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

First of all, I would stop being so hard on yourself. Caring about yourself and feeling like you're a worthwhile human being that deserves care does wonders (at least in my personal experience.)

I am also a little confused about your combination of medicines. Wellbutrin was an antidepressant my doctor tried with me after my father died; I gained about 40 pounds while I was on it.

Topamax is an anti-convulsant. Neither medicine is associated with BED, but both have been used for different combinations of anxiety/depression. I would think and ask yourself whether or not your mental health care professionals are invested in your care the way that they should be. I had one horrible experience years ago with a psychiatrist who just wanted to medicate me before I finally found a therapist and PCP who work together to provide a great level of care.

As for the carbs and detoxing your body...you already know how to do that. Stop eating them. Don't eat bread, rice, pasta, etc. Whole wheat bread and brown rice are better choices, but those (sparingly) are for people years down the road that are in their maintenance weight. I'm not trying to be mean, just honest. I did the back/forth for years before finally deciding to eat correctly and have weight loss surgery (I am NOT a veteran.) However, it sounds like you feel that you just can't NOT eat the carbs. The successful people I know that are years out have all eliminated carbs from at least one or two of their daily meals and RARELY snack on them.

Have you thought about having monthly meetings with a nutritionist? Maybe keeping logs and being accountable with someone else would help you! :-)

Topamax has a side effect of causing anorexia, and it gets used off-label for all sorts of things. I've taken it to try and prevent migraine (didn't work particularly well for me, and I developed the aphasia that happens so often with Topamax it's called 'the Topamax effect' and it didn't affect my appetite at all... go figure). Wellbutrin is used for all sorts of stuff from smoking cessation to ADHD. It's probably not the most used combo nowadays, but it isn't completely off the wall.

Thanks for your help and suggestions

You are not a complete and utter failure. You have an eating disorder. I, too, have an eating disorder, and we are not failures. We have disorders that we developed for many reasons, the main one being we often, at some point, lost control and cohesion in our lives.

The truth about eating disorder recovery is that it's not about the medication or therapy alone - it's also about the environment. If the environment becomes unsteady around us, or if we feel our sense of cohesion start to waver, we are at a risk of relapsing. And, lapses and relapses are inevitable for many of us. That is not an indication of willpower or failure or dumbness - it's how any chronic illness goes. There are good days, weeks, and months, and there are bad days, weeks, and months. If something in the environment is off, all the medication and therapy in the world will only be partially effective. Take a look at what is going on around you. What is on your shoulders each day? What do you see and hear? When we do well in a structured atmosphere, like intensive therapy, but things change at home and we have regain, it's almost always something in the environment that must change.

Our job is to be fiercely honest with ourselves and to examine what's up. Sometimes why doesn't matter. I can hear my own therapist going lol repeatedly at me as I type this, since I always ask whywhywhy. What matters is what we do in the present. And, in the present, you are examining things truthfully which is the best possible option.

Now for the science: it's well documented that Wellbutrin and Topamax do not work as well as Vyvanse for people with true BED. That's just how it is. Wellbutrin and Topamax have appetite suppressant effects which is why they were used, however this is why they are bad for BED.

We do NOT have BED because of appetite. We have BED because we eat to control our environment. Appetite suppressants do squat to fix that.

BED is caused by issues with dopamine regulation, very similar to ADHD. BED is a disorder of impulsive and compulsive behavior caused by a feeling of a loss of control, coupled with shame and guilt. Often severe trauma triggers the creation of BED. In fact many of us with BED, me included, have ADHD - which is 100% a disorder regarding motivation, impulsiveness, and compulsivity...just like BED. If we are women this often gets misdiagnosed as depression. Except that ADHD and BED can both mimic depression! Anyway....

If you aren't seeing a psychiatrist for BED, go see one. Alternatively seek out a bariatrician, as they often will also prescribe Vyvanse for BED...sometimes far more rapidly than psychiatrists do.

Donna,

This is the clearest evaluation of eating disorders I have seen. Eating disorder was/not my primary issue, mine is more physical response. ie low bood sugars necessitates eating etc. In making positive choices, seeking the proper professional and being honest with ourselves we can overcome many problems. You have explained his quite concisely.

I can't give much input on BED... my therapist said I described some very clear binge behavior, but she didn't diagnose me with BED. We worked on emotional eating and the binge behavior seemed to go along with that.

But I will say this. Don't beat yourself up. You've lost ONE HUNDRED POUNDS!!! That's HUGE. You're seeing a therapist and taking control of your life. Many people never do that, and blame everything but their behavior when they don't get to where they want to be.

Mental health issues can be very hard to treat, with progress made and lost constantly. That back and forth is not failure on your part, it's just the nature of the beast.

Huge hugs, and keep at it!

Thank you for your kind words

It's no small thing that you've lost 100lbs! The truth is, food is always going to be a daily struggle for those of us who got to the point of needing bariatric surgery. You are in good company here - many of us will struggle with carbs and overeating at various points in our post-surgery lives.

The best way I know of to "detox" from carbs is to give yourself very strict and simple rules for a short period of time. For example, for the next 7 days, tell yourself you will only eat meat, fish, or eggs. Nothing else no matter what. You can eat as much as you want and as often as you want, but anytime you eat it has to be just meat, fish or eggs. No sauces (butter is ok), no extras. To get ready for these 7 days, throw away all carbs in your house and make a list of things you like to do that bring you joy. Anytime you want carbs, look at your list and pick something to do to distract yourself. Keep busy! At the end of the 7 days, carb cravings should be greatly reduced, but of course you still have to choose to not bring carbs back into your house.

Thank you for your time and your help

big citygirl,

We can all give you advise, but you must be the one to apply it. You are still a 100 lbs lighter than when you started. Your determination to get back up and try again is to be commended.You must start at the beginning, of your diet...increase those protein and cut the carbs...My goal was 90 grams of protein and 30-50 grams of carbs for a day... that is still my goals. Do I make it every day? No, but the next day, I get up and try again. You have a surgical pouch. that is the tool you have now. utilize that tool to your best. I don't remember which medications are weight positive and which are weight negative... If i remember right wellbutrin is weight negative.( that is good) .

YOU should check every medicine /have your providers check to make sure your drugs are not adding to your problem. Each medication needs to be a weigh negative. ..ie some meds have known side effects of making people gain weight. examples. are.. depokote and prednisone.

Many of us have problems with cravings . I am 23 years post WLS and my pouch is still 6 ounces, but cravings and the munchies I still get. The best thing I have found is to simply go back to the main protein diet for a set period..a week? to start, then continue..from there. .One day at a time! Determine you will make healthy choices. stay away from your trigger foods.Don't allow them in the house.

Know there will be days you do not do as well as others. Celebrate the good days with taking an extra walk around the block, sitting in the sunshine, walking in the park..some short activity that is just for you to fully enjoy. All of your celebrations should be w/things that do NOT relate to food.

After the 3rd day the cravings will subside. Those 3 days are difficult. Vitamin B complex in the liquid sublingual is bet absorbed and seems to help with my cravings. I use 2 times a day for the first 3 days. It is the supplement my Nutrishionist recommended . It also gives me a energy boost. I will eat plain popcorn, or plain cherrio' for the munchies occassionally. My maximum amounts for these is about 3 ounces. Hope this information is something you will be able to use.