Sexual Concerns After Bariatric Surgery

Adjusting to life after bariatric surgery can be filled with ups and downs. Many people hope that one of the impacts of the surgery is that they will feel better and look better. And of course some people believe this will translate to more and better sex! Unfortunately it’s usually not that simple. Below are some common sexual concerns I here from clients post-bariatric surgery:

  • “I haven’t thought about that in years…” Sometimes old traumas can get stirred up after bariatric surgery. For people that endured trauma as a child (whether it was bullying by peers, sexual abuse by a family member, the loss of a parent, etc.) food may have been a source of comfort and coping. Also being overweight for some children serves as a way to protect themselves from abuse. So suddenly when you’re are loosing weight after bariatric surgery you may find yourself thinking about old traumas and feeling very triggered. If the trauma is too overwhelming, especially if the trauma impacted your body image or the way you viewed yourself sexually, you may find yourself not wanting to have sex. Sex may become a triggering and you might find yourself feeling unsafe in your body despite being physically healthier due to the weight loss! Seeking counseling to process these old traumas can be especially helpful.
  • “My sex drive is much higher! But my partner doesn’t seem to want to have sex…” Bariatric surgery often helps men’s testosterone reach a normal level, usually increasing libido. Women who have bariatric surgery often notice increased desire and generally better sexual functioning. Keep in mind however, just because you are feeling increased desire does not mean your partner is. If the pattern in your relationship before surgery was to have little sexual contact, this is not going to change overnight. Don’t make the mistake of assuming your partner’s lack of drive is about you! Your partner may have their own sexual dysfunction or low desire that was easily hidden and worked in a relationship that had little sexual contact. Now that you want to have more sex, it could be highlighting your partner’s own sexual issues. Couples often have to renegotiate and rediscover their sexual relationship. Couples therapy and sex therapy can be helpful in this process.
  • “I want to get naked in front of my partner again but…” One part of you might want to jump right back into sex, even flaunt your body for your partner. Another part of you might feel hesitant, self-conscious or even afraid. Both are normal reactions after surgery. Give yourself time to adjust to your new body—and for your partner to adjust to your new body too. Many people become more self-conscious about their bodies if they experience sagging skin, a common side effect of bariatric surgery. Counseling can be helpful in adjusting to your new body, regaining self-confidence and developing a positive body image.
  • “I haven’t really wanted to have sex because I’m feeling more down…” While some people experience increased psychological health after surgery, others notice decreases in psychological health after surgery. Sometimes this is related to unmet expectations about how the surgery would change your life or you may be struggling with keeping up with the lifestyle changes needed to maintain the weight loss. In fact, many studies have shown that those who have undergone bariatric surgery are at higher risk for substance abuse, depression and suicide. If you are not feeling well emotionally, you are generally not going to want to have sex. Depression, anxiety and trauma related disorders can all decrease desire. Seeking counseling to deal with emotional distress you may be experiencing after surgery is recommended.