Background

We characterized romantic relationships and explored correlates of risky sexual behaviors (RSBs) within romantic relationships for young adults (YAs) who did/did not undergo pediatric metabolic and bariatric surgery (MBS) using data from a prospective longitudinal cohort series.

Methods

At year 6 follow-up, 121 surgical YAs (Mage=23.0, 81% female, 68% Non-Hispanic White, MBMI=40.0; -22.2% weight change) and 62 nonsurgical YAs (Mage=23.0, 84% female, 53% Non-Hispanic White, MBMI=53.0; +14.8% weight change) completed the Sexual Activities and Attitudes Questionnaire and the Harter Self Perception Profile. An RSB score was summed for YAs in a current/most recent relationship (Table 1), with potential correlates examined by sex: group (surgical, nonsurgical), marital status, age, romantic competence, childhood abuse history, and physical abuse in a relationship. BMI and percent weight change from pre-operative/baseline were examined separately.

Results

At year 6, 88.93% of females and 81.8% of males reported ever being in a romantic relationship. For female YAs ever in a relationship, being single (versus married/engaged) and higher self-perceptions of romantic competence were associated with higher RSB scores, with group (surgical versus nonsurgical) unrelated. In the surgical group only, lower BMI and greater percent weight loss were associated with higher RSB scores for females. Recognizing small sample size, few significant associations were found for males.

Conclusions

While improved romantic competence and engagement suggest pediatric patients move towards age-normative roles post- MBS with weight loss, RSBs can lead to unintended consequences (e.g., unplanned pregnancy, STI) for any YA. Developmentally tailored guidelines addressing unique psychosocial concerns are needed.