Food obsession

Hi all, I have been plagued with binge eating for about 20 years and several times have explored surgery but ultimately have always thought that I needed to get my head straight before I pursued a surgical option. I'm to the point now where I have to accept that if I wait to get my eating under control through behavior modification only, it's never going to happen. I think I'm going to have to let my head catch up with my body post surgery. So here's my question. I can't imagine a life without the overwhelming urge to eat and constant cravings (which is psychological, I'm not actually hungry). Have any of you lived like this for decades prior to surgery and if so, how has your experience been post surgery? It sounds ridiculous but when I think about not having the comfort of food, I get so despondent and think there's no possible way I could/should do the surgery. It's the obsession/addiction of my life, sorry to say. Did having the surgery take some of the obsession away for anyone? I keep imagining myself losing weight but being psychologically/physically tortured with a need to eat and not being able to satisfy that urge. It seems like a pretty bleak post surgical outcome for me. I don't know that in the end it will have been worth surgically altering my body. I am considering the vertical sleeve. Any personal experiences would be appreciated. 

I don't mean to pry, but have you seen an eating disorder specialist to help you deal with your binge eating and compulsions? Your eating from the way you describe it in your post is highly emotionally charged. Surgery will not help you with dealing with that.

BUT WLS WILL GIVE YOU A FIGHTING CHANCE TO GET THE WEIGHT OFF AND KEEP IT OFF while you are working with an eating disordered psychologist to help you get the emotional aspect of your eating under control. 

Given what you say in your post, I would urge you to pursue the WLS only with the complement of therapy. 

Congratulations on taking this first step! 

Thank you, Kairk,

Yes, I have been in therapy in the past with an eating disorder specialist, and years back I was an inpatient in an eating disorders clinic. A psychiatrist has recommended trying Adderall for 6 months (it doesn't really work after that) to help deal with the cravings and compulsion to eat. For one stretch of time I had really good relief from symptoms when I was using Phentermine. I guess that's why I said that I think I have to stop waiting for my brain to deal with the emotional eating and instead, proceed with surgery and then use further therapy afterwards to help with any psychological difficulties and stress from not being able to eat. Do you still crave foods in the same way after your surgery as you did before? (Assuming you had some cravings, or issues with food) Again, thank you so much for your reply.

I do not crave foods the way I did in days gone by, but I've been working with a therapist for over a year. Just prior to starting therapy I was in what could be classified as an 18 month on and off binge cycle. I am currently experiencing a mild binge cycle, but it is nowhere near what a cycle would have been pre WLS and because of therapy and the acceptance of my issues, I don't feel helplessly out of control. I realize that sometimes stress, anger, emotional swings (both positive and negative) and exhaustion can trigger eating episodes for me. I have learned to own and accept and (as trite as it may sound) love that part of me. It's who I am. 

I will always have to work on my eating issues - always. I am very grateful for my WLS because without it, I never would have understood the profundity and depth of my compulsions with food. 

Hi Kairk,

When you talk about bingeing post sleeve, can you explain that a bit? My understanding is that post surgery the stomach can only hold about 40 oz of food. I don't understand how one can binge. Do you not just wind up throwing up? In the same vein, I also have trouble understanding how one can gain all of their weight back. There is such a limited capacity, it seems like it will be a challenge just getting in enough calories/protein etc., let alone too much. I understanding you could eat highly caloric food and not exercise, but you can't eat nearly the quantity of food as pre-surgery, or is that not true? 

Hi Animlz,

A binge for me does not involve huge portions or volume eating any more. A binge for me now is more like grazing on an intense level. It also has a great deal to do with the food choices I make. When I am eating improperly and away from my plan, I tend to choose higher refined carbohydrate foods that may also be very high in sugar and/or fat. These types of foods (think baked goods, pastries, ice cream, breads, candy, movie popcorn, etc...) do not force the pyloric valve at the bottom of your stomach to close the way high fiber green vegetables or unprocessed dense protein does. The reason is that most highly processed foods turn readily to liquid in your mouth and enter your sleeve as a liquid requiring no pre digestion in the stomach, therefore it can flow right on through leaving you plenty of room to eat more. 

When I am eating in a VSG appropriate manner I eat between 3 and 3.5 ounces of clean, lean, dense protein and 1/2 cup of vegetable (or 1/4 cup vegetable and 2-3 TBS of a whole grain). By volume this amount is roughly 1 cup. I tested my capacity once with very dry chicken breast. I was able to eat about 4.5 - 5 oz by weight. (Remember, I am 4 years and 4 months post op, so my sleeve is mature and the size it's going to be.)

How can someone gain weight after WLS? Simple! You eat more calories than you need. As an example, my 3 oz of meat and of 1/4 vegetable and 3 TBS of a grain usually runs me about 200 calories, give or take. That meal leaves me completely satisfied and sometimes, it is too much. Just depends on my appetite. BUT I can eat a huge, whopping hunk of chocolate decadence cake for 1500 calories and barely feel any restriction at all. These types of foods have earned the name "Sliders" or Slider Foods because they slide right on through the sleeve, past the pyloric valve and into your gut. Then you'll have a sugar high and then an insulin dump and a dip too far down in blood glucose and you will want sugar again, and again, and again.. The cycle starts.

Another culprit of regain is consuming calories through drinking fancy coffee drinks, Jamba juice types of drinks, wine and hard alcohol and some people even go back to soda. 

The limited capacity is for a life time, but the extreme limited capacity isn't long lasting. As your stomach heals the swelling goes down and capacity increases. The surgeon I see in support group says that most sleeves mature to 4 times their original capacity. That holds true for me. I could manage about 2 oz when I was first sleeved. Now I can manage 6 oz by weight and about 8 oz by volume (1 cup). 

The surgeon will fix your stomach and give you a fighting chance to lose the weight. Unfortunately, he isn't able to operate on your mind. We all have work to do in learning how to eat as a WLS patient. It can be very easy in the beginning, but IMO it's a damn good idea to practice and practice those behaviors that support weight loss and weight maintenance. This is not an easy road, but one that has done me a world of good on so many levels!

As I suggested, it's a good idea to have the support of a good eating disorder counselor. It has done me a world of good! 

Hope that answers your question.

Excellent response!

Thanks, that makes perfect sense. I was unaware of the Sliders situation. I so appreciate the time you took to answer my questions. :)

I was and am a binge eater. Originally lost 230 with the help of my sleeve but it came nowhere close to solving my issues. I regained 90lbs very quickly - even with a WLS procedure. 

I had met with every kind of therapist, inpatient eating disorder programs - all to no avail. 

Then I found OA. I was resistant to it until I realized I had no other way out of the hell that is binge eating. It's worked miracles for me. 

Just to say - no weight loss surgery will help in any way with binge eating disorder. There won't be any magical change that will flip the switch. Get the binge eating under control first. 

I have severe binge eating disorder and I had WLS in June.  I was in counseling several years before surgery losing weight.  I had to find things to bring me comfort and identity other than food.  It was a long process, but it's definitely possible.  I went from weighing around 750 and non-functional to being 425ish and in graduate school the month of surgery just from psychotherapy.  Counseling can be very effective if you work it - much like the sleeve.  You also need the right counselor.  They must be both compassionate and direct, and not all counselors are.  I was very lucky and found the right one off the bat.

It takes a lot of motivation and sacrifice.  I had to basically, well.  Get over myself.  There's no nicer way to put it.  I had to admit I have an issue that I can't always control, and that I have to always get help when it starts to get worse.  I had to admit I had several character flaws I needed to work on.  I had to admit that no one was responsible for my happiness or sense of self or sense of purpose besides me. I had to admit I will be on an antidepressant for good.  It's a mild dose still, but nonetheless it's for the rest of my life, and that irked me a lot.

I absolutely noticed a difference, even in the week pre-op versus the day of surgery.  I was terrified because my surgeon has us NPO the first 24 hours.  So, no water, or food.  At all.  Surgery happened and...I didn't even notice, actually.  It was surreal.  

Post-op it has been really good for me.  I literally cannot binge now, and I am never hungry.  It's like magic, really.  It is difficult to overeat.  I get very sick and don't get the "high" from overeating any longer.  However, in a lot of ways it has forced me to seek out other habits and paths.  My habits have definitely changed for the better, but I'm also very vigilant and post here or immediately see my counselor when I have overeating problems before they get worse.

Much of the obsession is currently gone.  I only feel compulsions to overeat during high stress periods.  The past month has been really awful, but I get my MA in a few weeks and then sit for licensure after, so its definitely been quite a roller coaster!  I also am having some crummy thyroid issues and need a biopsy, and possibly surgery, so it's been quite stressful.  I overate badly three times in the past month without binging, which for having severe binge eating disorder is pretty amazing, really.  It's been bad lately, but it's 1000x better than pre-op.  Of course, I think all my pre-op counseling and prep paid off in that regard.  Without counseling I'd have fared far worse.