Why is surgery not a good option for active bingers?

I am asking this question at the suggestion of my dietician.  I contend that if I have surgery, it will be so painful to overeat I simply won't be able to binge.  So, why the big deal about getting your bingeing under control BEFORE surgery?  I apologize if this seems simplistic or silly, but it's very much where my head's at right now and I guess I just would like some insights as to how a compulsive overeater could keep on bingeing post-surgery. 

Carbs will go right through your sleeve. If I wanted to eat an entire box of cereal, I probably could. Whole bottles of coke? Cartons of ice cream? Yup, I could do that if I wanted to.

If I tried to eat two sausages? Yeah, I'd hurt, and no way would I continue. But most people who binge don't eat massive quantities of steak when they have an episode.

I'm 11 month post op and can promise you that I have the ability to eat my weight loss back right now.  I could have stopped my loss at 3 months post op by eating slider foods.  

I struggle with compulsive eating,  but I'm seeing my therapist and do we'll enough that I'm still losing,  though it's slowed down a lot.  I can't bring crackers or corn chips in my house,  I just can't control it.  

Unless your go to binge food is solid protein the sleeve won't stop you. My go to foods used to be dry cereal right out of the box, crackers, chips, ice crean and baked goods all of which I could eat now no problems. 

To cure an illness, you must cure the cause.  No weight loss surgery will cure the cause of your obesity; working on the psychological issue is what will cure it in the long run.  Frankly, if I hadn't gotten the eating under control, I would be constantly miserable.  The problem is that with binge eating, we don't stop from discomfort.  If we aren't stopping pre-op, we certainly won't magically stop post-op.

As for why it's imprudent, there are a few reasons.  Since our nerves take some time to heal, we cannot tell for some time when we've overeaten until it's far too late.  This creates a dangerous situation if someone has uncontrolled eating.  You absolutely must have binging under control or you will be miserable permanently at best, or endangering yourself at worst.  It's nothing to mess around with.  Why?  A few more specific reasons:

The first is that it's extremely dangerous to binge post-op for some time due to the nature of the reconstructed sleeve.  The part of the stomach we have removed is stretchy.  That means when we overeat, it stretches to accommodate.  Post-op we no longer have this.  The sleeve that remains is inflexible and not really stretchy.  So, once we hit capacity it will spill over into the esophagus, cause extreme discomfort and pain, cause vomiting, and at its most serious, cause a rupture or a bleed close to surgery.  A bleed is very dangerous and is life-threating, as is a gastrointestinal rupture.  Overeating can, in theory, cause distortion of the esophagus long-term, as well.

Speaking as someone with severe BED, if you can't control it, surgery won't work - period.  A year out I can eat large amounts of binge foods.  Surgery doesn't cure binge eating at all.   I had my binge eating under control for years before I ever operated, and I still struggle with it.  It's exceptionally painful after surgery, and it carries with it the danger of permanent damage to the sleeve and esophagus if done repeatedly over time.  

I binged all of the time before I got the sleeve, and I'm a year post op and haven't binged once since surgery.  So, for me, surgery does appear to have stopped my binging.  My surgeon says he makes a tight sleeve, but I don't think it's the restriction that's stopping me.  I just rarely feel hungry and for whatever reason I don't feel the compulsion to eat anymore. I don't know if it's the lack of hunger hormones that come with having a small stomach or what it is, but being free from binging has been a huge relief. Is this common? I have no idea. 

For a small minority the lack of ghrelin can cure (temporarily) overeating.  Most people who binge eat though do so for emotion regulation.  It could also be a correlation - the actual cause of binge resolution may be something else.

Over 90% of the clients I see for eating disorders cannot cure them with surgery.

A year is nothing. I went over a year without binging. Maybe close to 2. You are sill susceptible to it. Worse thing you can do is assume you are cured. 

It may not mean anything to people who can go weeks without binging or even years.  It means something to me because I had never gone a month much less a year without binging since I was about 10 years old.  Maybe the desire to binge will come back in year two or year three, I don't know.  All I know is that the obsessive thinking has been completely absent over the past year, and I have had no desire to binge at all which is mind blowing considering that I have been doing it daily for years.  Even with years of therapy and participation in OA I couldn't stop for any length of time, not a month and certainly not a year.  If I had waited until my binging was under control before having the surgery, I wouldn't have ever been able to have the surgery because despite my best efforts I simply wasn't able to get it under control.  Even if I were to start doing it again sometime in the future (which I seriously hope is not the case) having even a year of freedom from binging is totally worth it. 

I still see a therapist, so she is aware and will pick up on it if I start sliding back in to old behaviors.  I have used this year of freedom to focus on following the plan.  I am now 140 pounds (at 5'5")but I know the real test comes with maintenance.  All I know to do is keep following the plan and doing what I'm doing.

"I contend that if I have surgery, it will be so painful to overeat I simply won't be able to binge."   I wish 

There are several problems with this line of thinking.  Most of the food you want to binge on will turn to mush in your stomach and will not keep you satisfied.  Crackers, cookies, ice cream, cake, bread, etc. - you will be AMAZED at how much you can eat and feel no pain.

You can learn to "eat around your sleeve" through grazing.  Instead of having regular planned meals throughout the day, you can eat small portions of high calorie, carb heavy foods and feel no pain.

Surgery absolutely will not cure your binge eating.  I am a compulsive/emotional/binge eater of epic proportions and I fight this demon every single day.  If I eat dense proteins, I feel full, but the urge to binge and eat other crap is always there.  

You can't rely on surgery to fix the problems in your head.  I was stupid and didn't seek help from an eating disorders therapist until a year after my surgery.  I white knuckled the first year with sheer determination and dedication, but that wanes over time.  The earlier in the process that you address your issues, the better off you'll be to deal with the temptations and mindless eating that never truly goes away.

All you have to do is read OH and you'll see posts daily about regain.  We are pernicious and secretive when it comes to food.  WLS gives us an opportunity to jump start significant weight loss, but the pounds don't magically stay gone.  It's going to be work, HARD WORK, for the rest of our lives.