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?