Each of us views and experiences our sexual identities, personalities and relations in different ways.  Attached below are multiple articles provided in hopes you will find at least one which resonates with your current situation or needs.  Some article topics may encourage you to explore your sexual self-understanding or your desires, while other articles may prompt change or stimulate your thoughts, feelings or senses.

I would like to personally thank all patients in attendance at the February CBSI Support Group, specifically for their willingness to participate in this discussion topic and, in some cases, to expose their individual situation for support or to provide insight to others.

I have attached an article about this topic in hopes of giving myself and you as the reader some insight into this week’s blog subject.  Additionally, I have attached some definitions regarding the various words and links to articles and websites.

Happy Reading,

Elisa Fadum-Montoya, LCSW

Bariatric Social Worker

Hospital Says Weight Loss Surgery May Lead To Better Sex By Armen Harevan

Does weight loss surgery lead to better sex? It certainly could, especially for men suffering from obesity-related erectile dysfunction. A clinical study recently published in The Journal of Sexual Medicine showed that obese men with erectile dysfunction had low levels of testosterone. As the severity of obesity increased, the levels of testosterone further decreased.

Excess abdominal fat, cardiovascular disease, high blood lipids and type 2 diabetes have been associated with erectile dysfunction. According to leading sex researcher Irwin Goldstein, M.D., this information may help motivate men to make healthier lifestyle choices.

“This is a landmark study that shows sexual health is clearly linked to overall health,” said Dr. Goldstein, who directs the sexual medicine program at San Diego’s Alvarado Hospital. “Improving one’s general health is an opportunity to improve erectile function.”

However, similar benefits are not as clear for women. Obese women do report more sexual impairment than obese men. However, published studies indicate this may be more related to low self-esteem, unsatisfactory relationships, social stigma, and other psychological issues.

“A woman’s libido can be affected by many factors, such as the stress of caring for a sick relative,” Dr. Goldstein said. “There is no evidence yet to indicate that weight-loss surgery automatically makes sex better.”

He added that when it comes to sexual activity, body size doesn’t always matter. Thin, healthy people may be perceived as having the best body image and sexual function, but that is not always the case.

“There are plenty of sexually active heavy people and sexually inactive thin people,” Dr. Goldstein said. “I see them every day in my practice.”

Weight Loss Leads To A New Body Image
Just as weight-loss surgery requires life-long behavioral changes in nutrition and exercise, body image must also be addressed. As the pounds come off, patients often find other people start responding differently to them. It is not uncommon for a partner to expect more sex. Additionally, some patients may become uncomfortable about increased attention from strangers.

Then there’s the new reflection in the mirror. A weight loss of 100 pounds or more may leave folds of excess skin. Plastic surgery is effective, but it is costly and not always covered by health insurance.

Psychologist Lisa Steres, Ph.D., who provides counseling for bariatric surgery patients at Alvarado Hospital, says it can take years for a patient’s brain to catch up with the new body. As part of her pre-surgical evaluation, she asks delicate yet direct questions: How has the weight impacted sexual relationships? How do they expect the weight loss to impact their sex life?

“Body image greatly impacts libido, particularly in women,” Dr. Steres said. “Young women typically have better body image, and some women are sexually confident at any size.”

Dramatic changes during the transition to a normal weight can impact self-esteem and confidence. During the pre-surgical evaluation, Dr. Steres prepares patients to expect this, so they may come back and discuss it if necessary.

Dr. Steres said that both patients and partners typically go through stages of being relieved about the reduced medical concerns, but are then surprised at their own responses to the excessive skin that often results from massive weight loss. Some patients choose to consult with a plastic surgeon, while others are just as content as they were before the weight loss.

“Occasionally, a woman doesn’t like how she looks after surgery without her clothes on,” Dr. Steres said. “But when patients are basically happy people in loving, caring relationships, we find they work these things out.”

The following information was posted by:

Katherine Rabinowitz, LP, M.A., NCPsyA http://therapycanwork.com/index.php?option=com_content&view=category&layout=blog&id=46&Itemid=95#intimacy and

Life Planning Education, Advocates for Youth, Washington, DC  http://www.advocatesforyouth.org/storage/advfy/documents/circles.pdf

Sensuality - is awareness and feeling about your own body and other person’s bodies, especially the body of a sexual partner.  Sensuality enables us to feel good about how our bodies look and feel and what they can do.  It also allows us to enjoy the pleasure our bodies can give us and others.

Intimacy - does imply closeness, honesty, trust and a willingness to be exposed and vulnerable.  To have emotional intimacy means being able to share the good, the bad and the ugly.  Sharing intimacy is what makes personal relationships rich.  While sensuality is about physical closeness, intimacy focuses on emotional closeness.

Sexual Intimacy - is the ability to let go of inhibitions and be naked, in both the literal and metaphorical sense of the word, with another person. For some people, that loving and tender kind of energy is easy. They feel united and alive. Others feel vulnerable and ashamed. 

Sexuality - is often confused with intimacy. For some people they can be one and the same, but not always. It is not unusual for an individual’s or couples' involvement in sexual activity to wax and wane. There are periods where one or the other person loses interest. Change in hormones (both male and female) can play a role. Weight gain, weight loss, the normal changes in appearance brought on with age, or plain old fatigue because of work/child/relationship stress might be the reason for the change. The need to be alone can also change over time and affect how sexual you feel. 

Love vs. Intimacy

"The value of the personal relationship to all things is that it creates intimacy... and intimacy creates understanding...and understanding creates love." ~Anaïs Nin

Love and intimacy are not exactly the same. You can love without being intimate, and you can be intimate without loving. Intimacy is that ineffable quality that authenticates a sense of closeness. What does it mean to be intimate? Some might say, "We have sex, so we must be intimate." While sexual relations can be one of the most intimate of human experiences, it is possible to engage in sexual activity without a drop of intimacy. Intimacy implies the willingness to expose yourself in all your naked vulnerability, to admit when you are wrong, to rejoice in the other's triumphs. Intimacy means sharing your feelings and accepting without judgment those shown to you. Difficulty with intimacy doesn't necessarily mean a relationship falls apart, but surely its presence solidifies one, and its absence is an indication of a lack of true relatedness.

OTHER INFORMATION and ARTICLES

DEFINITIONS

http://therapycanwork.com/index.php?option=com_content&view=category&layout=blog&id=46&Itemid=95#intimacy

http://www.advocatesforyouth.org/storage/advfy/documents/circles.pdf

RELATIONSHIPS

http://www.medicinenet.com/healthy_relationships/article.htm

http://www.psychologytoday.com/blog/love-and-gratitude/201112/5-thoughts-new-year-love-and-happiness

SENSUALITY

http://psychologytoday.tests.psychtests.com/take_test.php?idRegTest=1327

http://www.artofloving.com/artofsensuality/index.htm

WEIGHT AND SEX

http://www.yourbariatricsurgeryguide.com/sex-after/

http://www.psychologytoday.com/PRINT/32092

http://www.psychologytoday.com/blog/all-about-sex/201005/sex-and-weight

http://www.webmd.com/sex-relationships/guide/sex-and-weight

HEALTHY SEX

http://www.medicinenet.com/sex_and_love_quiz/quiz.htm

http://www.psychologytoday.com/blog/not-born-yesterday/201201/psychology-in-the-bedroom

http://www.aphroditewomenshealth.com/news/keeping_sex_fresh.shtml

http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/natural-sex-boosters-can-you-rev-up-your-libido?page=1

http://www.medicinenet.com/sexual_health_pictures_slideshow/article.htm

SEXUALITY

http://www.npr.org/templates/story/story.php?storyId=18975616

http://www.better-lifestyle-tips.com/papavibe

http://www.aphroditewomenshealth.com/news/reconnect_sexuality.shtml

http://www.psychologytoday.com/blog/enlightened-living/200902/sexuality-intimacy-and-the-masculinefeminine-archetype

DIFFICULTIES

http://www.psychologytoday.com/blog/love-and-gratitude/201201/love-make-sex-and-the-silent-treatment-0

http://www.webmd.com/sexual-conditions/ss/slideshow-sex-drive-killers

BODY IMAGE

http://www.medicinenet.com/beauty_and_body_image/article.htm

http://www.aphroditewomenshealth.com/news/female_sexuality_body_image.shtml

http://www.aphroditewomenshealth.com/news/20110509012819_health_news.shtml

WEBSITES

http://www.signaturesensuality.com

http://www.worldsexology.org

http://www.aphroditewomenshealth.com/news/female_sexuality.shtml

http://www.aphroditewomenshealth.com/forums/ubbthreads.php?ubb=cfrm

Research has shown that obesity has a genetic component AND that poor sleep habits play a role in the development of obesity.  At the SLEEP 2011 Meeting of the Associated Professional Sleep Societies, there was a presentation about a recent study providing further support that we should be getting more shut-eye.  The study found that sleeping less at night may increase the expression of genetic risks for obesity.  The study's finings revealed that lower Body Mass Index (BMI) was linked with longer stretches of sleep at night.  The researchers focused on heritability.  Heritability basically looks at how much variation between individuals is due to genetics, versus factors like environment.  One of the most interesting findings of the study was that when participants slept for only 7 consecutive hours, the heritability of BMI was more than twice as large as the heritability of BMI when participants got 9 uninterrupted hours of sleep.  This means that the heritability of body weight decreased as sleep duration increased.

The study was made up of 1,811 sets of twins with an average age of 37-years-old.  The researchers gathered the participants weight, height, and normal sleep habits through a survey.  The participants were on average categorized as slightly overweight, with an average BMI of 25.4 and on average slept 7 hours and 11 minutes each night.  The findings led the researchers to determine that not sleeping for long enough seems to increase expression of genes involved in regulating body size.

The team at the Colorado Bariatric Surgery Institute finds this study interesting because since sleep duration is largely under our own control, it is potentially a modifiable risk factor for obesity.

So remember that getting a good amount of sleep at night is a great way to work towards better physical and mental health!