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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A recent study by researchers from Ohio State University, published in the Journal of Family Psychology found that, for women, moving in with a romantic partner for the first time creates a similar decline in emotional distress to getting married for the first time.
Men, on the other hand, only have a significant increase in emotional health when they marry for the first time. And both genders become even happier if they’re living together and then take the step of getting married.
When it comes to second relationships after a first significant one ended, both men and women have similar boosts in emotional health when they move in together or get married.
Claire Kamp Dush, co-author of the study and associate professor of human sciences at Ohio State, said the results could reflect the declining social stigma in living together before marriage.
“At one time marriage may have been seen as the only way for young couples to get the social support and companionship that is important for emotional health,” Kamp Dush said in a statement. “It’s not that way anymore. We’re finding that marriage isn’t necessary to reap the benefits of living together, at least when it comes to emotional health.”
The study is based on a nationally representative survey of 8,700 people in the US born between 1980 and 1984 who were interviewed every other year between 2000 to 2010. Participants were asked about their relationship status and answered questions designed to test their emotional health, such as how often in the past month they’d felt “calm and peaceful,” “downhearted and blue,” or “so down in the dumps that nothing could cheer you up.”
There are some limits to the study, as the participants were not asked about the relationship quality of their union, and their emotional health was only tested biannually over 10 years. It could well be that cohabitation and marriage lead to different emotional effects over the longer term. But for those who’ve decided to put off marriage and live with their partner, this study suggests that they’re still benefitting from a happiness boost.
86% of 11-15 year olds surveyed in an online questionnaire agree that the age of consent in Malta should be reduced from 18 to 16
KNZ executive board member Samantha Pace Gasan presents the youth council’s sexual health report.
The National Youth Council (KNZ) has called for the legal age of marriage to be raised from 16 to 18, claiming that the current law enables parents to push their children into getting married.
“We believe that marriage should be the adult’s own decision, and marriage at a young age would hinder the development of the young person involved,” the KNZ said in a report on sexual health and the age of sexual consent.
The council also recommended a pilot project to distribute free condoms in Paceville and other places popular with local youth, and cited a World Health Organisation survey amongst Maltese youth that showed that 71% of sexually active 13-15 year old males do not use contraception.
Elsewhere, the youths said that a sexual health clinics should be set up in Gozo, as well as one in each post-secondary school.
They also suggested the provision of courses to help parents start having conversations with their children on sexual health, as well as the provision of scholarships to people keen on specializing in sexual health.
They focused heavily on the need for a revamp in sexual health education – suggesting that education about the body be taught prior to puberty, that education on sexual harassment start from a young age, and that pornography and the Internet be slotted into the curriculum.
86% of surveyed 11-15 year olds want age of consent reduced
At 18 years, Malta’s age of sexual consent is – along with the Vatican City – the highest in Europe, followed by Cyprus and Ireland at 17. In all other European countries, the age of consent ranges between 14 and 16.
Labour whip Godfrey Farrugia said in January that Malta should “move ahead with the times” and reduce the age of consent to 16 so as to “provide social justice to 16 and 17 year olds who are suffering as a result of this law”. His proposal was backed by other parliamentarians, including health parliamentary secretary Chris Fearne and Labour MP Deo Debattista, and a joint meeting of the parliamentary committees on health, social affairs and family affairs earlier this month recommended lowering the age of consent to 16.
While the KNZ did not explicitly propose reducing the age of consent, they argued in their report that the current Maltese sexual health policy law is “out-dated” and that the law “should not seek to protect minors’ innocence at the age of 16”.
Moreover, an online questionnaire by the council revealed that a whopping 86% of the 101 surveyed 11-15 year olds were in favour of having the age of consent set at 16. Out of the total 676 respondents – whose ages varied from 11 to 36 – the rate of approval of a reduction stood at a more modest 57.5%.
The most common reason given for approval was that youths would be properly informed by 16, marked 344 (53.1%) of participants, and that young people would have developed the ability to say no by the time they have reached that age, with 327 (60.6%). 282 (43.5%) respondents also claimed that young people would be mature by that age.
The historic US Supreme Court ruling on same-sex marriage could improve the health of gay, lesbian and bisexual people, says experts.
Evidence shows heterosexual people who are married have better physical and mental health than people who are not married.
Research done so on same sex marriage also suggests that marriage may provide the same benefits for same-sex couples.
“We know that marriage does enhance people’s health,” Richard Wight, a community health researcher at the University of California was quoted as saying in a Live Science report.
“Now, there’s the potential for marriage to enhance the health of sexual monitories in the same way it does for heterosexual people,” Wight added.
A recent study that Wight and colleagues conducted found that sexual monitories who were in same-sex marriages were no different than married heterosexuals in terms of their general level of psychological stress.
The right to marriage may have the potential to offset differences in mental health between sexual monitories and heterosexuals, Wight said.
Another study, which surveyed more than 2,600 people who were gay, lesbian or bisexual, found that those who were in legally recognized relationships reported lower levels of stress, fewer depressive symptoms and more meaning in their lives than those who were in committed relationships that did not have a legal status.
The exact reasons why marriage improves people’s health are not known, but it may be due to a number of factors, including being in a supportive relationship and having an improved financial status.
The benefits of legalizing same-sex marriage may even extend to Lesbian, Gay, Bisexual (LGB) people who are not married. A 2011 study found that after same-sex marriage was legalized in Massachusetts in 2003, there was a decrease in health care visits.
The US Supreme Court ruled on June 26 that same-sex couples can marry nationwide and states cannot ban such marriages. For more stories, follow us on Twitter and Facebook
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Professor Patricia Casey’s latest contribution to public debate on the topic of suicide is that young gay men who have suicidal ideation or who attempt to harm themselves will not necessarily go on to kill themselves. She has told us that we should not “conflate” the act of self-harm with the completed act of suicide. Her argument is that, although suicidal behaviour is disproportionately more common in LGBT individuals, that the completed acts of suicide may not be higher.
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The reality is that every individual who presents with either self-harm or suicidal ideation, regardless of their sexual orientation, is at a greatly increased risk of going on to die by suicide. One in a hundred individuals, whether gay or straight, who present to medical services with self-harm or suicidal ideation will go on to kill themselves in the following year. Presentation with self-harm is the single most important risk factor in the prediction of completed suicide. We have a national programme in suicide prevention that is focused, almost exclusively, on interventions for individuals who present to A&E departments, or to GP surgeries, with self-harm or suicidal ideation.
I practise in Tallaght Hospital and in the HSE community clinics in the Tallaght area. We have set up a dedicated suicide-prevention service, called Ceangail, operating between 5pm and 9am, in recognition of the fact that most individuals who present with suicidal thoughts or behaviours do so outside of working hours. We are now in the final stages of implementing a specialist self-harm assessment programme in GP practices in Tallaght, led by my community mental health team and Professor Tom O’Dowd (Professor of General Practice, TCD and a GP in Tallaght).
The question that one has to ask is how might a relative risk, between gay and straight men, of progression from suicidal behaviour to completed suicide, be relevant to clinical practice? Why would it matter if the risk of completed suicide were less for gay, than for straight, men? Would it change medical practice?
Rates of suicide are 18/100,000 for men and 4/100,000 for women (http://nsrf.ie/statistics/suicide/). Do we treat a suicide attempt by a young women less seriously than that of a young man because, statistically, the chances of a woman dying by suicide are so reduced, compared to men? Individuals are treated, not statistics. Statistics inform medical practice, they do not dictate it. Doctors, whether practising in psychiatry, in A&E departments or in GP surgeries, treat a presentation with suicidal ideation or behaviours as being serious, regardless of gender or sexual orientation issues, because some of these patients will go on to die by suicide.
What is established beyond doubt and in all layers of our society is the very high rates of mental ill-health experienced by LGBT people. This is all indisputable. Neither is it disputed that this ill-health is caused by the discrimination experienced by LGBT persons. This can be directly experienced as a rejection of one’s identity and oneself, bullying or in being denied human rights available to heterosexuals. A more malignant process can occur when the social discrimination experienced by LGBT individuals is internalised and this self-stigma can give rise to feelings of depression and self-loathing. Social isolation inevitably follows, and individuals can spiral into a paranoid and profoundly unhappy mental state.
I remember trying to “treat” a man about 25 years ago, when I was in training, who was so tortured by being gay that he wanted me to chemically castrate him: to neutralise his male hormones with anti-androgen medication. I have often thought about his tortured life since then, and of how futile and unnecessary his suffering was.
Many doctors in Ireland have become advocates for equal rights for LGBT people, including the right to marry, because of the health problems associated with repressed or stigmatised sexual orientation. The Irish Medical Organisation, the largest medical organisation in the country, is in support of a ‘Yes’ vote in the marriage-equality referendum. A new organisation, Doctors for Marriage Equality, composed of doctors from all medical specialties, of all ages and sexual orientation, is gaining momentum on a daily basis as May 22 approaches (https://www.facebook.com/doctorsformarriageequalityireland). The support for LGBT rights globally within the medical community was reflected in an editorial this week in the New England Journal of Medicine, recently voted the most influential medical journal in the world by doctors. The editorial, titled “In support of same-sex marriage”, states, “Same-sex marriage should be accepted both as a matter of justice and as a measure that promotes health”.
Former president Mary McAleese was correct when she spoke out about this, and also correct about the link between being of homosexual orientation, having mental health problems and suicidal behaviours. She was also correct about the link between suicidal behaviours and completed suicide.
Does it really help make us a better or more healthy society to calculate whether gay men are over-represented in our suicide statistics? Is it not enough to know that the mental health of our LGBT citizens is suffering because of social discrimination? Psychiatry and medicine are frequently involved in issues related to ill-health, such as poverty, income inequality and discrimination, because these issues affect peoples’ health. Medics can only treat the ailment, but the power to alleviate this ill-health lies with all the citizens of our country. Choosing to vote ‘Yes’ is a vote that will lead to a healthier society for us all.
Veronica O’Keane, Professor in Psychiatry, TCD and Tallaght Psychiatry Services
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