Eating Disorders after Bariatic Surgery?

So me and my wife are concerned that she may have developed a eating disorder after 10 years of having the lap-band. Long, Long, Long story short...she had a lap-band placed in 2008 and has lost over 100 lbs. since. However along the way she has been unable to keep food down (even very small amounts), has battled malnutrition, was diagnosed with Sjorgens Syndrome, and had issues with her weight loss surgeon. (see my posts in the LAP-BAND forum for all the details and specifics if interested). Her vomiting began more frequent and common. She learned to be discrete about it and we (her family) just accepted it as normal, and blamed the band.

In 2012, she begged her surgeon to remove all the fluid form her band (and thought it was). She continued for 4 years to have the same issues, but in the past 2 years has lost a dramatic amount of weight. In May of this year, I took her to visit my weight loss surgeon for a consult (different clinic from hers). At the end of the consult, the surgeon asked the P.A. to verify whether her band was empty of fluid. To everyone's surprise...it wasn't. It had over 1 cc of fluid in it. The P.A. removed all the fluid. They also verified that her band has NOT slipped and there are no issues with scaring or other problems common with lap-bands.

Now a month later she is eating much easier and able to eat a wider variety of foods. However, the vomiting has not completely gone away and she is continuing to lose weight. We are now suspecting she may have developed a eating disorder, likely bulimia. Her GP suspects so too. He is running a bunch of tests for her and is recommending that she meet with a psychologist who specializes in eating disorders related to bariatric surgery. Her GP thinks that stress is contributing to it and that her mind tells her to vomit whenever she gets full. She is so embarrassed to think she has a eating disorder, because to her she isn't intentionally forcing herself to throw up, but she is starting to accept that she might have one. She is also battling with the issue of removing the lap-band. She wants it gone, but doesn't want to regain the weight she lost. She loves the way she looks now.

Sorry for the long story, but does anyone have any experiences of developing an eating disorder (bulimia) after lap-band or any other bariatric surgery?

I would have had the band removed yesterday. The bulimia can cause permanent damage to her organs and can lead a heart attack. Also the acid in her esophagus can lead to cancer.

I hope a therapist can convince your wife to take care of her health. Being thin at this cost is not worth it.

Did she have an upper endoscopy?

Yes...she has had 2 in the past 10 years.

How recent was the most recent one? (Since "2 in the past 10 years" could mean 1 in 2008 and 1 in 2009.)

The last one was when she was diagnosed with Sjogrens Syndrome, which was in 2016.

Considering this is newer behavior, it might be wise to have a current upper endoscopy to see if anything has changed with the band - erosion, etc. Two years is certainly long enough that something could have changed to be causing this.

Thanks Gwen. I will have her ask the next doctor she sees.

Has she had a gastric motility study? Sometimes movement is slowed in the stomach/intestines leading to vomiting

Yes, people can develop eating disorders after bariatric surgery...or have current eating disorders or disordered eating that evolves into another iteration. It's possible to develop anorexia, for instance, after surgery when it was not extant before.

Bulimia requires intentional compensatory behavior, usually vomiting. The key word is intentional. The problem is that she has a lap band, and lap bands are known to cause frequent vomiting even if empty. There's a reason they have the highest revision rate of all bariatric procedures. Sjorgens also causes vomiting, actually, even if medicated.

If she's concerned about weight gain, I'd suggest converting the lap-band to another surgery, which is generally covered by insurance. The problem is that her GP is not a psychiatrist or psychologist - she really needs an assessment. The person who does it needs to be a counselor or psychologist who is familiar with integrated health principals. That is, your wife has a complex medical history, and to effectively confirm an eating disorder, the physical issues which may cause it (the lap band, Sjorgen's) must be ruled out.