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Sexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery

Published on Jun 1, 2019in Surgery for Obesity and Related Diseases3.758
· DOI :10.1016/j.soard.2019.03.001
Meg H. Zeller35
Estimated H-index: 35
(Cincinnati Children's Hospital Medical Center),
Jennifer L. Brown19
Estimated H-index: 19
(UC: University of Cincinnati)
+ 35 AuthorsRachel Akers10
Estimated H-index: 10
Sources
Abstract
Abstract Background Adolescents females with severe obesity are less likely to be sexually active, but those who are sexually active engage in risky sexual behaviors. Objectives To examine patterns and predictors of sexual risk behaviors, contraception practices, and sexual health outcomes in female adolescents with severe obesity who did or did not undergo bariatric surgery across 4 years. Setting Five academic medical centers. Methods Using a prospective observational controlled design, female adolescents undergoing bariatric surgery (n = 111; Mage = 16.95 ± 1.44 yr; body mass index: MBMI = 50.99 ± 8.42; 63.1% white) and nonsurgical comparators (n = 68; Mage = 16.18 ± 1.36 yr; MBMI = 46.47 ± 5.83; 55.9% white) completed the Sexual Activities and Attitudes Questionnaire at presurgery/baseline and 24- and 48-month follow-up, with 83 surgical females (MBMI = 39.27 ± 10.08) and 49 nonsurgical females (MBMI = 48.56 ± 9.84) participating at 48 months. Results Most experienced sexual debut during the 4-year study period, with a greater increase in behaviors conferring risk for sexually transmitted infections (STIs) for surgical females (P = .03). Half (50% surgical, 44.2% nonsurgical, P = .48) reported partner condom use at last sexual intercourse. The proportion of participants who had ever contracted an STI was similar (18.7% surgical, 14.3% nonsurgical). Surgical patients were more likely to report a pregnancy (25.3% surgical, 8.2% nonsurgical, P = .02) and live birth (16 births in 15 surgical, 1 nonsurgical), with 50% of offspring in the surgical cohort born to teen mothers (age ≤19 yr). Conclusions Bariatric care guidelines and practices for adolescent females must emphasize the risks and consequences of teen or unintended pregnancies, sexual decision-making, dual protection, and STI prevention strategies to optimize health and well-being for the long term.
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References43
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#1Jim BraxtonH-Index: 13
#2Darlene W. DavisH-Index: 8
Last. Niketta WomackH-Index: 1
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#1Janey S.A. Pratt (Stanford University)H-Index: 14
#2Allen BrowneH-Index: 12
Last. Jeffrey L. Zitsman (Morgan Stanley Children's Hospital)H-Index: 13
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Abstract The American Society for Metabolic and Bariatric Surgery Pediatric Committee updated their evidence-based guidelines published in 2012, performing a comprehensive literature search (2009–2017) with 1387 articles and other supporting evidence through February 2018. The significant increase in data supporting the use of metabolic and bariatric surgery (MBS) in adolescents since 2012 strengthens these guidelines from prior reports. Obesity is recognized as a disease; treatment of severe ob...
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#1David B. Sarwer (TU: Temple University)H-Index: 10
#2Thomas A. Wadden (UPenn: University of Pennsylvania)H-Index: 104
Last. Nicholas J. Christian (University of Pittsburgh)H-Index: 10
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Background Initial weight loss after bariatric surgery has been associated with improvements in reproductive hormones and sexual functioning in women. Few studies have investigated the durability of these changes.
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#1Marie N. Menke (University of Pittsburgh)H-Index: 4
#2Wendy C. KingH-Index: 32
Last. Susan Z. YanovskiH-Index: 54
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OBJECTIVE:To examine contraceptive practices and conception rates after bariatric surgery.METHODS:The Longitudinal Assessment of Bariatric Surgery-2 is a multicenter, prospective cohort study of adults undergoing first-time bariatric surgery as part of routine clinical care at 10 U.S. hospitals. Rec
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#1Jennifer Becnel (UA: University of Arkansas)H-Index: 3
#2Meg H. Zeller (Cincinnati Children's Hospital Medical Center)H-Index: 35
Last. F. M. Biro (Cincinnati Children's Hospital Medical Center)H-Index: 1
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Summary Background There is an increasing adolescent population with severe obesity with impairments in social and romantic relationships that are seeking clinical weight management, including weight loss surgery (WLS). Objective To document romantic, sexual and sexual risk behaviours in a clinical sample of adolescent females with severe obesity (BMI > 40 kg/m2) compared to those of healthy weight (HW). Methods This multi-site study—an ancillary to a prospective longitudinal observational study...
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condom use during sexual intercourse in a nationally representative sample of women and men aged 15-44 in the United States using the 2011-2015 National Survey of Family Growth (NSFG). Where data were available, patterns of condom use during sexual intercourse from the 2011-2015 NSFG were compared with the 2002 and 2006-2010 NSFG. Methods-Data were collected through in-person interviews with nationally representative, independent samples of women and men aged 15-44 in the household population of...
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#1Alexis Conason (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 3
#2Kimberly J. McClure Brenchley (St. John Fisher College)H-Index: 3
Last. Allan Geliebter (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 35
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Abstract 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 l...
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#1Kristine J. Steffen (NDSU: North Dakota State University)H-Index: 22
#2Wendy C. King (University of Pittsburgh)H-Index: 32
Last. Alison J. Huang (UCSF: University of California, San Francisco)H-Index: 21
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Abstract Background Obesity may impair sexual function through multiple mechanisms, but little is known about sexual dysfunction among adults with severe obesity seeking bariatric procedures. Objectives To describe sexual function and associated factors before bariatric surgery. Setting Ten U.S. clinical facilities. Methods Before bariatric surgery, 2225 of 2458 Longitudinal Assessment of Bariatric Surgery-2 study participants (79% female, median age 45 years and median body mass index 46 kg/m2)...
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#1Meg H. Zeller (Cincinnati Children's Hospital Medical Center)H-Index: 35
#2Gia Washington (Boston Children's Hospital)H-Index: 3
Last. Thomas H. Inge (Cincinnati Children's Hospital Medical Center)H-Index: 42
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Abstract Background Problematic alcohol use and increased sensitivity postoperatively in adult weight loss surgery patients heightens concerns. No data have characterized these behaviors in adolescents—a gap, given adolescent alcohol use and heavy drinking are public health concerns. Objective To examine alcohol use behavior in adolescents who underwent weight loss surgery across the first two post-operative years in comparison to nonsurgical adolescents. Setting Five academic medical centers. M...
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#1Meg H. Zeller (Cincinnati Children's Hospital Medical Center)H-Index: 35
#2Sanita L. Hunsaker (Cincinnati Children's Hospital Medical Center)H-Index: 3
Last. Kevin C. Smith (Children's Mercy Hospital)H-Index: 3
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Objective To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS). Methods Multisite prospective data from 138 adolescents undergoing WLS and primary caregivers (adolescent: Mage = 16.9; MBMI= 51.5 kg/m2; caregiver: Mage = 44.5; 93% female) and 83 nonsurgical comparators (NSComp: adolescent: Mage = 16.1; MBMI = 46.9 kg/m2; caregiver: Mage = 43.9; 94% female) were collected using...
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