Many who have struggled with their weight for a lifetime look to weight loss surgery methods like gastric bypass or the lap-band procedure to solve their weight problems. While these types of surgeries are successful for some people, many others still struggle after their operation.
For those with underlying psychological food issues, weight loss surgery can trigger other eating disorders. According to a 2007 Harvard study, 60 percent of all individuals seeking surgical treatment for obesity suffer from an eating disorder, usually binge eating. Those that have a previously unhealthy relationship with food and their body are at a higher risk of succumbing to other eating disorders after their operation.
Lap band and gastric bypass surgeries don’t typically create an eating disorder if there wasn’t previously one there. The major problem is that some who have these unhealthy food relationships have either left them untreated, or been unsuccessful in treatment prior to surgery. For binge eaters, the body cannot physically handle binge eating after surgery.
Bariatric weight loss surgery is on the rise every year in America. Between 200,000 and 250,000 adults receive bariatric surgery annually. A smaller statistic that seems to carry more weight is the fact that about 1,000 American teenagers received some sort of weight loss surgery last year and the number is increasing every day.
The most common types of bariactric procedures are gastric bypass, gastric banding, and sleeve gastrectomy, and all involve surgery which is very risky, especially for teenagers.
While some of the risks for post-op teenagers come from the surgery itself, other risks come from the ability of the patient to follow rules. Since the procedures limit the amount of food one can eat, malnutrition is a very serious threat, made worse for teenagers who are still developing and need those nutrients for proper growth. Because of the risk of malnutrition, most patients are required to be on a strict vitamin regimen for the rest of their lives to ensure the body receives the vital elements it can no longer obtain from food.
Kate Setter is a member of the media relations team at Cincinnati Children’s Hospital Medical Center, where she contributes to and manages Change the Outcome (www.cincinnatichildrensblog.org), the hospital’s corporate blog. She most often writes about pediatric public health issues, including obesity, pre term birth and immunization.
Perhaps nothing has been written, talked about or wrestled with more in health care circles the past few years than obesity- and for good reason. Obesity is becoming a national epidemic. The cost to treat its related ailments is approaching $150 billion a year and almost one in three children in the United States is overweight or obese.
Pediatricians across the country, including at Cincinnati Children’s, are doing their best to address overweight and obesity issues with patients and families, but many morbidly obese teenagers are finding themselves out of options to reverse the trajectory of their weight issues.
Tennessee’s TennCare may not want to pay for nutritional counseling, but the National Institute of Health requires some psychological counseling prior to any bariatric surgery. This counseling includes a psychological evaluation, often with a standardized objective test, as well as interviews to determine a patient’s preparedness for the life change required by weight loss surgery and information about those changes. One reason behind this requirement is that gastric bypass surgery cannot be reversed. It also requires major behavioral change to be successful; if a patient is not compliant with all behavior changes he or she can become very ill – I have even been told about the possibility of death. These are severe consequences for not following doctors orders implicitly.
Yet, the behavior change required is also severe. As a therapist, I see asking that kind of change from someone as setting them up for failure or disappointment because so much change is extremely stressful and mentally and emotionally taxing. I would caution any of my clients attempting such overnight life change, and counsel them on forgiving themselves when they do not stick to their plan. Eating more than planned one day may be a disappointment for someone committed to weight loss, but it can have devastating effects for someone who has had gastric bypass surgery.
Bills are piling up for Barbara Warnock-Morgan. After several years of diets that just didn’t work, she decided to get an adjustable gastric banding in November of 2009.
“I was the fat kid,” she said. “Over the years I yo-yo dieted my way up the scale. I’d lose 20 pounds, then gain back 30.”
Adjustable gastric banding, a form of bariatric surgery in which a silicone band is placed around the top portion of the stomach, costs $15,000 to $30,000. Though the 46-year-old, who lives in Brooklyn, was fortunate to have her insurance cover the costs, she will have to pay for body-contouring cosmetic surgery, also known as a “body lift,” to tighten up the loose skin.