Compulsive eating: spiritual or biological.

Consider the source, Tater. Someone who has never been able to figure out what kind of surgery she had or that she was using a butcher for a surgeon. Not the smartest apple in the barrel.

And I'm not going to flame you or go back and forth on this. You have every right for your beliefs. I just don't think it's fair to make assumptions about why I overater when you have not walked  my shoes. Your compulsive eating may have been emotional, but mine wasn't. I have never used food to cope.

"Your hunger mechanism is not fixed.  I guarantee that.  Talk to me at 5 years out and I will think you have something of value to add to the conversation."

Okay, I'm 7.5 years out---can *I* add something of value here?

I truly believe that I had a broken hunger mechanism, and I still think it's fixed. I know this is not consistent with YOUR experience with the DS, but if you'll ask over on the DS board, I think you'll find a LOT of people 5+ years out who do agree with me about their hunger mechanism.

This topic brings me back to something really funny that happened after my revision. It was my second or third day in the hospital and Keshishian had come to check up on me. He told me he needed to get some more meat and potatoes to feed me through my J-tube, but I told him I wasn't hungry.

I was hungry, in the 'normal' sense, fairly soon after surgery. Scared the crap outta me---until I realized that THIS sort of hunger was what 'normal' people experienced, that it was GOOD to feel the need to eat---when it was satisfied by a SMALL amount of food.

At about three months post-op---and I'm just guessing about the time line, because it's been a LONG time, now---I had a couple of days when I had NO hunger. THAT scared me, too, because it SUCKS to eat merely to live. I still have those days, occassionally, but it all evens out in the end.

You can't argue with success, especially long term success.  Maybe I just had a lousy surgeon who was unable to fix my broken hunger mechanism.
I do agree that people eat for different reasons and maybe my reasons were just not fixable.

It's also possible that you never had a broken hunger mechanism in the same sense that I (and some others) did. I'm perfectly willing to believe that people eat for a variety of reason, and that for SOME people, it IS purely phychological.

As it just so happened, just before I read this thread, I read one on the Revision board that raised a similar question. Someone had posted there, asking for advice and support due to regain---some serious regain---and one poster told her she needed to get her head fixed, implying that her surgery was still as good as ever.

We've had psychotherapy a lot longer than we've had WLS. If therapy worked for most people, far fewer of us would have ever had WLS. (*grin*)

 All I know is that I ate when I wasn't hungry.  I even ate things I didn't even like.  It was as if I had to eat, like an alcoholic that drinks mouthwash.
For myself I believe it is a combination of physical and emotional and genetics.  I have a child that eats the same way I did.  For years we were eating buddies.  Now that I am no longer participating I can see myself in action.  She needs to eat.  She has been that way since she was a baby.  When she was younger and didn't want to get up for school I got her up by promising her food.  I probably didn't help matters.
I do know that I haven't had to eat that way since my revision.  I don't know if it's because most of my stomach was removed, including the ghrelin producing part I assume, or if it's because I am no longer eating things that have refined carbs in them, which for me is like alcohol is to an alcohol.  Even in the past, before surgery, if I completely eliminated any refined carbs from my diet I lost my desire for them and didn't feel that compulsion to overeat.  I noticed that my daughter is the same way about refined carbs.  She never wants to overeat on things like meat or fruits or vegetables.  It's always things like ice cream or cake.  I know that if I were to give into a craving for things with refined carbs that I will lose my ability to choose not to eat them.  I will have to eat them.  There is no moderation for me when it comes to those things.
I do tend to forget that not everyone has the same problems when it comes to food.  There are many that are able to eat refined carbs in moderation just fine.  After my first surgery I was able to eat those things moderately for a while.  I remember even thinking that my compulsive overeating problem was over.  I never felt guilty for eating anything and could take a bite or too and be satisfied.  Some time after my 5th year it became harder and harder to control and I wanted more and more.  I started becoming obsessed with eating them again.  I don't know why that happened to me and it doesn't happen for most people.  I keep comparing it to alcoholism because that is the closest thing I can compare it to.  It was like being an alcoholic that is suddenly able to drink socially with no problems and then it just goes away again.  That is why I don't test or tempt it.  While I am in the mode to take it or leave it I choose to leave it because I don't know that if I do take it I will be able to stop it again.  Does that make sense?

Makes perfect sense, and I'm sure you're not alone. Over and over, we read/are told about carb cravings, and I know from personal experience that the later in the day I wait to eat carbs, the less I want of them. 

For ME---I always wanted to over-eat on MEAT. For years, while everyone was telling us that it's wasn't the spagetti that was making us fat, it was the rich, meaty sauce we put on it, I'd try to "be good" by eating the pasta FIRST, so I (hopefully) wouldn't eat so much sauce. Mashed potatoes, so as not to eat so much meatloaf. You get the idea.

Maybe it's easier now in part because I'm SUPPOSED to fill up on meat. (*grin*)

 "Anyone who eats their way to 100lbs or more overweight has a eating disorder."

Well that's bull****  Unless you define 'eating disorder' as "eating more calories than you burn" But that's not the clinical definition.

It is well documented that obese people are more likely to have physiological differences from people who don't struggle with their weight including (But not limited to)

-weaker signals in the part of the brain that registers satiety
-more ghrelin (which controls appetite) than normal -- at least 3x more in some studies
-caught a certain virus
-there is a large genetic component to obesity

WLS fixes some of these things in ways we understand and don't understand. We know that DS and VSG remove a large part of the stomach which is were most of the ghrelin is produced and that ghrelin levels go way down and stay down with these surgeries. So that's one way. But RnY and lapband don't remove ghrelin (well in some studies RnYers had reduced levels but in other studies they didn't and the remnant stomach still makes it) and they also provide hunger control. So there are other mechanisms.

In one study, they studies brain patterns when the subjects were shown food. The obese subjects' brains reacted differently to pictures of food. When some of those subjects had WLS, their brains then reacted the same way as the normal-weighted subjects. But the people who lost weight just by dieting continues to have the strong reactions to pictures of food.

So WLS does change the brain and not just the stomach.

Is obesity more complicated than just fixing ghrelin levels and having hunger control? Sure. But don't discount the physiological just because there are also environmental and behaviorial issues.

Let's put it this way: if obesity were largely caused by behavior which was caused by some sort of mental problems then WLS would work no better than dieting does. But WLS works MUCH better than dieting does. Since WLS is a physiological change, that points to obesity being cause mostly by physiological issues.