Addiction Transfer - Or, What Happens When You Have Gastric Bypass Surgery And You Can't Eat for Comfort?

Every two weeks when I go to Weight Loss Support Group, I have one piece of advice for those who are about to undergo gastric bypass surgery:  Deal with your need to eat for comfort, because you will replace your food addiction with another addiction when you can no longer eat for emotional reasons.  This is one area associated with the surgery that isn't stressed enough when patients prepare for their new journey post bypass.  

Gastric bypass is an amazing opportunity to begin life anew.  It really is a rebirth for many people, myself included.  I have been overweight since around the time I hit puberty at age 11.  Until then I was thin, athletic, and "normal".  I won first place in the high jump, first place in the hurdles, and played volleyball with passion in fifth grade.  By sixth grade I was packing on the pounds already, and although I still played volleyball, comments from my peers and my own self-consciousness made it miserable instead of enjoyable.  I fell in the hurdles that year, and was so embarrassed.  I didn't participate in sports after that and I dreaded PE.  Not because it was exercise, but because I was so "fat".  I was sure everyone saw me as a lazy pig.

Around that same time, I was experiencing a great deal emotionally.  Of course there are all the hormones that hit at puberty, but on top of that a lot was going on in my family at the time, and it became easy to fill some emotional voids with food.  We lived in the country, far from school and friends.  I would come home from school, grab a package of crackers and a cup of Kool-aid or an RC cola and retreat to my bedroom to read until dinner.  I often read at the dinner table, then back to my room to do homework or read some more.  It got to be a habit that I would want to eat while I read.  And I read a lot.  It was the perfect combination of comforts - a full mind and a full stomach.  My nutrition was horrible.  I didn't have the first clue about eating healthy and living on a ranch meant that dinner was usually beef or pork and some kind of potatoes.  I hated vegetables (still do!) and craved carbs (still do!).  

If I remember correctly, I was around a size 12 jean in seventh grade.  And I'm 4 foot 11 inches tall now, so I am sure I was a little shorter then.  I knew I was overweight, but I had a handful of friends who didn't treat me differently.  However, halfway through my seventh grade year, we moved, and I had to go to a tiny rural school.  I went from a junior high of probably 1000 to a class of ten.  And not only was I biggest in my class, I was the most overweight female in school.  It was excruciating.  Food continued to be a comfort, even though it seems odd that when I dreaded my weight and gaining any more, I continued to feed the problem - no pun intended.  Due to more moves and emotional ups and downs in high school, I just kept getting bigger.  

I denied the severity of my habit for years, and I was embarrassed about it.  I never even considered it could be an addiction.  I dreaded eating in front of people.  I imagined horrible things that people must be saying behind my back.  And I tied my self worth and worth as a human into my weight.  Because I was so harsh on myself about my weight, I was harsh on myself about everything else.  The way I treated myself was far worse than the way anyone else treated me.  In fact, rarely was I blatantly mistreated because of my weight.  More often than not, I was merely excluded from the activities and experiences of other girls my age.  And that was almost worse than someone just out and out saying something derogatory.  

I'm certain I have probably had some level of depression since somewhere around age 10.  I have also had an eating problem since around the same time.  So, at age 27, when I finally had the gastric bypass, I had been eating for comfort for 17 years.  Not an easy habit to break.  No, not an easy addiction to break.  


When one prepares for gastric bypass surgery, any good surgeon requires a psychological evaluation.  This evaluation is for several reasons.  Most importantly, the surgeon wants to know that the patient has realistic expectations about what this surgery will do for her.  It is not going to immediately change her life.  It is not going to take away her need to self medicate.  It is not going to make her worthy, acceptable, or change any of the ways she thinks of herself in and of itself.  It is not a miracle surgery.  Another reason the evaluation is required is to pinpoint areas that may need work before and after the surgery in order for the patient to succeed, because there are many ways to sabotage the surgery.  It is not a quick fix nor is it an easy way out, so the patient has to realize there is much work involved in order to maximize weight loss.  


I knew going into surgery that my love for chocolate, bread, and all those "filling" foods like pasta was coming to an end.  Those first few weeks after surgery can be really depressing for anyone, regardless of whether they struggled with depression before.  For about four weeks I was on a liquid died, gradually changing from clear to pureed.  It is miserable!  I longed to bite something, but everything was sipped, and carefully swallowed.  That new tiny stomach needs time to heal.  Now, the plus side is, you see the pounds melt off dramatically right away, so there is a payoff.  But it is still incredibly hard and I got incredibly cranky.  Poor Kyle.  I have joked that if a marriage can make it through this surgery and the few months after it, the marriage will make it through anything!


I am about 15 months out from surgery, and I can eat just about anything I want in moderation.  Nothing makes me sick except ice cream.  Some people experience dumping syndrome and can't eat anything sweet.  Other people become lactose intolerant.  Others can eat bread or pasta because it seems to swell in their tiny stomach.  Pop is forbidden because the carbonation is thought to maybe enlarge the pouch over time, allowing for more food to go in and obviously more calories.  Most people find carbonated beverages uncomfortable at the very least.  None of these potential effects have been true for me.  Which sounds good, but really makes it harder to be "good" about my eating habits.  I tend to slip back into bad habits and losing these last 28 pounds to goal has been DIFFICULT.  However, despite my being technically able to eat anything, almost nothing tastes good.  It certainly doesn't taste like it used to.  I didn't like chocolate for about a year after surgery.  Some foods taste better again, but the vast majority of food holds no appeal for me anymore.  This is good for me, but hard, too, because I have lost a major aspect of my life that was once emotionally filling. 


Last August I was under a lot of stress, trying to determine whether to return to work, and just experiencing many emotions.  And because I am still learning how to appropriately deal with emotions, and because I couldn't eat to fill that void of uncertainty anymore, I found another release:  shopping. 


Without realizing it in the beginning, I started to go shopping when I felt down or stressed.  It began with clothes, which was actually okay at first because I essentially had to replace my entire wardrobe.  I've lost over 100 pounds and am literally wearing clothes that are half the size (or smaller) than some of my pre-surgery clothes.  Better yet, shopping for clothes is finally FUN!  I could find cute tops and skirts in my sizes and in a much wider selection than when I was confined to a tiny corner of the store labeled "Plus" or "Womens'" sizes.  But my spending didn't stop at clothes.  I bought excessive amounts of certain items.  Journals, books, and pens.  I would argue one can never have enough journals and books, but apparently there is a healthy limit.  I bought little objects for around the house, or gifts for friends or family.  I was done with Christmas shopping by September.  

At times I balanced the checkbook, saw how much I had spent, but couldn't really account for where the money had gone.  This is when I began to realize that one addiction had been replaced with another.  I had, and have, a compulsion to spend.  I get an adrenaline rush from spending that I used to get from eating.  I lived on virtually no money for most of my life - especially in college.  I was so good at getting by on nothing.  So I couldn't quite grasp why I suddenly had to be shopping all the time.  I still struggle with the concept of addiction and willpower.  Logically, I know that our addictions can be bigger than we are, but that critical part of myself wonders why I can't just get over it.  Just stop going to the store.  Just STOP.  It scares me.  I don't like to feel out of control about anything, especially money and finances.  And I am out of control in this respect.  


I address it in therapy, and my medications for bipolar and depression address it.  But like any addiction it is a day to day struggle.  I can't properly explain it, because it doesn't make sense to me.  I don't understand completely how compulsion works.  But I do see how it is possible to go from one addiction to another.  I made it a point to talk to other bypass patients about this because it is a really distressing issue for me, and it is not one often addressed.  It is also something that isn't an immediate affect of the surgery.  For me, I was a good eight or nine months out from surgery before I saw the problem.  I wish I had dealt more with my need to self-medicate in those eight months before  the need to spend became so great.  This is why I feel like it essential to warn people before they go under the knife.  The minute recovery begins for the physical self, recovery must begin for the emotional and mental self. 


Regardless of the many challenges I have faced post surgery, I still couldn't be happier with the decision to undergo surgery.  It has been life changing in many ways, not in and of itself, but because of my own ability to try to make the most of it.  I try to focus on the successes I am having and not rehash my, as I see them, weaknesses.  Because I try to remember that I am a sum of my strengths.  And gosh.  It feels good to be thinner!