12/23/15

Can Bariatric Surgery Cause an Eating Disorder?

Repeated experiences seeing post-Bariatric surgery patients are perplexing and disturbing to the clinician who treats people with eating disorders. Obesity is clearly a significant health issue in large parts of the world; however, permanently altering someone's gastrointestinal anatomy to make possible longterm starvation is a destructive and counterproductive solution. 

The grand experiment of culturally sanctioned starvation has caused multiple chronic medical problems, number one on the list being eating disorders. The result of idealizing the extremely thin has been to encourage and blindly support constant dieting and starving. 

We have learned that people have a varied but ingrained and largely genetic response to chronic starvation. The most common response is overarching hunger that usually triggers one form of eating disorder symptoms or another. 

Bariatric surgery often causes a form of binge eating. Most people can starve for 6-9 months and lose a significant of weight before the starvation response takes over and the uncontrollable urge to eat dominates one's thoughts and actions, thereby leading to binging. 

The solution, as with all eating disorders, is to start by normalizing a meal plan. Consistent nutrition signals the body and mind that the famine is over so normal body function can resume. Doing so will gradually let the starvation response subside. 

What's particularly concerning is the medical community's reaction to these cases. Uneducated in eating disorders, most doctors are perplexed by these symptoms. Bariatric surgeons continue to encourage starvation and weight loss, while the Bariatric nutritionists do not consider changing their recommendations for prolonged malnutrition. Endocrinologists encourage medications to treat the increased hunger. No one considers the effect of chronic starvation, largely because thinness is of primary importance. 


The Bariatric community needs to team up more closely with eating disorder clinicians in order to better understand the repercussions of these surgeries. Curing obesity by causing an eating disorder is certainly not a viable means of treatment.

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