Vsg Overeating/purging -- Bulimia Or Inability To Cope With The Sleeve?!

[Peony 3]

I apologize in advance for the lengthy nature of this post, but I'm feeling quite desperate and would appreciate any help that this community can offer...

Back in September of 2006, I had the Lap-Band surgery. Things went well from a weight loss standpoint, but like many people on this forum I was constantly having issues with vomiting, undigested food remaining in my stomach/esophagus, etc. In June of 2011, I decided to have my band removed and (because I was terrified of regaining the weight) I paid to have the VSG procedure.

After about 2 months of just being on liquids and soft foods, I thought I was doing well with my sleeve, but I'm back in the same position of vomiting after virtually every meal, even if I only have a few bites. I've also taken to overeating/binging strictly with the intent of purging. I've started seeing a psychiatrist because I was concerned that the "bad habit" I had developed while I still had my band had actually turned into a psychological issue and I'm also seeing a therapist to deal with the "underlying issues" of my eating problems. The trouble is, I don't feel like anything the therapist has to say is resonating with me and I don't "feel" like I'm engaging in these eating behaviors to intentionally cause harm to myself.

I honestly believe that I need to be taught how to eat. Obviously, my relationship with food was never "normal" because I was overweight to begin with, but now I am constantly worried about causing a leak in my sleeve, disrupting the ulcers in my esophagus (from excessive vomiting with the band), and impacting my health overall. My electrolytes are a bit out of whack and my cholesterol is high -- both factors my primary doctor attributes to the constant purging.

If anyone has found any literature or other support resources about "learning how to eat" after VSG or gastric bypass, I would greatly appreciate the recommendations.

Many thanks!

[MegInNOLA 531]

First of all, a big hug from me. That must be a really difficult thing to deal with. I think I understand that you have 2 separate issues here--one, you get sick whenever you eat, even if it's just a few bites, and two, you deliberately overeat to make yourself sick. If that's not correct, I apologize. If it is correct, I think the first problem might be similar to one I had.

When I was first sleeved, I could never eat comfortably and was sick every single day for 8 weeks--didn't matter what I ate, how little, how well-chewed, how slowly. I threw up every stupid day. THEN people on this forum advised me to start taking Prilosec, and I did. WOW what a difference. A couple of days after starting it, I actually could tolerate eating without throwing up. Immediately, my mood and energy improved and I was able to start living more or less "normally."

I can't help with the bulimic aspect of your issue (and I'm really glad you have a counselor with whom you're addressing these problems), but it's entirely possible that you need to get on a particular type of antacid so that you can eat small amounts without needing to throw up from a physical standpoint. Sending wishes for healing and peace--

[Peony 3]

Thank you so much for the response! I do have an Rx for a PPI, but I've told my doctor that I don't think it's strong enough -- after reading about your experience I'm definitely going to push harder on this. I think that if I was able to eat a reasonable, healthy amount of food I would be less inclined to binge. By the end of the day I feel so desperate and "starving" (even though I don't have hunger pangs) I'm willing to do anything to get food into my body. Again, thank you for your response and support. I'll be following up with my surgeon this week.

[Fusilli66 22]

Maybe instead of a therapist you should see a nutritionist to learn the best way to eat. I am 6 weeks out from my sleeve surgery and all of a sudden I am finding myself vomiting sometimes after meals because I had just one bite to many. My problem is that I eat to fast and I am really working on slowing down while I eat. But I find it is so easy to vomit because it's almost not like vomiting because the food seems to get stuck in my esophagus and then it just comes up before it ever really went down. I have never been able to force myself to vomit (pre-surgery) and I am not forcing myself to now. It just happens here and there if I go a little overboard. I am eating so little already so I still need to find that sweet spot between eating the right amount and eating to much.

I am still pretty new to the sleeve so I am still learning what and how to eat (and how much), so I'm going to give it some time and if it doesn't get better eventually go to see what I can learn from a nutritionist. But it seems like you have been dealing with the issue longer so you might want to consider seeing one now.

Good luck and feel better.

[feedyoureye 3,087]

So sorry to hear you are having these problems. This may be a red herring, but sometimes when someone has a stricture, they can't eat without vomiting. I think it is good advice to talk to a nutritionist or perhaps a physical therapist about learning how to eat again. Best of luck, K

[GetInMyBelly 80]

What's ppi? Btw I understand how u feel as I'm afraid of eating little bites of bad things n getting back into that bad habit of happy foods and emotional eating.

[Becca 108]

So sorry you are going through this. I would try the PPI and see if that helps. My life was horrible with the band, so I can totally understand how things could get so bad for you. There are certain foods that make me throw up with the sleeve. You may try a food journal and see if there are foods you can tolerate. I wish you the best. Hugs!

[Lissa 2,631]

Peony, First of all, hugs to you for having the guts to post about your struggles here. It is TOUGH to admit that we are having problems, much less to ask for help. I am impressed that you were so honest!

Second, I agree with Meg that you should take a PPI. Why not start out with the one your doc has prescribed and see if it helps? You may have already tried that, so a stronger one may be in order, but SOME acid reduction should be better than no acid reduction.

Are you drinking milk and using regular dairy products? For me, those caused lots of problems. I'm lactose intolerant after the sleeve and haven't been brave enough to try regular milk again yet. Maybe eliminating those would help with the urge to bring everything back up.

I commend you for working with a therapist on your food issues. I'm seeing a therapist as well, just because I want to make sure I do as well with this tool as possible. It's tough to give up our friend and comforter and suddenly start doing what's required to lose the weight. And, lots of us aren't fat because we want to be, but we are compelled to eat to try to overcome unrelated traumas. I feel for you.

Have you thought about literally starting over with your sleeve? Go back to liquids, either full or clear, and then slowly move up through the mushie stage again? Maybe it will be like a mental reset button for you, allowing you to avoid the vomiting and the purge/binge cycle? Perhaps your nutritionist could give you some written guidelines to follow to help you get through the stages again.

My thoughts on that is that people do a "pouch test" when they feel that they are not on track, isn't a pouch reset possible? Sometimes you do just need the mental boost that comes from starting over and knowing you are doing it right.

Good luck and please check in and let us know how you're doing. (((Peony)))

[kekerene 35]

One of my sleeve buddies had the same issues and it turned out she had a kink in her stomach. They had to do some sort of balloon from what I understood. She is 100% better today. I would suggest getting it checked out just to make sure there is nothing serious going on. I can totally relate since I used to have the band and threw up every single meal. Now that I have the sleeve that NEVER happens. I hope everything works out for you. Best of luck to you!

[CowgirlJane 14,259]

I think you have gotten great advice and different things to check on.

A year ago I went to a therapist to "deal" with my food issues. Well, i do have some bad habits, but mostly I am just really hungry and feel like I could eat about 24/7 if I didn't really restrain myself. She accused me of holding back, after i had told her everything about my life, my childhood or whatever - basically nothing we talked about really reasonated with me. I feel like i have gotten more understanding reading this forum then I did in all those sessions.

I had a band that failed too. I haven't had the vomit thing in years because all the Fluid was removed, but I will say that living with the band did kinda mess with my head a little. When i had a filled band, healthy food hurt (Protein, veggies), but I was still hungry. It sucked. There were times when I chose to eat things that weren't the healthiest just to feel better. I haven't had a fill in my band since '04 even though I just had it removed this year. I hope/think/pray i have had enough time to undo the mental and physical damage caused by that dang band.

Best of luck in getting to the root of this.

[Sassygirl06 962]

What's ppi? Btw I understand how u feel as I'm afraid of eating little bites of bad things n getting back into that bad habit of happy foods and emotional eating.

ppi=proton pump inhibitor (or and acid reducer)

[GetInMyBelly 80]

Thanks! Too many abbreviations I need to remember on here ;0)

[Peony 3]

Thank you to all for the suggestions and the support. I'm going to follow-up with my surgeon to see about getting a stronger PPI and check into any physical/anatomical issues that I may be experiencing. I totally agree that I should be seeing a nutritionist (who is well-versed in bariatric surgeries!) rather than a therapist. In fact, I'm planning on "breaking up" with my therapist tomorrow. :-) As I mentioned in my initial post, this doesn't feel like an emotional issue. I feel like I'm physically unwell, unable to eat, and struggling to give my body the nutrients that it needs just to function.

I also agree with the suggestion that I should try to "start over" with my band. I'm certain that my esophagus is swollen and irritated from the constant vomiting, so giving that time to heal and return to normal is definitely a good idea!

I've been putting off seeing my surgeon, because he is very, very focused on weight loss -- more so than wellness, in my opinion. He suggests that my goal weight should be 125 lbs. even though I am 5'10" and currently, I weigh 145 lbs. I feel so discouraged when I see him, because I think to myself "I'm barely able to eat anything, I throw up the majority of my food, and I exercise regularly. What else do I have to do to reach goal?!" I feel like I'm failing him, me, and the process overall. I think these feelings have prevented me from seeking help sooner.

Again, thank you for all of the support and responses. I'll be sure to check in once I make some progress.

[feedyoureye 3,087]

What the heck? 5'10" and 125 lbs?!! I'm 5'9" and Im shooting for 165... 125 would be underweight according to the charts... 145 sounds PERFECT!

[italianlady13 80]

My goal is 125 and I'm 5'4. I think that your struggles are both psychological AND physiological. Maybe it would be a good idea to see a nutritionist who is well versed with bariatric patients and then to also see a therapist who specializes in eating disorders. I'm sorry to hear you are "breaking up" with your therapist however there are many many therapists out there who can help you set reasonable goals for yourself. If you get down to 125 on a 5'10 frame that will put you at 17 and some change BMI this is underweight and perhaps not a healthy goal. Also do you think it's possible that with the band your body just got so used to vomiting that perhaps in your head you thing this is a normal eating pattern? this is worth exploring with a mental health professional as well. I really would like to discourage you from stopping your therapy. My therapist has been a GOD SEND...and I advocate professional help any chance I can get......sorry if this sounded harsh but some of your comments about goals and weight waved red flags for me as I am a recovering food addict and had some issues with anorexia in high school....