“I drink because I’m lonesome, I’m lonesome ‘cause I drink.”
This song just came up on CMT whilst I wrote this post. Timely.
Two years ago I wrote a post about Las Vegas after I arrived home from a trip there for a professional bariatric conference. I titled it Las Vegas is a GIANT SPARKLY TRANSFER ADDICTION.
And I meant it. Vegas is full of 489230 reasons why post weight loss surgery patients are tempted and could be tempted and often fail to dissuade temptation and need to be careful about temptation.
I went back to Las Vegas last spring for another bariatric-related event. It is likely that I wrote a very similar post or re-posted the original, but angrier as situations were fresh in my mind. I tend to do that with blog posts. It is possible that I also deleted any post that referred to last year’s event.
This year brought another event in Las Vegas. When I first read about the event scheduled for Vegas again, I cringed.
This time, this particular event brought more than five hundred pre and post operative bariatric patients together in one place. While not the one thousand patients once expected to come, this was a very large turnout for a bariatric event. It was impressive.
Prior to the event, it was discussed that removing the temptation of having a cash bar from the event might be a smart idea. There were videos made – discussions started – and attendees sounded a bit miffed that there might not be easy access to cash alcohol bars. In the end, we did have bars at the nighttime social parts of the event. The compromise (or close to it…) was to halve the bars, and only have access to half of what the hotel might offer at each event. Even with just one bar, attendees came prepared. Some brought their own drinks in, some drank pre-event and brought drinks in, and some found the bar and some did all.
I heard that the bar drinks were terrible and watered down, but it was obvious that the majority of us were drinking something, regardless of where it came from. I drank as well.
I had one drink at both social events during the meet and greet, a light beer. Light beer is my go-to choice, mostly because it doesn't make me very tipsy, because tipsy for me is no good.
I am eight years and two months post op, and tipsy for me is still no good. It takes just few sips of hard liquor or wine to make me shit-balls drunk at eight years post gastric bypass. I have learned what works for me. And that is pretty much, abstaining from anything with liquor in it unless I am ready to get rolled home. Because being rolled home (or in this case, to your Vegas hotel room… gross!) is neither attractive nor memorable.
And yes, many of you (us… you are my people even if you don't want to admit that!) were rolled, carried, pushed, and shoved back to your rooms last weekend at the event we attended together. Collective "Gasp! Say it isn’t so, Beth! Tell me that bariatric patients do not drink alcohol nor drink to… excess?” They do. And it’s often hushed. (Among most other things. Out of sight, out of mind. Do not kid yourself.)
Estimates on the prevalence of new addictions after weight-loss surgery vary widely. Philip Schauer, director of bariatric surgery at the Cleveland Clinic and current president of the American Society for Bariatric Surgery, estimates that only about 5 percent of bariatric-surgery patients develop a new compulsive behavior after surgery, such as alcoholism, compulsive shopping or smoking. He adds there is no evidence that the new addictions have any direct link to the surgery.
At U.S. Bariatric, a weight-loss surgery center with offices in Orlando and Fort Lauderdale, Fla., therapists estimate that roughly 20 percent of patients acquire new addictive behaviors. Melodie Moorehead, a psychologist who spoke at a session during the American Society for Bariatric Surgery Association annual meeting last month, cited preliminary data suggesting that roughly 30 percent of bariatric-surgery patients struggle with new addictions after surgery. But she says the issue requires further study.
One possible reason for the disparity in estimates is that alcohol problems can surface several years after the surgery, when surgeons are no longer tracking patients as closely. And some patients may not see a link between their drinking and the surgery, or report their problem to a surgeon. Roughly 140,000 bariatric surgeries are performed in this country each year.
MM says in her totally un-professional opinion that no one should listen to — the rates of addiction post WLS are much higher. My non-pro opinion almost everyone develops some type of addiction after weight loss surgery, it's just not obvious to everyone else. Yes, compulsive gum chewing, mint eating, crotcheting/knitting, crafting, internet use, water-loading, calorie counting, exercise… ANYTHING can be an obsession or addiction when it takes over your life and keeps you from taking care of your personal business. "Hi, my name is Beth and I am addicted to caffeine, probably simple carbohydrates and I abuse the internet."
*hangs head in no shame*
"I didn't see any of that. Nah. I was drinking, but I didn't notice anyone else drunk. I deserve some fun… I was taking opiates or painkillers but I didn't see anyone else doing it. I took sleeping pills, someone gave me sleeping pills or muscle relaxants… I was shopping a lot, but… I gambled a lot, but…"
There's a lot of buts in our community, did you notice? "But…" I need, I want, I have to… I … deserve to.
<— not guilty party of one. I figure I should lay that out before I get called out on my "eating a mini Gigi's cupcake and having a beer," because I did. Oh, and the most expensive Beef Wellington, ever.
I am the same as everyone else.
It happens every single time, at every single event – conference – get together (for every topic, this is not something unique to the bariatric community) people are human, humans like to drink. We have all been affected in some way by alcohol (and other things…) at events.
However, what IS unique about our particular community is the intensity of the reactions to addictive behaviors. A group of typical people without the “benefit” of weight loss surgery will include individuals with addiction issues, and those without, and those who like to just have a drink in a social situation. It’s normal and typical to see a whole range of reactions to alcohol in a varied group.
But in our community full of people who have had weight loss surgery – there is often so much more history behind why someone might drink, drug, gamble, or even EAT.
Not everyone becomes a statistic, not everyone develops what is often called a “transfer addiction” after bariatric surgery; but too many DO struggle with addictions. The rates of abused children or those with addict parents who grow up to be morbidly obese individuals who go on to have bariatric surgery are staggering. Why? The way I see it, when someone’s coping skills and emotional self-soothing are stunted by weight loss surgery “I can’t eat anymore,” they HAVE TO FIND SOMETHING ELSE TO FILL THAT SPACE.
Post ops who fail to find a healthy substitution for stuffing food to stuff feelings down will find other, often entirely self-destructive ways to self-soothe.
Theories abound for how childhood abuse relates to adult obesity.
• Abused children may eat as a form of coping, a pattern that continues into adulthood.
• Increasing size by gaining weight may offer protection from physical threats.
• Weight gain may repel sexual abusers, and help adults avoid sexual advances.
• People may believe that being fat is socially protective, that society will expect less from and think less of someone who is obese.
• The emotions associated with abuse are thought to lead to higher levels of cortisol, the stress hormone, in the bloodstream. This can increase appetite.
A study in the Obesity Journal stated that extremely obese bariatric surgery candidates reported rates of maltreatment comparable with those reported by clinical groups and roughly two to three times higher than normative community samples.
Yes, I am fully aware that “not everyone is a food addict,” nor is everyone abused. I am one of the lucky ones. But, I still struggle with the same "stuff it down" issues as many of you. I guarantee that when I get angry hater comments on this post, I will be compelled to get up and go find a snack. I might not follow through, but somewhere deep inside, I am triggered to do just that.
I consider the greatest portion of those of us who have weight loss surgery — Emotional Eaters, and Emotional Eaters can cause serious caloric damage in many ways. (Do you remember eating a pint of ice cream or a half-bag of potato chips? Do you remember why you were prompted to eat that much at one time? How did you feel?) “We” often move from abusing food (which is what it was… there’s no other way to describe it, honestly…) to abusing other substances or even moving into unhealthy behavior patterns that are just as destructive as food once was.
Certainly, pre-op psychological exams are meant to weed “us” out if we are engaged in self-harmful behaviors prior to having weight loss surgery, but post-ops know how easy it is to get shoved through the process without being psychologically prepared for a starvation diet. Many of us were ill prepared to deal with WLS for-EVER.
Once you arrive, as a post surgical weight loss patient, all if not most of your baggage comes back and falls at your feet. “But, I thought the surgery would make everything okay and make me win at life.” No. If you’re lucky, this crash/burn/reality doesn’t happen until after your “honeymoon” period of weight loss. Many post ops get hit with life issues much sooner – and fail to reach weight loss goals because they can’t get past themselves, their history, and often people give up. It is what it is, and I am sitting here at eight years plus post op, and clearly one of the only ones in this community that is willing to call it out.
As weight loss surgery patients – having given up what was probably our number one self-soothing method; we are LIKE SPONGES and ready to ABSORB whatever New Thing comes our way. That might be alcohol, and often is. It could be something else – just as addictive – or even behaviors that we do not even realize as dangerous. (I do NOT have a problem with coffee or Internet overuse. I. do. not. I am serious. insert link here…) These things can take over – and how. Alcohol, drugs, sexual promiscuity directly effect the WLS community, as does gambling, shopping to extraordinary excess, over-exercise, eating disorder behaviors, and the list goes on and on.
But alcohol in particular is a huge component of post weight loss surgery drama.
It can directly impact you, your family and every part of your life. I hear too many sad stories, likely because I watch this community and probably get the concentrated sad story juice of our peers. I am thankful every damned day that I haven’t had any disastrous addiction issues, nor has my post op spouse picked it up, because we could. Something I have learned in this community – never say never. Both of us have addiction issues in our extended families – and it was highly likely that we would also deal with one or ten of them. I am thankful, but I worry about you. I worry about this same WLS community – because post op addiction issues are rampant. Every so often there’s a study posted – that warns us of the dangers of Too Much Alcohol – and then another comes out that says that It’s No Big Deal. I am telling you – where I sit – it’s a big deal.
It isn’t just alcohol – and I suppose that since we were in Las Vegas – the issues were magnified by the simple fact that anything you WANT to medicate with is available. If you are addicted to something or have a behavior issue – you can get it in Vegas and get it in bulk. Personally, my coffee addiction gets stunted in Vegas because it costs too much to continue my habit. I do not know if that makes me less addicted, because I still sought out coffee. As for food, I gave up and decided that next time I will live on beef jerky. I think that just makes me cheap, not addicted. But if I did have a food problem, Vegas would feed it. But had I a sex addiction, not just one hired hand, I could get five! If I had a shopping addiction, Vegas offered anything I could want. Gambling, don’t even discuss the options. I gave up pretty quickly since my husband and I ran out of cash without really eating, shopping, or gambling. We could not maintain addictions in Vegas if we wanted to.
But it happens at every social event we have as a community. This was just more intensified due to locale and sheer number of attendees.
I worry that many of the WLS community find themselves “having their first…” everything post surgery surrounded by others who have recently started having their firsts too.
It’s a super-scary situation. If I am drinking, I cannot possibly help YOU. Post op drunks are not pretty. We are sloppy, nasty and often rotten.
The biggest clue I saw at this last event was the sheer number of people who noted that they had to Have Drinks to deal with other people. Had to. The pre-loading and constant level of buzzed-to-drunk was interestingly higher than I remember at other events.
It’s not new, of course, many attendees at events often note how they have to pre-medicate with anti-anxiety medications to even get into the room with other people. (I cannot judge this, as I had to take a double dose of Ativan to fly home. That, dear readers, is another post.) What I can concern myself with – is that there are SO. MANY. OF. “US” doing the same thing.
It’s clearly an indication of the lack of coping. As a community, we are not coping.