Limit Addiction Transfer After Bariatric Surgery
Singer Carnie Wilson, known as the face of weight loss surgery after her gastric bypass procedure was broadcast live on the Internet, has made headlines again by confessing to Oprah that she gave up food but took up alcohol. Carnie is not alone. Addiction treatment centers like the Betty Ford Clinic in California report that an increasing number of people seeking help for substance abuse say they developed the problem after they had bariatric surgery. The phenomena of swapping one compulsion for another, known as “addiction transfer,” has only recently been associated with weight loss surgery patients. However, in the past year, the phenomenon has been the subject of such considerable media attention that has led observers to wonder about how prevalent is addiction transfer is after bariatric surgery?
The answer is that no one knows for sure. Estimates by different experts vary from a low of 5% according to Dr. Schauer, immediate past president of the American Society for Bariatric Surgery, to a high of 30% according to psychologist Melodie Moorehead, who treats weight loss surgery patients. Weight loss patients do not gravitate towards any one new addiction. Alcohol abuse is one of the most common addictions bariatric surgery patients develop, but recreational drug use, compulsive shopping, excessive gambling, and indiscriminate sex have also been reported.
It is important to recognize that weight loss surgery does not cause addictions, but that weight gain may be a sign of an addictive personality.
Different estimates may result because the problems that develop from these new addictions can take several years to surface. A patient may not make the connection between developing a habit of alcohol abuse two or three years after surgery and weight loss surgery itself.
The field of psychology has traditionally taught that addiction transfer occurs because people try to fill the void created in their lives when they are deprived of a particular substance or behavior. But emerging brain-imaging and chemistry data is challenging this theory. Scientists have found that the brain chemistry of people who are addicted to food is very similar to the brain chemistry of people dependent on other substances like cocaine or alcohol or who compulsively engage in other behaviors like shopping or gambling. Specifically, dopamine levels are elevated in the brains of people who behave compulsively. So instead of seeking to fill an emotional void, addiction transfer may occur because neurological pathways in the brain drive behaviors that boost dopamine levels, creating a feeling of being in balance in the brain again.
Preventing Addiction Transfer after Weight Loss Surgery
Science is currently seeking ways, from behavioral to pharmaceutical inventions, to prevent addiction transfer from occurring after weight loss surgery.
Ensuring patients undergo adequate psychological screening before bariatric surgery is a potentially preventive measure that is getting more attention lately. These screenings can help ensure that people undergoing these procedures have a low level of addictive behavior. Physicians should also emphasize the need for ongoing behavioral counseling to prevent the development of new undesirable behaviors. People need to understand what drove them to overeat initially and learn new skills to deal with underlying issues like loneliness, stress, traumas, and so forth.
In addition to counseling, support groups have proven to be beneficial because they put people into contact with others like themselves who are able to ease some of the isolation and shame they feel regarding their predicament. Participants also feel encouraged by the progress others are making. There are several support groups that deal with food and drinking addictions.
- Overeaters Anonymous (O.A.)
- Food Addicts Anonymous (F.A.A.)
- Food Addicts in Recovery Anonymous (F.A.)
- Alcoholics Anonymous (A.A.)
Clinical trials examining the effectiveness of various drug therapies are also underway. Topomax, a drug originally developed to treat epilepsy, has shown some promise as a treatment for alcohol abuse and compulsive overeating. The antidepressant Wellbutrin and the smoking cessation drug Zyban have demonstrated potential as treatments for gambling, overeating, and nicotine dependence. Many other drugs specifically designed to treat compulsive behaviors are currently under development and testing.
Weight loss surgery does not cause addictions. Instead, people who are addicted to food may find a new compulsion once they are unable to overeat. The lesson to be learned from addiction transfer is that to lose weight successfully and keep the weight off, you must find a way to treat the cause of your food addiction.
Dieting and surgery will treat the symptom – obesity, but not the issues that caused you to overeat initially.
To improve your odds of success, you need to be honest with your surgeon about your eating habits and other lifestyle issues before and after surgery, and you need to participate in the behavioral programs prescribed. With openness and hard work, you can set yourself free from your old habits and body weight.
Side Bar
“Addiction transfer” is a term coined by psychologists involved in substance abuse treatment. It refers to the tendency for people who relapse after being treated for one form of substance abuse to develop a compulsion for another substance or harmful behavior. For example, a person with a history of alcoholism may give up drinking, but may start using prescription painkillers or gambling excessively.