A reader emailed My Bariatric Life and asked bariatric dietician Elizabeth Anderson for her perspective on eating disorders and WLS (weight loss surgery). Learn how to get your question answered.
In this edition of ‘Dear Elizabeth’ I’m sharing information about eating disorders and WLS (weight loss surgery). I’ve included several questions from readers to provide as much information as I can about this important topic.
Is there a Link between Bariatric Surgery and Binge Eating Disorder?
“Is there any connection between bariatric surgery and eating disorders? I’ve heard you’re at higher risk for getting an eating disorder if you have weight loss surgery. Is that true?”
First, there’s a lot of information about WLS that is anecdotal—or based on a personal story, not evidence-based research. As a health professional, I’m obligated to share information that can be backed by science and not opinion.
I checked in with the ASMBS (American Society of Metabolic and Bariatric Surgery) and a leading researcher in the field of eating disorders, to find out what links, if any, there are between eating disorders and WLS.
Here’s what we know so far and WLS and eating disorders:
- BED or Binge Eating Disorder is the most common eating disorder for patients with obesity.
- BED is defined as regularly eating a large amount of food in one sitting, (or a two-hour period of time) and feeling a loss of control or inability to stop.
- About 20 % of WLS candidates have BED — that’s a much higher percent than in the general population.
- Post ops who can’t stop binge eating after WLS are at higher risk for complications after surgery.
Are Bariatric Patients at Increased Risk for Eating Disorders?
“Is there some part of bariatric surgery that increases the chances of developing an eating disorder?”
Nutritional changes after WLS may negatively affect mood. How? Not taking vitamin and mineral supplements and/or not eating enough protein can make it impossible for the body to make the brain chemicals that allow us to be happy. If eating brought us relief, joy, comfort or escape before surgery, it’s likely we’ll do what whatever it takes to get that same experience with food after surgery.
“What’s the number of bariatric surgery patients who develop an eating disorder?”
The actual numbers of WLS post ops with eating disorders is unknown and hasn’t been measured. Experts believe only a small minority of patients develop eating disorders (ED).
Those who do exhibit signs of disordered eating, tend to be those who suffered from an ED before surgery.
“Can WLS cause you to develop addictions after surgery?”
5-30% of post ops with pre-op addictions develop another addiction after weight loss surgery surgery. This is called cross addiction and it can occur after all types of WLS procedures.
Eating Disorders and WLS:
Learn Healthy Coping Skills
Okay, stats aside, now here’s my chance to editorialize.
In my practice, I probe my pre-op surgery candidates hard for signs of current stress or trauma in their lives.
I believe clients who tend to emotional scars before surgery through counseling and developing new coping skills, are less likely to turn to misuse food after surgery.
But what if you’re post op and don’t know if you’ve got a toxic waste dump of painful emotions buried somewhere deep inside?
Ask yourself the following questions:
- Do you have a history of abuse, neglect or trauma? Go all the way back as far as you can remember.
- Do you have a history of addiction in your family?
- Have you ever considered food your best friend?
- Do you obsess about what you’re going to eat to escape especially hard days?
A great therapist is as important after surgery as before. Run, don’t walk to a trusted professional.
Support for Eating Disorders after WLS
Contact the National Eating Disorders Association to find contacts and help near you. You may reach the Helpline at (800) 931-2237. For crisis situations, text “NEDA” to 741741 to be connected with a trained volunteer at Crisis Text Line.
Reach out to the Obesity Action Coalition for peer and professional support.
Don’t wait another day.
Until next time, take good care of YOU!
Content is the opinion of the author and does not constitute or is a replacement for medical advice.
- “Eating Disorders and Eating Behavior Pre-and Post Bariatric Surgery.” Martina de Zwaan, MD and James Mitchell, MD. Chapter 4 pp. 25-32 ASMBS Textbook of Bariatric Surgery.
- Weight Loss Surgery and Cross Addiction. Carolyn Coker Ross, MD, MPH. Obesity Action Coalition website link: https://tinyurl.com/crelyzt.