According to a Harvard study, over half of the people who undergo surgery for obesity have pre-existing food and eating issues, including binging. In a recent article, Lisa Lilenfeld, president of the Eating Disorders Coalition at Argosy University in Washington, D.C., and a practicing psychologist, says that this segment of the population is at the highest risk for developing additional food issues after surgery. She says, “The most likely thing is that people who had untreated or unsuccessfully treated binge eating disorders before surgery will continue to have problems after surgery. The problem is it becomes physically challenging and potentially dangerous to binge like this because of the structural changes in the stomach.”
Some patients go to the opposite extreme, and extremely reduce their food intake resulting in anorexia and malnutrition. Dr. Donald Kirby, a gastroenterologist at the Cleveland Clinic who practices weight-loss surgery, said, “I’ve had a number of patients go from very obese to very underweight, so much so that they need to be rehabilitated with intravenous nutrition.” Most people seeking weight-loss surgery are required to have psychological screenings, but these are usually less than adequate at discovering real food and eating issues. Many do not even address mental health issues at all.
Dr. Leslie Seppinni, an obesity therapist specialist, says it is important to understand the difference between medical and psychological reasons for bulimia and anorexia. After surgery, many patients will purge simply because of the physical discomfort from overeating, not because of a psychological issue with food. Whereas, when psychological issues cause problems with food, it is usually because someone was addicted to food prior to surgery, and now that method of coping through overeating has been taken away. The addiction is still, there, it has just been transferred to another area. Seppinni says, “You take away the coping strategy they’ve been using all their lives, and the addiction has to go somewhere else.”
© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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