Can You Develop Eating Disorders After Bariatric Surgery?

When an individual is seeking weight loss surgery, they normally have to go through a qualification process. The surgeon may have a set of criteria the patient has to meet, and if the individual is using health insurance to cover part or all of the cost, they will be subject to additional requirements. One of the requirements they are often asked to complete is a psychological evaluation.

Studies have shown that individuals who suffer from unhealthy eating patterns may still struggle with these eating disorders after bariatric surgery, or they may develop these habits for the first time after their weight loss surgery.

Today we are going to talk about different types of unhealthy eating patterns and what might cause an individual to develop an eating disorder after gastric sleeve or other type of bariatric surgery.

Is An Eating Disorder A Choice Or A Condition?

Are eating disorders the result of conscious personal choices, or are they considered physiological or psychological conditions?

This is not such an easy question to answer because the underlying causes of eating disorders are numerous and complex. Many people mistakenly believe that eating disorders are a personal choice but they run deeper than that. According to the National Eating Disorder Organization (NEDO), they stem from a mixture of psychological, biological, and sociocultural elements that piggyback on their feelings about their weight, size, or food. Eating disorders are serious conditions that are tied to thoughts and emotions, which disrupt their eating patterns and can result in declining health or even death.

What Does An Eating Disorder Look Like?

Currently, there are nine different eating disorders identified on the NEDO website, including:

  • Anorexia Nervosa (AN);
  • Bulimia Nervosa (BN);
  • Binge Eating Disorder (BED);
  • Avoidant Restrictive Food Intake Disorder (ARFID);
  • Other Specified Feeding or Eating Disorders (OSFED);
  • Unspecified Feeding or Eating Disorder (UFED);
  • Rumination Disorder;
  • Pica;
  • Orthorexia (not an official category but recognized as becoming significant).

Some of these disorders may be familiar to you, and you may have never heard of the others, but these categories were all created based on real individuals and their behaviors. These categories are used by medical professionals to quickly classify patients for diagnostic purposes. There are a few categories that were created for those who do not “fit” neatly into a certain category.

Most Prevalent Eating Disorders

Research has shown that there is a natural relationship between patients who undergo bariatric surgery and eating disorders. Most of these individuals have an unhealthy relationship with food before they undergo surgery, but some develop issues after their procedures.

Individuals tend to have a distorted view of their own bodies and visualize themselves as bigger than they really are. They can become obsessed with controlling everything they eat, and often with exercising.
Individuals who suffer from bulimia often overeat large amounts of food and then get rid of the food before it can turn into extra weight. This is done by forcing themselves to vomit, misusing diuretics, laxatives, or medications, or engaging in excessive exercise.
Binge Eating
While anorexia and bulimia are more widely known, binge eating disorder (BED) is more prevalent and is the second most commonly diagnosed eating disorder. An individual with BED usually eats more food in one sitting than the majority of people would. A lot of times they eat by themselves; they eat fast, continue eating when they are full, and eat when they are not even hungry. Then they become tormented by a cycle of guilt and shame for their out-of-control eating habits.
Other Specified Feeding or Eating Disorders
This is the number one diagnosed eating disorder and is used for those patients who do not meet the specific criteria for other categories but still struggle with a dangerously unhealthy eating disorder.

What Can Trigger Eating Disorders After Bariatric Surgery?

First, it is important to understand that bariatric surgery is not a treatment or cure for eating disorders, so if the patient was experiencing these tendencies prior to their weight loss surgery, their underlying issue will not magically go away as a result of the surgery.

After bariatric surgery, eating disorders may look different, or the psychological reasons fueling them may be satisfied by the forced changes they have to make resulting from the alterations to their digestive system.

In some cases, the issue of negative body image continues even after the individual loses weight. They may end up with a large amount of loose skin after shedding a large amount of pounds, trading one source of discontent for another. Or psychological reasons may prevent them from recognizing the positive changes that have taken place.

The most crucial aspect could be the absence of both social and professional support. It is not uncommon for individuals considering bariatric surgery to keep their existing eating disorders to themselves during evaluations. Sadly, this can hinder their medical team’s ability to provide them with the type of support and help they need to become healthier.

What Does An Eating Disorder After Gastric Sleeve Or Another Form Of Weight Loss Surgery Look Like?

The changes that are made to the body during weight loss surgery can affect an existing eating disorder or even create an opportunity for one to begin. After surgery, the stomach size is significantly reduced, which can make it difficult for an individual to eat an unusually large meal.

Patients who had issues with binge eating before their surgery often translate their behavior into what is called grazing. This involves snacking or eating randomly, whatever, and wherever, so food is consumed continually. This can result in a high consumption of calories, weight gain, and gradually stretching out the stomach so the restrictive nature of the surgery is undone.
Individuals who do not chew their food adequately after undergoing bariatric surgery may experience what is called “plugging.” This causes a blockage in the now very narrow digestive route and induces vomiting. This is a natural consequence of eating food that has not been reduced to a certain size, but some patients figure out how to deliberately use this to control their weight.
Alternate Addictions
In addition to eating disorders after bariatric surgery, some patients who are now unable to regulate their mood with food turn to other addictive behaviors. They may turn to drug use, overuse of the internet, compulsive gambling, or alcohol abuse. Many of these individuals struggled with these tendencies prior to their surgery. Patients who have had these types of addictions need extra support for several years after their weight loss surgery.

What Is The Best Treatment For Patients Who Experience Eating Disorders After Bariatric Surgery?

Patients who suffer from eating disorders after gastric sleeve or bariatric surgery need an extensive support system. They benefit the most from long-term support provided by a team of professionals who work together. This team might consist of a behavioral health therapist, a certified nutritionist or dietician, a doctor who specializes in obesity medicine, a professional who will provide guidance related to physical fitness, and a host of supportive friends and family members.

If left untreated, obesity and eating disorders can evoke substantial medical problems and serious psychological impairments.

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