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
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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