My therapist disapproves sleeve?

[glitterdaisies 10]

So I mentioned to my new (non-WLS) therapist that I am meeting with my WLS surgeon to discuss a surgery date. She said I needed to work through my eating disorder before surgery bc I mentioned I am a stress eater and sometimes I don't have Portion Control. It's not all the time, so I don't feel like it's a disorder. I have PCOS so it's been a struggle with losing weight, even when I tried really hard to lose. Just curious if anyone experienced anything similar...

[Christinamo7 4,041]

many professionals are biased against WLS. I would let her know that this is something you are planning to do and ask her if she is uncomfortable working with you to refer you to someone else.

[KristenLe 5,979]

Go to a therapist who deals with Bariatric Surgery. I went for a few sessions for emotional eating. It's best to get some help before surgery even if it's something you only do on occasion. Stress can be difficult post-op and learning how not to turn to food will help tremendously.

[Inner Surfer Girl 12,015]

I would be curious to know how much she actually knows about WLS.

If she is unwilling or unable to work with you as you go through this process then definitely see if you can find someone else.

But, this might be a good opportunity for her to learn more about the surgery and the implications for people with eating disorders.

[OutsideMatchInside 10,166]

The therapist isn't wrong. I would still get my date, because insurance changes etc. That doesn't mean you can't work on your eating issues.

Any issues you have before surgery, the pre-op diet and the first month after surgery are going to bring them all to the surface.

You have to find ways to cope with head hunger, and stress eating before surgery or you are really going to suffer post op.

[Clementine Sky 707]

I also have PCOS and definitely understand the struggles it causes, including with weight. You might want to read through some of the medical research about how the VSG has been shown to help women with PCOS and then discuss it with her. Here is one paper:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334389/

Your therapist is unlikely to be aware of the health benefits of having the surgery, and how it can help to alleviate symptoms of PCOS. Since your hormones have an impact on your mental health, it can help to improve your psychological wellbeing as well as your physical.

If you have a history of binge eating and purging, then it would definitely be more of a concern because it's harder to break compulsions than habits. You could cause harm to yourself, especially in the first month post-op when you're healing, if you deviate from the eating plan. If you just have a problem with Portion Control and stress eating, as many of us do / did, and you think you can work on managing them, then you'll likely be fine. The sleeve is a way of enforcing portion control on you. It doesn't do all the work for you - you still have to make wise choices and use self discipline - but it helps tremendously. It will require you to learn other coping methods for handling stress. In the past I'd treat myself with food, and now I buy little things that indulge other senses, like a candle or fresh flowers.

[WLSResources/ClothingExch 3,443]

@@glitterdaisies, it doesn't sound to me that your therapist is opposed to bariatric surgery, but is concerned that you learn to overcome the emotional eating you've described. Surgery isn't a 'cure' for it. Our own strategies and understanding what makes us tick are what matter.

Jargon comes and goes. Don't get hung up on labels. Eating that causes weight gain and/or impedes weight loss is important to tackle. Whether it's a "disorder" or no, so what?

Your best bet would be to ask the therapist what she had in mind.

[KristenLe 5,979]

"@@Clementine Sky" Thank you for that link. Very interesting! I wish I knew that 20 years ago.

Edited June 23, 2016 by KristenLe

[sharonintx 1,275]

That's a good one. If all of us had the ability to conquer our eating issues then WLS would be a non-issue wouldn't it?

I say dump the therapist

[OutsideMatchInside 10,166]

That's a good one. If all of us had the ability to conquer our eating issues then WLS would be a non-issue wouldn't it?

I say dump the therapist

If people can't find coping mechanism for emotional and stress eating. They will continue to do it after WLS and fail.

WLS works best in combination with therapy. WLS makes it easier to resist emotional eating, and therapy makes it easier also.

There is no reason not to do both at the same time.

[VSGAnn2014 12,992]

I won't comment on your particular therapist -- don't know at all what she knows or doesn't know about WLS.

But be warned that WLS doesn't fix binge-eating. That may seem counterintuitive -- after all, the sleeve is a much smaller stomach, so how could anyone binge eat post-op?

Trust me, you could.

Yes, you'll probably lose a significant amount of weight post-op. But as your stomach heals and the early, temporary strong restriction eases and a year or longer out when you can eat more than a cup of food at a meal, you will find just how many calories you can put away.

Post-op, you can always graze (nibble on throughout the day) "slider foods" (highly processed foods with little nutrition in them that don't require much stomach digestion (ice cream, sweets, chips, crackers, dips, etc.). Those foods and high-calorie drinks -- like sodas, sweet tea, high-cal coffee drinks, sugary alcoholic drinks -- will pack the pounds back on.

There's an old saying around here -- they operate on your stomach, not your brain. Yes, you could have the surgery. But keep your therapist (or find a new one) and work on your brain, too.

[kadie777 50]

I'm a psychologist and had the gastric sleeve surgery. The research on sleeve showed better effectiveness for weight loss in obese groups than dieting did. I don't know your history with food, so obviously would not make any recommendations for you. But, for me, I'm a stress eater and surgery is providing a tool to help me change my relationship with food. I'm also myself examining the factors that contribute to overeating and eating unhealthy foods and trying to address them.

[Hollyhock 62]

I have not gone through surgery yet but I have completed 8 months of intensive outpatient therapy for an eating disorder and it has been really helpful. Your therapist may simply mean that surgery will be more successful if you resolve stress eating in advance. The IOP I attended included DBT therapy and supported eating which were really helpful.

Did your therapist discourage WLS, or did she tell you to work on stress eating prior to surgery? If the former, I'd get another therapist. If the latter, I might still seek out someone who specializes in stress eating. Does your surgery clinic also have a therapist and nutritionist? That might be the way to go.

PCOS does wreak havoc, no doubt about it. But from what I am told, surgery doesn't cure stress eating. But there are indeed therapies and therapists who can help you with this if you need it.

[Amurillo04 109]

It doesn't sound like she disapproves of the sleeve in general because she makes a good point but it seems like she just doesn't know the effect it will have on someone who has an eating disorder and which makes sense because she's a therapist not a dietician or surgeon. As long as she's not super pushy about you not getting it I don't think you have anything to worry about.

Sent from my iPhone using the BariatricPal App

Edited June 28, 2016 by Amurillo04

[theantichick 2,204]

My therapist doesn't like the surgery. She keeps pushing the health at every size thing, and thinks I'm pinning too much hope on the surgery to improve my quality of life. I don't think the surgery is going to cure anything, but losing weight will absolutely help a bunch of my chronic issues, and she just doesn't see that.

I'm seeing her because of food issues, but it's a pretty specific post traumatic stress thing. I mean, I do emotionally and stress eat, and we're also dealing with that, but I don't really do full-on binges. I started seeing her before I decided on the surgery, because these are issues I need to deal with whether I get the surgery or not. I'm not dumping her because we're doing good work on those issues. I just used a different therapist recommended by the bariatric surgeon for my surgery clearance so I didn't put my therapist in a position to approve me for a surgery she doesn't believe in. So we'll agree to disagree on the surgery, and focus on the issues I'm actually seeing her for.

I think that the mental health professionals who see a lot of body image issues develop a bias against the surgery because they see so many people who think the surgery will fix all of the problems in their life. Instead of rejecting the surgery outright, I think they would do better to help people realize that it can be *a* tool, but it is not a magic bullet.