Body Image and Sexuality After Bariatric Surgery

Effects of Bariatric Surgery on Body Image Level and Sexual Life of Individuals

Sexual desire may decrease among obese individuals who feel worthless and therefore there may be behaviors that avoid sexuality. Sexuality, one of the activities of daily life, is an issue that is affected by cultural norms and rules and individuals have difficulties expressing their sexual problems comfortably. In a systematic review which is about the effect of bariatric surgery on sexuality; it was emphasized that bariatric surgery, the most widely used treatment in obesity, has positive effects upon reproductive hormones and sexual functions thanks to weight loss. In light of these information above-mentioned; the study was done to examine the correlation between body perception and sexual life before and after bariatric surgery among obese individuals.

Study Overview

• Status: Completed
• Conditions: Sexual Dysfunction, Physiological; Obesity, Morbid

Detailed Description

Obese individuals who want to learn healthy life behaviors and wish to acquire and to realize behavioral changes that will help them cope with health problems are in need of training and counseling. In this process, nurses -being in close and continuous contact with individuals- play counselor role as a part of their educator roles. It is stated that nurses need to understand, empathize with and support individuals who suffer from different problems while they play this role. In presence of obesity, which is a psychophysiological condition; nurses should also consider the fact that obese individuals who face bitter criticisms and social exclusion may show low self-esteem and impaired body image due to excessive weight and therefore they should give these individuals opportunities to express their feelings as to how they perceive themselves. The studies in literature that investigated the correlation between body mass index (BMI) and self-esteem and body perception report that obese individuals demonstrate relatively lower self-esteem and body perception as compared to the normal individuals. Psychological and hormonal disorders, impaired body image and chronic diseases that develop with obesity influence sexual life negatively, too. Therefore; sexual desire may decrease among obese individuals who feel worthless and therefore there may be behaviors that avoid sexuality. Sexuality, one of the activities of daily life, is an issue that is affected by cultural norms and rules and individuals have difficulties expressing their sexual problems comfortably.

• Study Type: Observational
• Enrollment (Actual): 33

Contacts and Locations

Study Locations

• Turkey
  • Mersin, Turkey
    • Mersin University Faculty of Nursing

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

The population of the study was consisted of 33 patients who received obesity diagnosis at General Surgery Unit, Mersin University Hospital and underwent bariatric surgery between 1.6.2017 and 1.12.2018. It was identified that the number of the patients who had bariatric surgery at the hospital between 30.11.2016 and 30.5.2017 was 33. During the sampling phase, at least 27 of the 33 patients who volunteered to join the study and met inclusion and exclusion criteria were targeted between 01.06.2017 and 01.12.2018 when Data Collection Forms were distributed according to the statistical calculations in which 20% loss of the population was predicted. However, the whole population was achieved.

Description

Inclusion Criteria:

• Accepted to join the study,
• Did not have such psychiatric disorders as anxiety, depression and personality disorders
• Were aged between 18 and 65.

Exclusion Criteria:

• Do not accepting to join the study,
• Have such psychiatric disorders as anxiety, depression and personality disorders
• Older from 65, under the age of 18.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Obese individuals' Descriptive Characteristics and Findings Related to the Disease as assessed by "Information Request Form".	At the first stage of the research, by the obese individuals "Information Request Form" is filled in to specify socio-demographic characteristics.	1 day
Obese individuals' Body Perception as assessed by "Body Perception Scale" at the pre-operation period	"Body Perception Scale" filled in to determine how satisfied they were the various parts of their bodies and various body functions at the pre-operation period by the obese individuals. The scale includes 40 items and each item refers to an organ or a limb (arm, leg, face, etc.) or a function (sexual activity level). Each item score ranges from 1 to 5 by marking "I do not like at all", "I do not like", "I am uncertain", "I like", "I like a lot". Total score ranges from 40 to 200. High scores indicate high level of satisfaction. Cutoff score of the scale was 135 and scores lower than 135 (≥135) indicate lower body perception.	1 day
Obese individuals' sexual functions respective of sexual orientation as assessed by "Arizona Sexual Experiences Scale " at the pre-operation period	The "Arizona Sexual Experiences Scale" was filled in to measure sexual functions related to sexual orientation and the relationship with partners at the pre-operation period by the obese individuals. Scores for each question range from 1 to 6 and total score ranges from 5 to 30. Lower scores indicate strong, easy and satisfactory sexual response while higher scores indicate presence of sexual dysfunctions. According to Soykan, a score ≥11 is a cutoff score for sexual dysfunction.	1 day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Obese individuals' Body Perception as assessed by "Body Perception Scale" at the post-operation period	"Body Perception Scale" filled in to determine how satisfied they were the various parts of their bodies and various body functions at the post-operation period by the obese individuals. The scale includes 40 items and each item refers to an organ or a limb (arm, leg, face, etc.) or a function (sexual activity level). Each item score ranges from 1 to 5 by marking "I do not like at all", "I do not like", "I am uncertain", "I like", "I like a lot". Total score ranges from 40 to 200. High scores indicate high level of satisfaction. Cutoff score of the scale was 135 and scores lower than 135 (≥135) indicate lower body perception.	1 day
Obese individuals' sexual functions respective of sexual orientation as assessed by "Arizona Sexual Experiences Scale " at the post-operation period	The "Arizona Sexual Experiences Scale" was filled in to measure sexual functions related to sexual orientation and the relationship with partners at the post-operation period by the obese individuals. Scores for each question range from 1 to 6 and total score ranges from 5 to 30. Lower scores indicate strong, easy and satisfactory sexual response while higher scores indicate presence of sexual dysfunctions. According to Soykan, a score ≥11 is a cutoff score for sexual dysfunction.	1 day

Collaborators and Investigators

• Sponsor: Mersin University

Publications and helpful links

General Publications

• Kaya H. Patient education in health services and responsibilities of nurse: review. Turkiye Klinikleri Journal of Nursing Sciences. 2009; 1: 19-23.
• Tedik SE. Healthy life and role of nursing in thecontrol of body weight. TurkishJ ournal of Diabetes and Obesity. 2017; 2: 54-62.
• Pujols Y, Seal BN, Meston CM. The association between sexual satisfaction and body image in women. J Sex Med. 2010 Feb;7(2 Pt 2):905-16. doi: 10.1111/j.1743-6109.2009.01604.x. Epub 2009 Nov 24. Erratum In: J Sex Med. 2010 Jun;7(6):2295.
• Hamurcu P, Öner C, Telatar B, Yeşildağ Ş. The impact of obesity on self esteem and body image. Turkish Journal of Family Practice. 2015; 19: 122-128.
• Wallwiener S, Strohmaier J, Wallwiener LM, Schonfisch B, Zipfel S, Brucker SY, Rietschel M, Wallwiener CW. Sexual Function Is Correlated With Body Image and Partnership Quality in Female University Students. J Sex Med. 2016 Oct;13(10):1530-8. doi: 10.1016/j.jsxm.2016.07.020. Epub 2016 Aug 23.
• Hall AM. Sexuality. In (Chapter 28) : Potter, P. A, Perry, A. G. E., Hall, A. E. & Stockert, P. A. (ed.), (2009). Fundamentals of nursing. Elsevier Mosby. pp: 426-442.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2017
• Primary Completion (Actual): December 1, 2017
• Study Completion (Actual): December 1, 2018

Study Registration Dates

• First Submitted: April 23, 2020
• First Submitted That Met QC Criteria: April 23, 2020
• First Posted (Actual): April 28, 2020

Study Record Updates

• Last Update Posted (Actual): April 30, 2020
• Last Update Submitted That Met QC Criteria: April 28, 2020
• Last Verified: April 1, 2020

More Information

Terms related to this study

• Keywords: obesity; bariatric surgery; sexuality; body image
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Obesity, Morbid; Sexual Dysfunction, Physiological
• Other Study ID Numbers: Sexuality and obesity

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No