Think back to the times you may have felt uncomfortable discussing the topic of sex, now imagine discussing sex after a life-altering bariatric surgery. Enter the world of openness and support as Tammie and Marie navigate the unchartered territory of intimacy and fertility after weight loss surgery. Maria takes an empathetic look at the profound impact on your sex life and digs into the science behind the improvements many people experience after the surgery. Tammie also talk about the emotional and physical adjustments that accompany these body changes.
Their conversation gets richer as Tammie shares her own struggles with body image and sexuality post-bariatric surgery. While acknowledging the discomfort around this topic, she stresses the necessity of sharing experiences to promote mutual understanding and support with spouses. They will walk you through how these body transformations can influence your sex life and how surgery can potentially resolve infertility issues. Together, Tammie and Maria offer practical advice for those experiencing these changes, focusing on patience, understanding, and transparent communication. This episode promises to be an open, insightful, and supportive discussion you won’t want to miss. Tune in and let’s break some taboos together!
Think back to the times you may have felt uncomfortable discussing the topic of sex, now imagine discussing sex after a life-altering bariatric surgery. Enter the world of openness and support as Tammie and Marie navigate the unchartered territory of intimacy and fertility after weight loss surgery. Maria takes an empathetic look at the profound impact on your sex life and digs into the science behind the improvements many people experience after the surgery. Tammie also talk about the emotional and physical adjustments that accompany these body changes.
Their conversation gets richer as Tammie shares her own struggles with body image and sexuality post-bariatric surgery. While acknowledging the discomfort around this topic, she stresses the necessity of sharing experiences to promote mutual understanding and support with spouses. They will walk you through how these body transformations can influence your sex life and how surgery can potentially resolve infertility issues. Together, Tammie and Maria offer practical advice for those experiencing these changes, focusing on patience, understanding, and transparent communication. This episode promises to be an open, insightful, and supportive discussion you won’t want to miss. Tune in and let’s break some taboos together!
Welcome to Core Bariatrics Podcast hosted by Bariatric Surgeon Dr Maria Iliakova and Tammie Lakose, bariatric Coordinator and a patient herself. Our goal is building and elevating our community. The Core Bariatrics Podcast does not offer medical advice, diagnosis or treatment. On this podcast, we aim to share stories, support and insight into the world beyond the clinic. Let's get into it, all right, maria. Let's get juicy. Let's get into sex after bariatric surgery.
Speaker 2:
Yeah, baby.
Speaker 1:
But also infertility, how bariatric surgery can help with those things. This is a topic!
Speaker 2:
This is it should be. I honestly think billboard should be made out of this. Bariatric surgery can make your sex life better, or it can help you have babies, or this is a big deal.
Speaker 1:
But it can also make things a little worse, so we'll talk about both, right. So I'm going to let you talk about all infertility stuff and how bariatric surgery can help with those things just the more technical terms, Absolutely so.
Speaker 2:
Actually, I'll just get started by saying not a lot of people know that infertility can be related to weight. It's definitely not related to weight for everyone. People can be fertile at all weights and things like that. But some people who have things like PCOS, Polycystic Ovarian Syndrome, but even men who have erectile dysfunction or low libido those things can actually be related to metabolic problems and weight too, and that's not something we talk about a lot Definitely Right. So there's a huge advantage to going through bariatric surgery for the treatment of infertility or low libido, and it actually really can improve your sex life outcomes there Both men and women.
Speaker 2:
That's right. That's right, and that's what it did in our patients too. In fact, this year alone, after having bariatric surgery, we've had a few patients who have had pregnancy, and even some people who have had pregnancy despite some forms of birth control. This is a really, really effective treatment for infertility. When it comes to that, we definitely encourage people to be very responsible in how they're getting pregnant after surgery, because there's a lot of risks to having pregnancies close to bariatric surgery. It really impacts your ability to have good nutrition, make sure you stay hydrated and definitely your weight curve too. Right, so nobody is recommended to have bariatric surgery and then get pregnant within a year, but in the long term, definitely, bariatric surgery is actually a treatment to help some people become pregnant and have a better sex life. What is your experience with this, Tammie, I'm actually pretty interested because, while there is a lot of positive here, there is not just across the board necessarily positive.
Speaker 1:
Correct. Yeah, so a little about me. I am married. I have been married for three years now, but we've been in a relationship for almost 10 years now. Beginning of our relationship, it was always, you know, you do, you have that honeymoon phase, but that honeymoon phase never went away for me.
Speaker 2:
Oh, wow, and us, so I'm like this is crazy. That's great.
Speaker 1:
So always very attracted to each other all of that stuff.
Speaker 1:
Yeah, I mean, while I was at my heaviest, sex definitely a struggle, not only stamina wise, but also how I look wise. I know my husband loved me for me. We got together while I was not my heaviest, slowly gained weight, but I knew he didn't mind. You know, a little bit, yeah, yeah. So after bariatric surgery things kind of changed, though Now I don't know if I can talk this up to just bariatric surgery. I have a lot of mental health stuff going on as well, which is another thing we need to dig into. But so I am on medications for anxiety and depression, so it might play a role in it. But the thought of having sex with loose skin, not perky boobs, it kind of really throws things off for me. So I've really been on the struggle bus with that.
Speaker 2:
Has anything helped you feel sexier or helped you feel the way you want to feel, physically or emotionally? Clothes, yeah, clothes. Unfortunately, yeah like wearing clothes, unfortunately. Yeah, like I mean, if I could be in a bra and underwear you could good support.
Speaker 1:
It push up bra and underwear during sex. Yeah, yeah, you know, maybe that'd be, I don't know, but it has been a struggle. My personal sex drive just isn't there, and it's not that I'm not attracted to my husband. I very much so, am Right, yeah.
Speaker 2:
I just, but it's been a struggle. That's tough because that's a really personal thing that has an impact on other how, yeah, your relationship and your satisfaction and things like that too. Is there anything you would recommend to people as they go through this process to sort of have eyes wide open as their body is changing?
Speaker 1:
That's a good question. I think the advice I would definitely give people is to be patient with yourself and realize that it is an adjustment period, not only for your hormones and all of that it could be hormonal, I'm not sure but also like I still feel like my mind and my body are not at the same point, like my body is smaller but my brain is not. So now you asking that question actually makes me wonder. Am I still stuck in being an obese sexual partner?
Speaker 2:
What do you think?
Speaker 1:
Well, crap! Real talk guys. Yeah, because even when I was bigger sex was I mean great, like we always right, but it always lets the lights off.
Speaker 2:
I mean like so maybe I'm still stuck there.
Speaker 1:
That's very I'm glad you asked that question.
Speaker 2:
Well, thanks, but I think you're not wrong.
Speaker 1:
I think a lot of people struggle with how their bodies look, yeah, during sex, more than how their bodies feel yeah, I think maybe my mind is like my stamina is so much more like being on top is definitely a thing, but then also, you know, boobs that aren't where they were.
Speaker 2:
10 years ago. Yeah, so well, that's all bodies, honey. Let me tell you that is not a weight-based thing, that is a time-changes thing.
Speaker 1:
Yeah, so, and something for me I have been very open and honest with my husband. And I think that is huge when it comes to any dynamic changing after bariatric surgery.
Speaker 2:
Oh, definitely.
Speaker 1:
Because your spouse needs to know that you are struggling with some things and it's not them, especially if your spouse is kind of on the insecure side.
Speaker 2:
Right.
Speaker 1:
I have all the time told my husband I'm still very attracted to you. I still very much so want to have sex with you. This is truly a me issue. Like this is a me thing.
Speaker 2:
Why? Let's say, you think, do you think a partner has a role to play in this? Do you think that the person that is on the other side that is not experiencing this, but is affected? What is their role in this?
Speaker 1:
I think even my husband I think he could do better even just reinforcing, if I do look good. My boobs used to be a real good size. They're not as big as they used to be and he has made this like comment of " they're a little smaller than I would like. And as much as he was not trying to be rude about it or anything like that, it really stuck with me.
Speaker 1:
Yeah, and so yeah, maybe just yeah maybe I just need to open, communicate with him even more so and being like I need to know that you are still attracted to me.
Speaker 2:
Yeah, maybe that is a huge thing, you know I think you're really hitting on something, because bodies change through this process so much they don't change in a fully predictable way and no matter what skin is going to look, different Body parts are going to move sometimes and some of the things are ways that we want them to and some of them are not necessarily. And your body in some cases, you know if you have a partner and things like that is shared right yeah, 100%.
Speaker 2:
You're both experiencing that body and how it's changing. So really keeping your partner in the loop and telling them sometimes, or communicating with them, what you need from them to yeah, that's got to be really hard.
Speaker 1:
Yeah.
Speaker 2:
But also something that's really important, through the process.
Speaker 1:
I think you're absolutely right. I think we're definitely onto something there, yeah.
Speaker 2:
Yeah, but I can't imagine how it changes the dynamic of the relationship, even though, like you said, your stamina might be better or certain positions are different now or more exciting. But if your brain isn't catching up to your body and you're caught in your head about how the other person is perceiving you, yeah, I think that's the biggest thing.
Speaker 1:
It's really hard to be in the mood when all you can think about is how I look.
Speaker 2:
Yeah, yeah, and how they think I look. Yeah, do you think that there is a way to focus on how you feel more? Do you think that would be helpful, or is that not really part of it?
Speaker 1:
Once I figured that out.
Speaker 2:
Yeah.
Speaker 1:
I think that's the. We need to figure that out.
Speaker 2:
That's a good. Yeah, that's a good point. I think it's really okay for that not to be figured out. Yeah, you know, that's something a lot of couples struggle with, or a lot of people struggle with, in their sex, sex lives no matter what size, what they look like, who it's, with any of those things right, and some of this could definitely just be the chapter of my life of three crazy boys running around.
Speaker 1:
Who has time to make love? Yeah, yeah.
Speaker 2:
So that's so true because you're right, when people go through big life changes, you don't get to just delete things out of it. You don't just get to put some things on pause and be like hold on three kids, we're now going to do this other thing, or a move or a job change. How many yeah, like how many of our people have gone through big life changes and your mental health is affected by all of it, your physical health is affected by all of it and your relationships are affected by all of it.
Speaker 2:
So sometimes it's figuring out we're going to take one issue at a time and focus on something that's really hard to do.
Speaker 1:
Yeah, but I would definitely be curious to see what other people what kind of experiences they've had with this.
Speaker 2:
Yeah Well, you know, what's funny is, this is a topic I feel like that there isn't a lot of content out there. Very few people are willing to ask this question and, to the point, honestly, where you know, in our own program and the materials that we had and everything, it didn't mention sex once, and this is something you know, this is a really big part of people's lives 100%.
Speaker 1:
Sex is still taboo, I feel. Oh, it's totally taboo.
Speaker 2:
Why? Yeah, right, well, we're working on that. But in this process it was I mean, it was so eye-opening to me to hear a patient ask like, well, what about? And they actually had their partner in the room and things too. But they asked, like, when can I have sex after surgery? And I said, whatever it feels good to do, that, as long as you go low and slow, right, start, low and slow, right, exactly. And that's not the case with any other activities right After surgery. But I was really taking it back that we didn't even have any materials that even put a word to this really important topic, you know, because there are some really big changes that happen with sex as you go through this and the fact that you're getting, you know, the better stamina you're feeling positive about.
Speaker 2:
Your body changes. Your mental health can go or down or sideways through this process. All of that has a really big impact on how much you're bedroom to.
Speaker 1:
Yeah 100%.
Speaker 2:
Yeah, would you say that there's anything that you would want to know? What would you have wanted to know ahead of surgery in order to prepare you a little bit better for some of these changes?
Speaker 1:
I'm not sure anything could be given to me because, as you said, every person's experience is so much different, so we can't pinpoint what's going to happen to you. We cannot tell you how much weight you're going to lose. We cannot tell you if your depression is going to get better or worse. But I think this is just another thing that, no matter how much education I had, I wouldn't know until it happened to me, until experiencing it Until experiencing it.
Speaker 2:
Yeah.
Speaker 1:
And I think I've experienced so much that this is where some of this content comes from. Right Of like Maria!, there's not enough content out there to help me with this problem, Right.
Speaker 2:
So we need to.
Speaker 1:
I want to talk about the not so.
Speaker 2:
Well and like, how much more personal can you get than something we're not supposed to talk about, we're not supposed to ask about? But it's something that we for a lot of folks, it's a daily. It's a daily consideration, even if it may not be a daily activity.
Speaker 2:
Right, yeah, but you know, what's interesting to me also is I have had a lot of people who are couples, that come to us as couples, and people who bring their spouses, which I think is a super great practice, because then your spouse can really understand a lot better what you're going to go through and how they can help, Also how they can hurt sometimes right. So, as a spouse, you can either be. You can be anything, you can be helpful, harmful or neutral through this process, right?
Speaker 1:
Do not tell your spouse their boobs are too small.
Speaker 2:
That's one thing you know. And the thing is, as we engage partners through this process, that's a really interesting thing to think about is what do we want the partners to be doing right? Because just being cheerleaders, supportive through this process, sure that's nice as a goal or a dream, but I don't know that that's fully possible, because spouses and partners have their own goals and dreams or need too. What do you think would be, would be a good way to like engage a spouse through this process?
Speaker 1:
Oh, I think, even my own journey. I think a spouse, your husband or significant other, should have to come to one appointment or support group or something. My husband is very just go with the flow and I could tell him I'm going to do something off the wall, crazy and he just be like, okay, and so with this I really wanted because I've seen other people's experiences and divorce rate is high within the bariatric community. True, True.
Speaker 1:
I really wanted to make sure he was okay with this decision, so I did tell him these things could happen. Yeah, absolutely.
Speaker 2:
Well, you know, and there is quite a lot of data actually about relationships and we will dedicate an entire episode, oh yeah we will.
Speaker 1:
What's your?
Speaker 2:
relationships and things. But there's quite a bit of data that people's sex life change after surgery, both good and bad. Definitely we know that more babies are born after bariatric surgery. For people who have infertility issues, for sure.
Speaker 2:
And you know this is a great treatment for erectile dysfunction and other kinds of low libido states for a lot of folks. But, like you said, divorce rates are statistically higher in the bariatric population after surgery than in the general population. Right, and some of the reasons for that are probably because expectations change after surgery, and those there's changes no matter what you do. And if you're not on board with your spouse and if you're not going through those together yeah eyes wide open. That can be a really big problem.
Speaker 1:
And I think you know, maybe this just sparked this topic in my brain, but I think he can meet my needs physically.
Speaker 2:
Yeah.
Speaker 1:
But emotionally we're struggling. I mean we struggle with emotional immaturity a little bit in both of our households growing up. We did not have it.
Speaker 2:
Sure.
Speaker 1:
And I feel like this journey has really helped my emotional intelligence maturity. And so I think, if you're not emotionally on board or on the same page, physical is hard, physical is hard. I think, I feel like the lightbulb just went up there, too Interesting.
Speaker 2:
I think you're really bringing in a really good point there, which is that sex, like many other things, isn't just a physical activity for most people it's very largely mental too right.
Speaker 2:
Yeah, and emotional and things like that. So if something is bringing up uncomfortable emotional things, feelings, if the mental health piece is being tricky or challenging, then it's difficult to have good sex when other parts of your mind are struggling or you're not connecting in other ways. Absolutely Interesting. Maybe there needs to be some supports and things like that specifically to address relationships and how relationships between partners change and how to support each other through those. Absolutely. Yeah, I 100% agree with you. Yeah, you're right, because that's really out there for you.
Speaker 1:
Nope, a lot of the stuff that we're touching base on in this podcast is not out there there's not a lot of information on. As I said, I've done so much research about everything possibly to research on when it came to bariatric surgery, and this is a huge missing Okay, not even missing, it's just not talked about. Nobody's talking about sex.
Speaker 2:
Yeah, you know, and I will say from my perspective, like in my training, residency, fellowship and things like that, I can tell you there was no talking about this. Not once did I see somebody being asked about their sex life right after surgery or before surgery or anything like that, or, you know, partners really being encouraged to participate in this process, anything like that. So it really was eye-opening to me when patients started asking questions here.
Speaker 2:
And I was like holy hot dog. There are no resources on this. I don't even know what to tell people outside of you know, don't hurt yourself.
Speaker 1:
But yeah.
Speaker 2:
But, you know, try things out and be creative in how you can support each other Because, you're right, the loose skin, the physical changes, some of the body dysmorphia things that you're touching on, those are big, hairy issues and they do not change overnight and some things do require other ways of dealing with them, right, that are necessarily just accessible and like an easy conversation between a couple of people.
Speaker 1:
Right, right. And so I think, stay tuned for when we have an open conversation, for when we have an OBGYN. Yeah, or even someone that specializes in hormones, absolutely. I mean, this is a whole topic that I think even professionals are still learning about.
Speaker 2:
Oh, yeah, the number of people who are shocked within our healthcare industry that bariatric surgery can be used to treat infertility or to help people with sexual function, it's really high. A lot of people don't know that, even within the industry and, to be honest with you talking about research on this topic or guidelines on this topic, it's sparse. Yeah, it is very sparse. I've maybe mentioned in a prior episode we don't understand all the ins and outs of why these surgeries change our bodies so much the way that they do, and we're just scratching the surface of that. And a big, big part of that is how it affects our sexual health. Yes, it does, but why and how we're just beginning to understand. And then, on top of that, that's just the physical changes, mental changes and how it really impacts relationships. That's what we really want to dig into too.
Speaker 1:
I agree Absolutely. So I also want to hear from listeners if you've had bariatric surgery, how has it impacted you? Has it been better, has it been worse? How did you personally battle those things Definitely and honestly? Maybe we'll have one of you on with us to discuss your journey Absolutely.
Speaker 2:
How you handled it Absolutely.
Speaker 1:
And you probably teach us something.
Speaker 2:
So make sure you are following us and please comment about how you've experienced with all of this and we may be in touch to talk with you, absolutely, absolutely, because we'd love to hear a perspective of both the folks that are super happy they're having babies after surgery yes but also the folks that are not so happy that their bodies changed in ways they didn't expect and it's having an impact too In ways they didn't want in their sex life.
Speaker 2:
So we'd love to hear your perspective. Don't forget to comment, to give us your thoughts and join us next time. Can't wait to see you, thank you.