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Weight-Loss Surgery and the New Addiction, Part 1 of 2

TriciaBy Tricia Greaves, President of The Nelson Center

Stopping a deadly addiction can give an addict a new lease on life unless he or she neglects to heal the underlying cause of the addiction and instead replaces it with another. The Betty Ford Center in Rancho Mirage, California reports that about 25% of alcoholics who relapse switch to a new drug such as opiates.1 When people switch addictions, the new addiction often ends up being as dangerous and difficult to treat as the original one.

Patients of weight-loss surgery also fall victim to addiction transfer. About 140,000 people have weight-loss surgery each year, and it is estimated that somewhere between 5 and 30 percent of them pick up addictive behaviors afterwards.6 Patients who undergo gastric bypass surgery are four times more likely to require inpatient care for alcohol abuse than the general population, according to a study presented earlier this year at the Digestive Disease conference in Chicago.2

The reasons for the addiction transference are both psychological and physical, say experts. “When you take away someone’s primary addiction, in this case food, they often need to build their world around something else,” said Dr. James Mitchell, chairman of neuropsychiatry at the University of North Dakota School of Medicine.3

Overeating fills a psychological need. When a person who overeats has surgery and can no longer physically consume the quantities that they previously ate, they search for something else to pacify the feelings they were trying to soothe.

Carnie Wilson, former singer for the popular group Wilson Phillips, has become the unfortunate poster child for addiction transference. In 2006, an emotional Wilson revealed on-air to Oprah Winfrey that she once consumed a bottle of wine and 10 margaritas a day and was “absolutely crocked” when she shot her infamous Playboy spread in 2003. She has confessed that she spiralled into an alcoholic haze that nearly destroyed her marriage two years after her very public gastric bypass surgery. The singer thought her problems were over when she shed 150 pounds after drastic surgery in 1999, but admits she simply transferred her addiction to food to one of alcohol. 4

In addition to the psychological need to replace the comfort that food provided, bypass surgery patients can also suffer from the unpleasant shock that their new thin body doesn’t bring them the happiness they had fantasized it would. Andrew Kahn of Tamarac, Florida admits that post-surgical depression played a role in his turning to alcohol. Andrew had surgery in 2003, and within a year he had lost 187 pounds off his 5-foot, 7-inch frame. He joined a gym and in 2005 ran a marathon.

But the excess skin that sagged from his belly depressed him. Like many patients who lose a lot of weight, Kahn’s skin didn’t shrink with the rest of him. “It just hangs there. I hate looking at it,” he said. Though his insurance covered his weight-loss surgery, in 2008 the company declined to pay for the skin-reduction surgery, which is considered cosmetic, and Kahn couldn’t afford to pay for the $10,000 procedure himself.

That’s when he started drinking. “My finances were bad, I couldn’t do anything about the extra skin, which depressed me, and vodka would tell me everything was okay.”

“If I had one to two drinks, I could get very stoned very quickly.” Soon one to two drinks became five to seven miniature bottles of vodka. He started drinking in the morning, and often woke up shaking. “Drinking for me became like eating used to be — instant satisfaction,” he said. “My wife was furious with me.” Last August he checked himself into a detox clinic.5

Due to the nature of the bypass procedure, alcohol has a stronger effect on the digestive system of post-surgical patient. “You drink alcohol; your blood alcohol level is going to be higher than you think. Watch out,” said Dr. Bruce Wolfe, the president of the American Society for Metabolic and Bariatric Surgery. “It’s a precaution that should be passed along to virtually all the people who have gastric bypass.”6

A single glass of red wine can make a bypass patient legally intoxicated regardless of weight loss,” said Dr. John Morton, the director of bariatric surgery at Stanford University and the lead researcher on the study.7

So if this underlying need for an emotional pain-killer remains, even after weight-loss surgery, what can be done?

Next Week Part 2

 

As an addictions expert for over 20 years, and more recently as the President of The Nelson Center, Tricia Greaves has been educating clinicians, trusted advisors, families and the public about the root causes and complex issues surrounding addictions. To learn more, visit TheNelsonCenter.com

1 Spencer, Jane. “The New Science of Addiction.” Wall Street Journal. July 18, 2006.

 2 Woodward, Downey, Hernandez-Boussard, and Morton. “Impaired Alcohol Metabolism after Gastric Bypass Surgery: A Case-Crossover Trial.” Journal of the American College of Surgeons. December 22, 2010. http://www.journalacs.org/article/S1072-7515(10)01090-2/abstract. September 14, 2011.

3 Jameson, Marni. “After Gastric Bypass Surgery, Some Patients Battle New Addictions.” Orlando Sun Sentinel. June 30, 2011. http://articles.orlandosentinel.com. September 14, 2011.

4  “Carnie Wilson Comes Clean About Alcoholism.” Starpulse.com. October 26, 2006. http://starpulse.com/news/index.php/2006/10/25/carnie_wilson_comes_clean_about_alcoholism. September 17, 2011.

5 Hartman, Pat. “Famous Food Addict Carnie Wilson.” Childhood Obesity News. April 18, 2011. http://ChildhoodObesitynews.com/2011/04/18/famous-food-addict-carnie-wilson/. September 17, 2011.

6 Bell, Stacy. “Gastric Bypass Alcoholism Addiction Transfer.” New Jersey Rehab Centers. July 20, 2010. http:// NewJerseyRehabCenters.com/alcoholism/gastric-bypass-alcoholism-addiction-transfer/. September 17, 2011.

7 Woodward, Downey, Hernandez-Boussard, and Morton. “Impaired Alcohol Metabolism after Gastric Bypass Surgery: A Case-Crossover Trial.” Journal of the American College of Surgeons. December 22, 2010. http://www.journalacs.org/article/S1072-7515(10)01090-2/abstract. September 14, 2011.

8 Hartman, Pat. “Famous Food Addict Carnie Wilson.” Childhood Obesity News. April 18, 2011. http://ChildhoodObesitynews.com/2011/04/18/famous-food-addict-carnie-wilson/. September 17, 2011.