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If there’s any “magic” cure, it’s Body Acceptance

Posted Jun 18 2008 6:09pm

I stumbled uponthis post on a sitethat I generally find annoying, and often find offensive. The actual post wasn’t really all that exciting, and didn’t tell me anything I didn’t already know. It’s not widely publicized, but somewhere around30% of WLS patients* will develop some sort of substitute for eating, which is sometimes referred to as a “transfer addiction.” Since I take issue with the concept of a “food addiction” to begin with, I won’t touch that phrase, but there’s no denying that for many with an ED, be it anorexia, bulimia or binge eating disorder (BED), eating (or not eating) satisfies something emotional, something psychological.

The post in question discusses the link between WLS and alcoholism. It’s hardly shocking that WLS patients would be at a greatly increased risk for alcoholism. First of all, they can barely eat, which means there’s not a lot of food in there to absorb alcohol. That means that it more quickly gets into the bloodstream, which makes for a faster “high.” Supposedly, some WLS patients state that they feel drunk almost immediately. Moreover, since WLS patients are strongly discouraged from eating sugar, alcohol - which contains a lot of sugar - undoubtedly is digested very differently in a post-op person than it would be in a “normal” person. Finally, when you take the tendency of many of these patients to use food as a drug, it’s only logical that they’d find an alternate drug. For some, it’s gambling, compulsive shopping (because clothes shopping is not only very necessary as weight rapidly drops off, but also starts to be fun for the first time for many of these patients, especially women) and often sexual experimentation/addiction (again, not sure on the “addiction” aspect, but we’ll leave that for another post). I’ve read many stories where women who have never been the center of male attention suddenly are, and it’s terrifying and thrilling at the same time. I’ve known a few women who had a very hard time remaining faithful to husbands they’d loved, husbands who’d supported them and cherished them no matter what, simply because there was a sense of “did I settle? Could I have done even better?” and also just because the attention was intoxicating. I’ve read stories of women who cheated and destroyed their marriages and families, because suddenly they thought they were somehow able to get better than what they had. I’m sure it happens with men, too.

The point is that none of this is exactly news to me. However, reading the many, many comments from WLS patients who became alcoholics after surgery really struck a chord for me. I was a bit shocked at how many said they’d still have had the surgery - because in some cases, they’re talking about how the resulting alcoholism really ruined their lives, but being thin is still worth it. They just wish they’d been warned. Others don’t seem so rosy on the surgery after battling alcoholism and gaining back large amounts of weight (because, as they themselves notice, the common theme is an addiction to wine and a weight gain of roughly 60 pounds). Many of these patients found the site because of a story Oprah did (and you can read some ofthose storieshere).

The story that really broke my heart, however, was posted by a man named David A. I have copied his comment here, because it’s something anyone considering WLS should read. ?

Wow. I can’t believe how common alcoholism seems to be in relation to this surgery. My wife Amber had the surgery in October 2004. I was against it, but supported her decision nonetheless.

Within a month she was hooked on Xanax. She took them for panic attacks, but quickly started abusing them, taking ten or more a day. After kicking them, she started drinking, after a lifetime of not drinking and not liking alcohol. She would drink a bottle of Evan Williams like it was apple juice! Vodka, wine, tequila — and she would stay drunk all the time.

Her business went down the tubes. She would stay out all night doing god knows what, and would all but ignore our child (who is 5 now).

Whenever she was sober, she would claim to want to quit drinking and get her life together, but would hit the booze as soon as my back was turned. It’s almost like she had a love/hate relationship with her new self.

She started talking suicide, and I attempted to get her help, but she repeatedly sabotaged my efforts. It was like she was two different people — sober she was my wife who loved me and our child, drunk she was like a crazy, wild partying, screw everybody, unpredictable wreck.

On June 30, 2006, she committed suicide by overdosing on Benadryl. The woman I love, my wife of 12 years, is a casualty of a surgery that she thought would improve her health and the quality of her life.

I would not recommend this surgery to anyone except in the most extreme cases. You have no idea what kind of psychological monster it can unleash.

This poor man lost his wife, and his child lost his mother. Poor Amber lost herself and ultimately took her life because of her sorrow. And for what? To be thin? To be socially acceptable?

His story prompted me to search on suicide rates after WLS, and though there is limited research,one studysuggests a very frightening trend. This study focused on post-op patients in Pennsylvania. The study followed nearly 17,000 patients for a period of several years. In that period, 440 patients died. Out of those 440, 16 deaths were classified as suicides, but another 14 were simply classified as “overdoses” - which means the actual suicide death rate could be higher. Even if it doesn’t mean that, it’s still frightening and likely linked to the surgery itself, since it’s easier to overdose when your body behaves in a way so dramatically different from how it is designed to behave as a result of the surgical procedure. The researchers said that there should be no more than 3 suicides in a group that size in the same time period.

Another studydone in Utah showed this:

The New England Journal of Medicine reported a review of nearly 10,000 bariatric surgery patients by Utah researchers, who compared them to a control group of obese people who had applied for a state driver’s license. Although the surgery patients had a 50 percent lower risk of dying from disease compared to obese people who hadn’t undergone surgery,their risk of dying in an accident or suicide was 11.1 per 10,000 people — that’s 58 percent higher than the 6.4 per 10,000 rate in the obese group.The study suggested the suicide risk was twice as high for surgery patients than for those who had not had surgery, but the finding wasn’t statistically meaningful.

Maybe that’s not high enough to be “statistically significant” to researchers, but it’s high enough - especially when combined with the information from the PA study - to be deeply concerning. It’s enough evidence to make me realize (yet again) that I made the right call in not having WLS.

Why aren’t doctors talking about this more? Why aren’t more long-term studies being done? You may have noticed the * next to the statistic about 30% of WLS patients developing some other form of “addiction.” I put that there because - of course - theAmerican Society for Bariatric Surgeryhas claimed only 5% of patients actually develop some other form of addiction. You’ll excuse me if I don’t exactly trust their numbers, especially when we knowthey’ve skewed information in the past. Look, they are in the business of selling this surgery and making money for their members. While I’m sure some surgeons really have only the best intentions, I’m not going to trust them. My husband broke a finger last year. His regular doctor told him that surgery probably wasn’t necessary. The surgeon told him it was. When he pressed the surgeon, he mentioned that he, for example, played the piano - and that a break of that nature would make it far more difficult for him to play. My husband countered with “okay, so my non-existent career as a concert pianist aside, is there any actual reason I should have this surgery?” and the doctor basically kicked him out, exasperated by a patient who was educated enough to challenge his authority. Doctors make money when the perform surgeries. That’s simply a fact. Some are far more ethical about it than others, but many, sadly, will simply do it to make a buck.

Where am I going with all this? I swear, I’m getting there… just bear with me a bit longer.

I never had WLS, despite some seriously intense pressure - especially from Dr. Daniel Stein, a reproductive endocrinologist in NYC who is a PCOS “expert.” Dr. Stein told me, during our first appointment, while performing a vaginal ultrasound, and before ANY bloodwork was in to confirm PCOS (before he’d even seen the tell tale “string of pearls” cysts) that my best “hope of having children” was to “have weight loss surgery.” Yes, he said this while shoving an ultrasound wand up my vagina. Great bedside manner, huh?

At the time I was still a WW devotee, and told him in no uncertain terms that I was not having a major surgical procedure. I wish, in retrospect, that I’d walked out of his office as soon as I’d gotten dressed. I publish his name because any doctor who treats a patient like that deserves it. If I can prevent some other woman from suffering that sort of heartbreaking humiliation, good. I did question him on the fact that women who have WLS are chronically malnourished - and how is that good for a developing fetus??? I did some research on my own, because he really evaded my questions on the matter, and what I discovered was that there is staggeringly little research done on this issue. Most doctors strongly advise patients who have had WLS to weight at least 18 months before trying to get pregnant, but because birth control pills become far less effective, there are a lot of “oopses” that seem to happen. Due to the lack of research, there is really very little evidence to say whether or not babies are affected by their mother’s inability to absorb nutrients properly. Which to me is a good enough reason to not have surgery - why take that sort of chance?

I think I knew something, even back then… I wasn’t conscious of said knowledge, but I think on some primitive level I realized that WLS wasn’t the magic cure all people tried to convince me it was. I think I recognized that without loving the person I already was, WLS would just create new and unknown - and potentially much bigger - problems.

I would never say that I like being fat. That said, I’d rather be fat than be an alcoholic (and with the family history, I’d be at an even bigger risk). I’d rather be fat than develop a gambling or shopping “addiction.” I’d rather be fat that risk being so out of control, so lost and depressed that I killed myself, abandoning the husband who loved me for who I was to start with.

What I realize now is that, there is no “magic cure” for weight loss. Pills, surgery, diets… all come with inherent risks. None are going to magically solve your problems. Even if you succeed and lose gobs of weight, at the end of the day, you have to be able to accept yourself for who you are… and if you didn’t have the ability to do that to start with, the odds are good that you’ll continue to struggle - and especially in the case of rapid weight loss, that struggle may increase by major magnitudes.

I never had WLS, but I continued to desperately diet, to struggle on a daily - even hourly - basis with food, with the crazed desire to be thin and, in some respects, to be someone else. I remember in high school thinking that when I met the man who loved me for me that would be some sort of “magic” cure for my weight problem, because then I could lose weight and know that even if I gained it back, the man would still love me. When I met my husband, I lost 60 pounds in our first year together, and I thought that high school fantasy was realized. I reached my lowest adult weight, and then did fad diet after fad diet and in about nine months time I gained 75 pounds, leaving me heavier than I was when we met. He still loved me, but I wasn’t “cured” of my eating disorder or my “weight problem.”

It was only when I found my current therapist, and really began to realize that I need to let go of that “ideal me” that I began to truly accept the person I am today and love that person. There was some self-love before… but there also was always the thought of “I’d be so much prettier, hotter, sexier, happier… BETTER if only I was thin.”

Finally, I realize that’s simply not true. I’d be exactly the me I am now, only struggling to cope with that reality as a thin woman. I’d be disgusted, disappointed and crushed to recognize that losing weight didn’t change anything other than my dress size. I would still not have the “ideal me” because I am simply not built that way, and no amount of exercise or weight loss can change genetics. I’d have to cope with all the emotional angst being thin would certainly bring up AND I’d have to cope with the fact that nothing changed in my twisted, eating disordered brain.

And here we’ve reached my point…the closest thing we can get to “magic” isacceptance. It’s still not magical, because it means dealing with ALL of the angst, the emotions and the confusion of letting go of an eating disorder, of letting go of an idealized version of yourself that doesn’t - and most importantly, can’t - exist. It means learning new ways to deal with the issues you resolved by eating or not eating or over exercising or purging. It means realizing that the “control” you thought you had was a facade, and not a reality. So it’s not magic… but it is freeing.

I may never be thin. In fact, I’ll go so far as to say it’s pretty bloody unlikely that I’ll ever be what is deemed thin by our fucked up society. What I will be, however, is so much happier that it won’t matter anymore.

I chose life over WLS. I chose to find my own path, my own way to happiness - because somehow, even when caught up in the chronic dieting mindset, I knew thinness wasn’t the solution to every single problem in my life, whether psychological or physical. I chose to forge ahead on a journey that was at times heartbreakingly painful and slow. I chose to believe in what I knew what right for me, even when faced with doctor after doctor who insisted I was wrong.

Ultimately, I’ve won. My battle isn’t over - not even remotely… and yet, I’ve already won. I sit here with tears streaming down my cheeks, and they are tears of acceptance, relief and love.

I want everyone to know this feeling. I want you all to know the beauty in the pain, the joy in the suffering. It’s never going to be easy, but the point of all this is that there is no easy… but there is freedom. There is relief.

Find your path, and forge ahead - no matter what. Don’t let anyone convince you to do something you know is wrong for you.

I didn’t, and though I doubted - and even now sometimes doubt - I am a better person for the strength I found in my struggle to stand up for myself.

xoxo,

Juliet

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