive influence of supportive and engaged spouses. In situations where the spouse is not supportive, a health care team could work to line up other resources to assist the patients in reaching goals after surgery.

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Could weight-loss surgery hurt a marriage?

Hurt spine killed sex life? Hope alive

NEW DELHI: At 25, Sumit Sanyal met with a car accident that left him paralysed below the waist. While he was happy not to have lost his life, he, however, agonised over whether he could now marry, or whether he could ever father a child.

“Thoughts like these haunted me, but I was too shy to discuss them with family members or doctors,” Sanyal recalled. Three years after the 1998 accident, the young man who runs a textile business, married Sumita Sharma. But the years following were traumatic for both, with Sanyal unable to have sexual relations with his wife due to the spinal and nerve injuries he had suffered.

He finally gathered the nerve to approach doctors at the Indian Spinal Injuries Centre (ISIC) in New Delhi. “My inadequacy was affecting my personal life and work. The doctors at ISIC decided I should be helped to regain my libido, even if partially, and then try for a child through in-vitro fertilization,” said Sanyal, now 42.

Sanyal’s determination and ISIC’s success has prompted the centre to start a dedicated facility on fertility services for spinal injury victims. Hundreds of young men who suffer from spinal injuries face a similar predicament, and they often lose hope of ever having a normal family life because of their inability to have children.

As with Sanyal, the procedure will look both at helping patients regain healthy sexual functioning as well as achieving good semen quality, said Dr Rachna Verma, the infertility specialist at ISIC who worked with Sanyal for nearly two months to make the process a success.

Reproductive health issues are more common among men than in women with spine injuries, Dr Shakir Hussain, chairman of the Stroke and Neuro-Intervention Foundation, explained. This is because injuries lead to erectile dysfunction and inadequate ejaculation, while women mostly suffer from loss of genital sensation.

“People with spinal injuries have the same desires and expectations as any other human being,” said Dr H S Chhabra, director and chief spine surgeon at ISIC. But he termed it unfortunate that the sexual health of spinal injury patients or their desire to have a family is often played down in India.

“In our country, medical management focuses mostly on improving mobility, bladder control and preventing infections. Few clinicians address the physical and psychological needs of the patient. Sexual and reproductive desires are rarely discussed,” Hussain said.

“In the US, UK and other countries, rehabilitation of spinal injury patients involves helping them regain their sexual and reproductive life. But in India these issues are barely addressed as we struggle even to provide basic care and treatment to such patients,” said a senior doctor at AIIMS.

He cited the example of the AIIMS Trauma Centre, a government institution, where figures showed that in 2013 nearly half the beds in the neurosurgery department were occupied by patients with slim chances of recovery. Often, victims who have suffered spine and nerve injuries in road accidents or falls need oxygen support.

“Poor patients cannot afford oxygen support at home, and in the absence of dedicated rehabilitation facilities, we are forced to keep them in the hospital for long periods,” he pointed out.

In this rather sorry situation, the sexual needs of a patient must be rather low in the list of medical imperatives, but Sanyal and Indian Spinal Injuries Centre might just have moved the item further up the agenda.

(Name of the patient has been changed on request)

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Hurt spine killed sex life? Hope alive