Weight Loss Surgery Can Trigger Increased Food Problems

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.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • esther turner

    esther turner

    June 19th, 2011 at 3:21 PM

    “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.”

    What? That’s unbelieveable. How can they possibly qualify for such a drastic surgical procedure without proper screening? There’s already all the inherent risks that go along with any surgery. Do they know how much more damage they could do internally if they continue to binge and purge post-surgery? The body needs time to recuperate from such procedures.

    That’s so wrong that surgeons will take them on board without asking such important questions beforehand. Screening for eating disorders should be mandatory, not optional.

  • J.C. Main

    J.C. Main

    June 20th, 2011 at 12:08 AM

    @esther turner: I’ll fill you in on how they qualify without going through a psych evaluation, esther…by the power of the mighty dollar.

    The surgeon’s greed overrides commonsense precautions. As usual when it comes to prioritizing the patient’s welfare is last and the inflated price tag comes first. The patient’s money would be better spent on having therapy to address their eating disorders first. Then they may not even need the surgery.

    Ah, a lightbulb moment!

    Of course, that’s what the weight loss surgeons are probably afraid of, hence their reluctance to insist upon that being resolved prior to an operation I imagine.

    And if the patients rip themselves up inside after it because they keep bingeing, hey-more surgery! It’s money in the bank for the surgeons all over again.

  • W.Frances


    June 20th, 2011 at 12:31 AM

    @esther turner: Absolutely spot on there, esther! I agree 110%. And that screening has to be a non-negotiable condition that must be fulfilled before any surgical treatment is authorized.

    You would think if they went through all the pain and discomfort associated with weight loss surgery that the patients would be plenty motivated to not do anything untoward or downright dangerous after that and risk undoing all the good it did. I don’t follow their logic at all.

  • Deanna


    June 20th, 2011 at 4:23 AM

    This has been one of those quick fix kind of surgeries that is simply being done to put a bandage over the problem and not really solving the issues at hand. People get overweight to this level for a reason. It is not just about the fact that they like to eat. It is that they like to eat but may also be covering up some other issues through food. I am that person so I know. I had weight loss surgery a few years ago and had a lot of success at first but it did not fix what was really going on and as a consequence I have gained back all of the weight that I lost and then some. It was mortifying to go through that but I am working on accepting me for who I am and not covering up my issues through food.

  • Cody


    June 20th, 2011 at 2:40 PM

    My aunt underwent a weight loss treatment and after that she was so obsessed with staying that way that she almost gave up on food.Many friends told her that no extremes are good but she will not listen.We are getting concerned about her too.Even doctors have grown tired of advising her.

  • BETH


    June 21st, 2011 at 4:37 AM

    Do most candidates for weight loss surgery have to undergo therapy first to determine if they are a good possibility for this kind of tough surgery?

  • Lucy K.

    Lucy K.

    June 21st, 2011 at 8:03 AM

    ^^I suppose they do.And this report of them having issues even after such a procedure is followed can only mean that it’s not being enforced enough or is ineffective..

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