Need all the help I can get, please...

I haven't been here in a while because of feelings like a complete and utter failure. I had v s g surgery July 26, 2016 and never reached goal weight. My highest recorded weight was 361, and 354 when I started the 6 month required supervised diet . On the day of surgery I was 313, and today I am 260. I got down to 248 while attending group therapy for my binge eating disorder. I was diagnosed with eating disorder n o s, I went to intensive group therapy for 8 hours a day for a couple of months, and for 3.5 hours a day for about 6 weeks. I am seeing a therapist every Friday, and I also take wellbutrin and topi Max to help my b e d. I don't know what to do, I have gone from 248 to 260 from 9/21/17 to present. I have allowed old habits and carbs back in. Please give me some ideas of how to detox my body from carbs so that I can get back on track. I try but it never lasts more than a day. Any help would be greatly appreciated, thank you for your time.

I'm confused - you say you have binge eating disorder, but that you were diagnosed with "eating disorder NOS" which isn't binge eating disorder?

Wellbutrin and Topamax aren't FDA-approved for treating BED. So I think I'd start with that conversation with my psychiatrist were I in your shoes.

That makes sense from a mental health perspective, actually.

This answer involves a bit of psychiatric history. If the doctor or therapist is using the DSM IV to diagnose and someone has BED, they will get a diagnosis of eating disorder NOS, because BED doesn't exist in the DSM IV. Some psychologists and psychiatrists still use the DSM IV because they like the Axis system or because Reasons which I don't get. At any rate, I'll use myself as an example: I had a BED diagnosis from my psychiatrist, but the psychologist doing the assessment did DSM IV diagnosis instead of DSM 5 (and yeah the DSM IV uses roman numerals and not the DSM 5 which I don't get either), so my medical history says I have BED but my assessment says EDNOS. EDNOS was actually the most common diagnosis for bariatric patients for quite some time, many of whom would be rediagnosed with BED right now.

As for topamax and wellbutrin, they actually are an old treatment for BED (and binging), from long before there was diagnostic criteria in the DSM-5 for it, actually. While the official diagnosis didn't exist until DSM 5, it was discussed and treated long before that. For true BED they tend to not work nearly as well as actual stimulants, though. Many doctors are unfortunately still reluctant to prescribe Vyvanse, so wellbutrin is commonly used instead. Sadly, they don't work nearly as well.

Complex PTSD is an example, too. Technically according to the DSM 5 it doesn't exist, however it is very pernicious and requires particular medications and therapies that are not necessarily the same as typical PTSD. But, because it "doesn't exist" there can't be FDA-approved medications or therapies for it, and you can't bill insurance to treat something with it. I think WHO just added an ICD-10 code for it this past October.

Mental health diagnosing is weird.

Yes :/ As I've experienced in my own hunt for a psychiatrist. Very aggravating.

I get where the OP is coming from, but I think that they need to advocate for proper diagnosis and medication based on current information. Know what I mean?

It is. Most psychiatrists are lackluster, I am coming to find, regarding eating disorders. Most don't understand the etiology for BED, and often shrug it off as being appetite based despite clinical evidence. Even many counselors who treat eating disorders, sadly, do the same thing.

With mental health issues especially we must always cultivate being good advocates for ourselves. This happened with my ADHD diagnosis. It was actually the bariatric surgeon, not a psychiatrist, who commented about how similar ADHD and BED was. After doing literally 20 minutes of research, there was a clear connection between bulimia, BED, and ADHD....yet few psychiatrists ever make it :/

I advocated for my assessment and I was humored for doing so partially by the psychiatrist since my counselor was adamant we get a correct diagnosis and because I was a pain about it, however the psychologist wound up agreeing with me 100%.

Mental health diagnosing is problematic in many ways, though, because it's not always beneficial to give diagnoses in some cases, and it's both annoying and frustrating the way it works. However, that's a tangent.

I have been trying to get the proper meds, no one will give them to me, I have seen numerous psych doctors only to be given more antidepressants, I have an appointment with a new doctor on Thursday. My primary care doctor won't prescribe anything, she says it is a mental health issue. I keep trying to get in to my surgeons office and they keep saying their system is down, can't make an appointment. I have been communicating my issues with the surgeon s office since I was about 4 months out if surgery, the were no help, told me they fixed my stomach not my head. His assistant asked what difference would it make if I had a diagnosis if b e d, it would help a lot, I would know what to do to mange it, I want their help, but now that the surgery is done, I feel I am no longer important.

Yes. You've posted about this before (I forget you previous username) and I don't know what advice anyone can give you other than to keep trying. :/

If you keep having issues finding a provider, contact your insurance company and ask if they have case management. Request a case manager's help. Explain what is going on and they might be able to assist.

have you tried bariatricians/weight loss doctors rather than bariatric surgeons or psychiatrists? It might be worth it if you keep having trouble A bariatrician prescribes medication for weight loss, and they often will prescribe Vyvanse, at least here near Chicago. My BED medication is actually prescribed by the bariatrician rather than my psychiatrist, since he is more familiar with it than the psychiatrist by far.

And that's abysmal about your surgeon's office. My bariatric surgeon will prescribe it if necessary and will always see his patients...I am 2.5 years out and he always follows up with me. That makes me so angry they treat you that way.

Thank you for your time and your help

Thank you for the response and info