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Eating disorders prior to bariatric surgery



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Hi guys, I'm new to this community but have been struggling with my weight my entire life. I've been considering WLS for the past year. I would very much like to undergo surgery this year. I have access to a large academic medical center through my employer, and the weight loss clinic there has excellent providers (I say this to say I didn't see a hack). I saw one last year and we discussed my history of disordered eating (restricting then binging/purging, yoyo dieting, hiding extra food from others) and was very candid. I also have a history of alcoholism (sober 10 years). The provider I saw told me I was very different from the patients she usually sees which leads me to ask this community - are there really so few bariatric patients with eating disorders and other mental health conditions??? I'm just looking to hear from others with similar experiences who are traveling or have traveled this road.

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I have bipolar disorder and some history of eating issues but only for brief periods of time (maybe 15 incidences of vomiting and a few months of restrictive eating). I can't think of anyone who hasn't yo-yo dieted: I have once lost 50 lbs and another time lost 100, but gained it back. I'm not sure what you mean by "hiding extra food from others". I have no history of addiction, but I know that can be a concern for WLS because cross addition especially alcoholism is a problem after WLS.

For me, the weight center (also a major academic medical center) is requiring that my psychiatrist speak to their psychologist and clear me for surgery. Did you see the bariatric psychologist?

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Thanks for taking the time to reply!! "Hiding food from others" just means hiding my eating habits from others, like sneaking food to eat by myself so no one sees my portions and criticizes. I think that's a normal behavior for someone who's ashamed of their eating. I have seen a bariatric psychologist and started CBT to identify the thoughts behind the behaviors. I can see how cross addiction could be a problem, because the coping mechanism of food is taken away after surgery. I think in my mind I just want the answers to be "ok you're a perfect candidate let's go to surgery tomorrow!" and in reality there are some things I need to work on first.

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I also have bipolar disorder which they didn’t care about because it’s being treated and my psychologist signed off. But When you mention hiding food from others I guess if that constitutes an eating disorder then I have one too. I have a history of occasionally eating poorly while I’m alone and then eating again so that My husband wouldn’t know I ate something bad for me (because I’m embarrassed and don’t want him to be disappointed that I couldn’t stick to my diet) but that didn’t come up at my psyc evaluation.

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Yeah, even if you're a perfect candidate I think the only way to get surgery quickly is to go to Mexico. And even then, it's not TOMORROW. I wish my surgery process wasn't taking as long as it is; I am so frustrated right now! But every time I say this people who have had their surgery tell me it will fly by and then the efforts I'm putting in now to make the necessary brain changes are super important.

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5 minutes ago, kalassi said:

Thanks for taking the time to reply!! "Hiding food from others" just means hiding my eating habits from others, like sneaking food to eat by myself so no one sees my portions and criticizes. I think that's a normal behavior for someone who's ashamed of their eating. I have seen a bariatric psychologist and started CBT to identify the thoughts behind the behaviors. I can see how cross addiction could be a problem, because the coping mechanism of food is taken away after surgery. I think in my mind I just want the answers to be "ok you're a perfect candidate let's go to surgery tomorrow!" and in reality there are some things I need to work on first.

I think that will be very helpful. I wish I could get to the root of why I eat so much whr I am board. Idk if that is considered disordered eating or not but I also have that. I felt like the psychiatrist I seen just gave a rubber stamp and really didn’t do me any favors to set me up for success. To be honest you may have to do a bit more work up front but it sounds like they are better preparing you for what is to come. Like right now I am 6 weeks out and I do not have actual hunger but I am home and I have thought about eating several times outside of eating time and it’s just boredom. I am able to control it without the hunger hormones on top of it but once they come back it would be helpful to know how to control the head hunger.

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IMHO... I don't think that it's that people don't have the eating disorders - I used to go to McDonald's, get a cheeseburger, scarf it, and then go home and eat dinner - maybe it's that not everyone is as candid as you were?

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13 minutes ago, njlimmer said:

IMHO... I don't think that it's that people don't have the eating disorders - I used to go to McDonald's, get a cheeseburger, scarf it, and then go home and eat dinner - maybe it's that not everyone is as candid as you were?

Maybe. I think that the job of a good psychiatrist is to get it out of us though so they can do what your dr is doing to better prepare us to be successful. I have thought of asking for the list again and seeing someone else off the list on my own to try and work on the eating while board and I guess now the hiding it sometimes.

Edited by ShoppGirl

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16 minutes ago, njlimmer said:

IMHO... I don't think that it's that people don't have the eating disorders - I used to go to McDonald's, get a cheeseburger, scarf it, and then go home and eat dinner - maybe it's that not everyone is as candid as you were?

I replied to this as if it was kalassi saying it. Sorry for the confusion. I was just typing on a roll and thought it was same person. 😂

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I can't speak for everyone. I failed my psych evaluation and am having to do 3 months of therapy then check in on my eating habits/behaviors again. The psychologist that evaluated me did tell me she appreciated my honesty, and mentioned that a lot of people try and "pull the wool over her eyes". Based on that, I would wager that the honesty is what was uncommon, and not necessarily the unhealthy relationship with food. I'd think anyone that qualifies for the surgery due to weight would have some sort of unhealthy relationship with food.

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43 minutes ago, SunnyinSC said:

I can't speak for everyone. I failed my psych evaluation and am having to do 3 months of therapy then check in on my eating habits/behaviors again. The psychologist that evaluated me did tell me she appreciated my honesty, and mentioned that a lot of people try and "pull the wool over her eyes". Based on that, I would wager that the honesty is what was uncommon, and not necessarily the unhealthy relationship with food. I'd think anyone that qualifies for the surgery due to weight would have some sort of unhealthy relationship with food.

Yeah I remember not wanting to tell my doctors anything that would get me denied. "I never drink, I exercise regularly, sure I did the test for sleep apnea already... etc." It sucked because this was the most medical attention I've ever received but I was too scared to be honest.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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