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

Abstract Background Adolescents females with severe obesityare 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 obesitywho did or did not undergo bariatricsurgery across 4 years. Setting Five academic medical centers. Methods Using a prospective observational controlled design, female adolescents undergoing bariatricsurgery (n = 111; M age = 16.95 ± 1.44 yr; body mass index: M BMI = 50.99 ± 8.42; 63.1% white) and nonsurgical comparators (n = 68; M age = 16.18 ± 1.36 yr; M BMI = 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 ( M BMI = 39.27 ± 10.08) and 49 nonsurgical females ( M BMI = 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 Bariatriccare 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.