Eating Disorders After Bariatric Surgery

Bariatric surgery does not treat food addiction. This statement might be a revelation to some, but it is also the title of a book by Dr Connie Stapleton, PhD. According to Dr Stapleton, "Food addiction is often undiagnosed and can sabotage even the best efforts to lose weight and keep it off. Food addiction is a disease separate from the disease of obesity. If food addiction is present and untreated, it will overtake efforts to treat the obesity, resulting in ongoing medical comorbidities, hopelessness, and frustration."¹

Like food addiction, other eating disorders can be common among bariatric patients. A study of eating disorder rates among people with a BMI below 40 found that although women are as much as 3 times more likely than men to suffer from any eating disorder, men and women were equally likely to experience binge eating.²

Binge eating disorder

What exactly is binge eating disorder? Beyond eating large quantities of food in a short period, clinical binge eating is accompanied by a sense of losing control and occurs at least once a week for at least 3 months.³ By conservative estimates, 10% of bariatric patients meet the criteria for binge eating disorder, compared with 1.2% of the whole population.³ This is one of the reasons a pre-operative psychological evaluation is so important for bariatric patients.

Factors to consider

Here are 5 factors to consider if you have had bariatric surgery, are thinking about it, or are losing weight without surgery:⁴

1. Be honest. Patients may be afraid of being disqualified from surgery if they admit to disordered eating. However, treatment for eating disorders before surgery is not an automatic disqualification and leads to better outcomes after surgery.
2. Research the team. The care team should include a variety of professionals to cover all the patient's needs, including cognitive behavioural therapists to address mental health concerns.
3. Support groups. Attending support groups regularly improves success, both with weight loss and with your relationship with food. A support group is often the best way to keep regular contact with a registered dietitian, nurse or coordinator.
4. Embrace change. Taking the first step towards getting help is not easy, but embracing behaviour change is needed for long-term health and wellness.
5. Self-compassion. Obesity often comes with feelings of self-loathing, remorse, guilt and shame, none of which are erased by surgery. Finding self-compassion helps alleviate these feelings along the journey.

While bariatric surgery can treat obesity, diabetes, high blood pressure, orthopaedic concerns and more, these physical conditions often take the spotlight while eating disorders and mental health are ignored. Take care in addressing eating disorders after bariatric surgery. As Dr Stapleton put it in her book, "weight loss surgery does not treat food addiction".

This article is for general information only and does not replace personal medical advice. Always discuss your situation, blood test results and supplementation with your bariatric team or healthcare provider.