Meg H Zeller1, Jennifer L Brown2, Jennifer Reiter-Purtill3, David B Sarwer4, Lora Black5, Todd M Jenkins6, Katherine A McCracken7, Anita P Courcoulas8, Thomas H Inge9, Jennie G Noll10. 1. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: meg.Zeller@cchmc.org. 2. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio. 3. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 4. Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania. 5. Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, Missouri. 6. Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 7. Department of Pediatric and Adolescent Gynecology, Nationwide Children's Hospital Medical Center, Columbus, Ohio. 8. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 9. Department of Pediatric Surgery, Colorado Children's Hospital, Aurora, Colorado. 10. Department of Human Development and Family Studies, Pennsylvania State University, State College, Pennsylvania.
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.
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.
Authors: Ronette L Kolotkin; Meg Zeller; Avani C Modi; Gregory P Samsa; Nicole Polanichka Quinlan; Jack A Yanovski; Stephen K Bell; David M Maahs; Daniela Gonzales de Serna; Helmut R Roehrig Journal: Obesity (Silver Spring) Date: 2006-03 Impact factor: 5.002
Authors: Caroline M Apovian; Christina Baker; David S Ludwig; Alison G Hoppin; George Hsu; Carine Lenders; Janey S A Pratt; R Armour Forse; Adrienne O'brien; Michael Tarnoff Journal: Obes Res Date: 2005-02
Authors: David P Bernstein; Judith A Stein; Michael D Newcomb; Edward Walker; David Pogge; Taruna Ahluvalia; John Stokes; Leonard Handelsman; Martha Medrano; David Desmond; William Zule Journal: Child Abuse Negl Date: 2003-02
Authors: Ronette L Kolotkin; Ross D Crosby; Richard E Gress; Steven C Hunt; Scott G Engel; Ted D Adams Journal: Surg Obes Relat Dis Date: 2008-06-30 Impact factor: 4.734
Authors: Janey S A Pratt; Carine M Lenders; Emily A Dionne; Alison G Hoppin; George L K Hsu; Thomas H Inge; David F Lawlor; Margaret F Marino; Alan F Meyers; Jennifer L Rosenblum; Vivian M Sanchez Journal: Obesity (Silver Spring) Date: 2009-02-19 Impact factor: 5.002
Authors: Jeffrey H Herbst; Elizabeth D Jacobs; Teresa J Finlayson; Vel S McKleroy; Mary Spink Neumann; Nicole Crepaz Journal: AIDS Behav Date: 2007-08-13
Authors: Meg H Zeller; Katherine M Kidwell; Jennifer Reiter-Purtill; Todd M Jenkins; Marc P Michalsky; James E Mitchell; Anita P Courcoulas; Thomas H Inge Journal: Obesity (Silver Spring) Date: 2021-02-02 Impact factor: 5.002