Search This Blog

Saturday, November 3, 2012

Anorexia After Gastric Bypass Surgery??


A typical description of Anorexia Nervosa is as follows:

Anorexia nervosa is an eating disorder characterized by immoderate food restriction and irrational fear of gaining weight, as well as a distorted body self-perception. It typically involves excessive weight loss.  Due to the fear of gaining weight, people with this disorder restrict the amount of food they consume. This restriction of food intake causes metabolic and hormonal disorders.  This is a quote from Wikipedia.

If this sounds a lot like what we go through as gastric bypass patients, then I agree.  However, according to Eating Disorders Review :

Full-onset Eating Disorders
The onset of full-syndrome eating disorders—anorexia nervosa, bulimia nervosa, or binge eating disorder—after surgery is unlikely, but possible. However, it is important to recognize that aberrant eating patterns may develop after the operation that do not meet current diagnostic criteria for eating disorders, but that nonetheless are associated with distress and impaired weight management. For example, research studies indicate that the resumption of or onset of loss of control over eating is not uncommon at longer-term follow- up, and may be associated with inadequate weight loss or weight regain.

Segal and colleagues (2004) have observed the co-occurrence of eating disorders and anxiety symptoms in this patient population. As a result, they have proposed a new diagnosis, “postsurgical eating avoidance disorder (PSEAD).” Because patients with a history of eating disorders prior to surgery may be at risk for developing full-syndrome or subthreshold disorders after operation, these individuals may benefit from close follow-up.

My question is, who of us didn't have an eating disorder before having weight loss surgery?  No offense, but we didn't get morbidly obese without having either a binging disorder or without just overeating.  My point is when you have the surgery, it puts you in a state of malnutrition (if you had an RNY) due to your small intestines being removed.  Is that not a form of anorexia?  We are gaining control by limiting our food intake and by causing malabsorbtion. Scary notion is that Anorexia has a 20% mortality rate.

Now for some of us, I am included in this, once you hit your goal weight or below, the fear of regain is so strong, you remain in "control" mode.  Now for me, I suffer from the perfect stereotype, I have struggled with body dysmorphia since the inception of the "new" me. I still walk through a crowded store, avoiding aisles like I still weigh 260 pounds.  I still drink my meals when possible and when no one is there to watch me.  My ready to drink proteins have been on backorder and I am freaking out. I have always been a perfectionist.  I over exercise to stay in control to deal with the anxiety.

It all boils down to anxiety. But, where does that anxiety come from? Stressors in my life that bring up emotions.  It isn't about the pretzels I ate that I must exercise off.  It is about why I ate the pretzels in the first place.  Was I under stress to make a dead line?  Are my adult kids driving me nuts? Do I constantly worry about my grandchildren? Am I excited and nervous about starting school?  Hell yes to all the above!  Am I making wise food choices, no.  So what do I do?  I restrict my intake to an unhealthy level. I drink my meals instead of eating real nutritious food.

For those of you who don't know me, I had adhesions that left me unable to eat real food for 7 months.  I got down to 103, my liver enzymes were climbing and by the time they operated, I almost died.  So, if it takes 3 weeks to make a habit, I am well past making liquid my food of choice.  I am 2+ years out and I still have very little hunger sensation, so if I am to eat, it is by the clock.  I am not making excuses, just stating facts. 

I give great advice, but I need to start taking my own.  I am stepping back and starting at the basics.  I am starting with a meal plan and on Sunday, I am shopping and prepping for the week.  I will be filling lunch boxes and making breakfast for myself daily, snacks included and eating by the clock.  I will hold myself accountable.

Will you join me?  Whether you have regained or you are in the same boat as I am. I could use the support.  Perhaps we could swap recipes? 


  1. This comment has been removed by the author.

  2. I am suffering with anorexia now after 14 years of successful rny.... i would like to know how you are doing or can offer some hope?

  3. Hello I am new Here and I think one of few males. I had my RNY 5 years ago. I went from 305 to 140 in a matter of 6 months. It honestly was a very big mental at how fast it happend. I am just now starting to see my reflection match my brain. Everyone thinks I am crazy when I say I am never hungry. It has gotten so bad my doctor recommended I smoke Marijuana. And even this has now only got me to 157. I have to buy my pants in the boys section. Its very embarrassing. I will have to try the preparign my meals for the week with snacks. It is just so hard to eat when you have no hunger. I wonder if this is a long term effect or if it will ever go away. I am 5 years out and still can only eat at max a cup of food every couple hours.

  4. It is a great website.. The Design looks very good.. Keep working like that!. pure forskolin

  5. I had an RNY Gastric Bypass 13 years ago. I lost almost 200lbs and over the years would go up and down. I developed some health issues or so I had thought. I was given diagnosis of internal bleeding, bad heart, ileus, the list is endless. The colonoscopy, upper endoscopy and CT scan proved that I was now fine. However, I started losing weight about 6 months ago and am clearly anorexic. I have dental issues I cannot address due to money so chewing is difficult but in the past month I have aged so much. I am down 60lbs and weigh less than I did in high school. I am 55 years old. I have classic anorexic fingernails, all my bones are sticking out, and I want to eat but throwing up I dread more. Its painful to barf as I have zero fat or muscle. Just loose skin. I need to go to the hospital before I die but here as my alzheimer fathers caregiver. I feel stuck. My grand total from the bypass to now which is a 13 year span is 255 lbs gone.