Anonymous wrote:Please encourage him to spend some time - weeks/months, not hours - reading in the bariatric forums and support pages on Facebook, Reddit, etc.

I was considering bariatric but was depressed at the time so my therapist wouldn’t initially clear me psychiatrically.

I used the time while my depression was resolving to do a deep dive into the research on rates of weight regain and rates of transfer addictions in bariatric patients. I was shocked, and remain disturbed by how little attention is paid to this in the surgeon’s presentation to patients - I met with the surgeon twice, the dietitian several times and did all the extensive pre-op screening testing to be approved for the surgery and the entire time risks and complications were downplayed and zero attention was given to regain and addiction until I raised it with the dietician who acknowledged it’s a reality.

The weight control program I went to is excellent, the surgeon is excellent and has a super low rate of complications etc. I don’t doubt that they are among the best bariatric centers going as I live in an area with some of the best healthcare in the world.

That said, there is little offered in terms of resources on food addiction as a behavior disorder. Patients are encouraged to get counseling if they feel they need it. From what I read about on the support pages and forums, this is a huge problem and the pun is intended.

Patients are posting about hacking their diets before they even get surgery and wanting to get back to their food favorites within days - those who experience the worst physical side effects (vomiting, nausea, chills, etc.) when they try to eat the old way are typically the ones who start up an alcohol or other addiction - and it’s easy to do because the altered gut metabolizes alcohol differently so bariatric patients have a totally different relationship with alcohol.

I would strenuously encourage the weight loss drugs first - they are largely reversible. Once you alter your gut through bariatric surgery yes it can stretch and you can gain all the weight back, but you will still have the same long term risk of obstruction and malnutrition if you aren’t religious about supplementing because you can never absorb nutrients from food again the same way.

As for me - not at all virtuous, still struggling with food urges and working all the time on the behavioral aspects of my disordered relationship to food which in my case is related to childhood trauma. But I have lost 35 of the 160 pounds I gained over the decades and am steadily losing weight- slowly, healthfully - by eating a much healthier diet with lots of plants, much less saturated fat, little to no processed foods and very, very minimal sugar. No alcohol, fizzy/sweetened drinks or fruit juices.

Honestly to lose 100 lbs I would recommend trying just about anything else before major gut resection. Therapy for what’s at the root of the eating, and significant dietary changes plus exercise for the mental health benefits and to boost metabolism and maintain muscle as he loses.

Anonymous wrote:Please encourage him to spend some time - weeks/months, not hours - reading in the bariatric forums and support pages on Facebook, Reddit, etc.

I was considering bariatric but was depressed at the time so my therapist wouldn’t initially clear me psychiatrically.

I used the time while my depression was resolving to do a deep dive into the research on rates of weight regain and rates of transfer addictions in bariatric patients. I was shocked, and remain disturbed by how little attention is paid to this in the surgeon’s presentation to patients - I met with the surgeon twice, the dietitian several times and did all the extensive pre-op screening testing to be approved for the surgery and the entire time risks and complications were downplayed and zero attention was given to regain and addiction until I raised it with the dietician who acknowledged it’s a reality.

The weight control program I went to is excellent, the surgeon is excellent and has a super low rate of complications etc. I don’t doubt that they are among the best bariatric centers going as I live in an area with some of the best healthcare in the world.

That said, there is little offered in terms of resources on food addiction as a behavior disorder. Patients are encouraged to get counseling if they feel they need it. From what I read about on the support pages and forums, this is a huge problem and the pun is intended.

Patients are posting about hacking their diets before they even get surgery and wanting to get back to their food favorites within days - those who experience the worst physical side effects (vomiting, nausea, chills, etc.) when they try to eat the old way are typically the ones who start up an alcohol or other addiction - and it’s easy to do because the altered gut metabolizes alcohol differently so bariatric patients have a totally different relationship with alcohol.

I would strenuously encourage the weight loss drugs first - they are largely reversible. Once you alter your gut through bariatric surgery yes it can stretch and you can gain all the weight back, but you will still have the same long term risk of obstruction and malnutrition if you aren’t religious about supplementing because you can never absorb nutrients from food again the same way.

As for me - not at all virtuous, still struggling with food urges and working all the time on the behavioral aspects of my disordered relationship to food which in my case is related to childhood trauma. But I have lost 35 of the 160 pounds I gained over the decades and am steadily losing weight- slowly, healthfully - by eating a much healthier diet with lots of plants, much less saturated fat, little to no processed foods and very, very minimal sugar. No alcohol, fizzy/sweetened drinks or fruit juices.

Honestly to lose 100 lbs I would recommend trying just about anything else before major gut resection. Therapy for what’s at the root of the eating, and significant dietary changes plus exercise for the mental health benefits and to boost metabolism and maintain muscle as he loses.