Vulnerability, Weight Loss Surgery and Cross-Addictions

[Sara Kelly Keenan LC 350]

Extremely overweight people who become thin very rapidly through surgery can sometimes feel very vulnerable and unprepared to deal with not only their own changing bodies but also the reactions of friends and family to the "new" body. Sometimes they are uncomfortable being the object of sexual desire for the first time in their adult lives. Especially with women, I have also seen that some feel as though they are ostracized by other women because those other women believe that their formerly fat friend has become an attractive threat to their own relationship.

Others may feel self-conscious or unattractive because an extreme weight loss leaves them with skin folds or scars. They sometimes feel that surgery did them no good because their bodies still stand-out in public and in private as unusual. One client referred to it as the "Is That All There Is?" syndrome. She said she somehow believed that losing 150 pounds would leave her with a body that society would consider beautiful and what she got was abdominal flesh hanging over her thighs. I notice this is especially true when a person going into the surgical process is focused on getting thin or attractive rather than on getting healthy.

There can also be problems in intimate relationships. One woman spoke of her husband's lack of interest in her sexually. In all other ways the relationship was healthy so they were able to talk about it. What she learned was that after the weight loss her husband felt unworthy of her because he was still overweight. He also lost his sexual confidence when his overweight wife, in his words, became "one of the girls in high school who wouldn't give me the time of day."

Also, if a WLS patient has early-life traumas unaddressed or not completely addressed prior to surgery the loss of food as a way to placate stress and to reduce anxiety can be a new source of trauma. This leaves many facing a very difficult transition to a life not centered around food. All of these stressors and others are a breeding ground for cross-addictions. It is vital to consider before surgery and in the "thinning" months and years after surgery how you will deal with stress, sadness, fear, loneliness, anxiety, or whatever thoughts and feelings triggered emotional eating in the past. If there is no healthy outlet for these the body and mind will create whatever outlets they can, which most commonly include alcohol, drugs, sex or gambling.

The problem of replacing food addiction with alcohol addiction is the one I have personal experience with and have seen the most in people I've encountered. In 2006, three years after LapBand surgery, I developed an addiction to alcohol. I had lost food as my companion, soother of stress, provider of sensual satisfaction and entertainment. I was not able to eat the comfort foods that placated my fears of life prior to WLS and I desperately craved an outlet for uncomfortable emotions and beliefs I took-on and began running from during my childhood in a violent home. So three years after WLS, and after loosing 110 pounds, my dinner every night became a 6-pack of Vodka coolers or more (Sour Apple or Grape) and ironically Healthy Choice low-fat ice cream.

At my lowest I was 220 pounds and I felt very uncomfortable and vulnerable in a smaller body. I continued to wear large, baggy clothes because I was afraid to look feminine. Feminine to me then meant I was vulnerable and open to attack. This went on for a year, during which I regained all 110 pounds lost and felt like a failure. Worse, I felt like a public failure because everyone around me knew I'd had LapBand surgery. What I had to do was address the beliefs and fears I had about what it meant to be feminine. I had to come to terms with my past and embrace a future in which it is possible and within reach to be healthy, feminine and safe.

To avoid cross-addictions, it is important that individuals considering surgery or those who have had surgery take this very personal, individual journey into the beliefs they hold onto from their pasts. These are the beliefs that caused them to turn to food in an unhealthy way for comfort. It is vitally important to plan what healthy outlets for emotional pain they can create. A therapist or Weight Loss Life Coach can help with this.

Dealing with the thoughts and emotions that caused compulsive overeating in the past and forming healthy patterns for working with and releasing fear and anxiety in the future are essential to long-term weight loss and the avoidance of cross-addictions for WLS patients.

[scootergirl 118]

Thank you for posting this. I think you address an important but sensitive issue. I would not have expected myself to be plagued by "cross-addiction" issues. I did not think I was "addicted" to food. Ha! I was very under-aware of the degree to which food soothed my stress of life. Now that I don't have food for comfort or calming, I face my stress alone. I have allowed myself to relax and socialize with friends by enjoying a drink in the evenings (I could not eat the foods they ate so I joined them with liquid). I can see that it would be easy for alcohol replace my old reliance on foods. Thank you for reminding me of this.

[Jack 855]

Thanks a TON for posting this kind of article. It strikes squarely at a point rarely discussed.

"Sometimes they are uncomfortable being the object of sexual desire for the first time in their adult lives."

Once in my pre-Op life circa 1972 or so I had undergone at considerable effort and a large outlay in therapy/pills/various quackery of the era, sufficient toning/fat loss to generate a noticeable wake of something resembling pheromones attractive to a far wider range of females than I had previously been aware. It had considerable effect on my fledgling confidence and I felt on-the-spot as an object of former-cold-contempt by having opportunity to make something of my own appearance. Without being able to verbalize such I felt drawn back to the safety of the Old Fat Habits and in short order managed to once again reside in the Zone of Morbid Obesity.

I've managed to recover from that unwelcome shock, and fortunately along the way had the burden of any desire for alcohol lifted from me, by nothing less than what I can attribute to Divine Grace.

Thanks again for your bravery in broach a complex subject.

Cheers in your Journey

[Jammil0411 17]

I have been addressing my food addiction for 15 years. I regularly attend 12 step meetings and talk about stressors in a group setting.