Associations between relationship stability, relationship quality, and weight loss outcomes among bariatric surgery patients

Abstract

After weight loss surgery (WLS), psychosocial functioning, including the quality of social relationships, generally improves, but for a minority, relationships worsen. We examined how changes in relationship stability and quality from pre- to post-WLS relate to long-term weight loss outcomes. Postoperative patients (N=361) completed surveys which queried relationship changes and weight loss. The sample was 95.9% Caucasian, 80.1% female, averaged 7.7years post-WLS, with a mean age at surgery of 47.7years (range 21–72); 87.3% had a Roux-en-Y gastric bypass. Four relationship status groups were created: Not in a relationship at surgery or follow-up (No-Rel, n=66; 18.2%); Post-WLS relationship only (New-Rel, n=23; 6%); Pre-WLS relationship only (Lost-Rel, n=17; 5%); and Pre–Post Relationship (Maintainer, n=255; 70.6%). Current BMI was 34.5 for No-Rel; 40.5 for New-Rel; 37.4 for Lost-Rel; 33.3 for Maintainers (p<.05 for Maintainers and No-Rel vs. New-Rel). These same group differences were significant for weight loss, which was not associated with gender, time since surgery, or age at time of surgery, but was associated with pre-WLS BMI (lower pre-WLS BMI was associated with greater %EWL). Analyses were repeated with pre-WLS BMI as a covariate; group differences remained significant [F (3, 355)=3.09, p=.03], as did pre-WLS BMI, [F (1, 355)=9.12, p=.003]. Among Maintainers, relationship quality was associated with weight loss outcomes: those with improved relationships post-WLS had significantly greater %EWL [F (2, 234)=15.82, p<0.000; p<.05 for Improved>(Stayed Same=Got Worse)]. Findings support the importance of assessing relationship stability and quality in pre-WLS candidates, as healthy and stable relationships may support improved long-term outcomes. Interventions to improve relationships pre-and post-WLS may increase both quality of life and weight loss outcomes.