Bariatric surgery is becoming more and more common, with approximately 200,000 people electing to undergo this procedure each year. Bariatric surgery has one goal: weight loss. This is accomplished primarily through restriction of gastric capacity, which means people simply cannot eat as much as before. Another strategy is restriction combined with bypassing a portion of the intestine; this results in fewer calories being absorbed.
Many undergo this surgery with the hope of improving physical health or ending a life-long struggle with their weight. A “successful” surgery results in fairly rapid weight loss during the first 12-36 months, with additional weight loss over time. However, up to 20% of patients experience a “failed” surgery, meaning they lost an insufficient amount of weight, or regained weight after the initial loss.
This is typically associated with a tremendous amount of shame and guilt; after all, this type of surgery is presented as a panacea, a “quick fix.”
The truth is, for many it is anything but a quick fix, since this surgery is designed to get rid of the “problem;” it is not concerned with what is behind the problem. These women are like any other person with an eating disorder: they are using food as an unhealthy method to cope with the issues of life.
Therefore, it is no surprise when they come to Timberline Knolls for treatment. Whether they engage in compulsive overeating, binge eating disorder (BED), or now struggle with obesity, we treat them all the same in terms of therapy. Although similar, the treatment plan and especially the dietary component are much more complex. Due to the malabsorbtion issue, they require special foods, vitamins and supplements. If the individual is obese, special environmental accommodations must be made.
Sadly, we also see women who have proved a success story in terms of the surgery, yet now come to us due to self-harm, substance abuse or other addiction. Again, this is not unexpected; when they could no longer cope with their drug of choice—food– they turned to alcohol or drugs.
As with most things in life, bariatric surgery is not all bad; in certain cases, this intervention is appropriate. However, one psychiatric assessment prior to surgery is not enough–therapy must be an ongoing part of the equation; otherwise that person is either being set up to fail, or being led unwittingly down the path to another addiction or disorder.