Over the years I’ve coached many people after they’d had weight loss surgery. They were seeking help from me because they continued to struggle with emotional or binge eating. Many had regained their pre-surgery weight, or were in the process of doing so, or they had never lost what they thought the surgery promised. All were feeling disappointed, some desperate, some were full of shame.
How could this be? They’d taken this drastic, hopefully final, “this-will-finally-fix-everything” step, and they were still fat? Now they blamed themselves for “failing” at this, too. Nothing left to try? Now what?
Numerous times I’ve tried, with little success, to find solid statistics that might explain what I was seeing in my practice; that this was not their failure. This week Paul Ernsberger, PhD, whose is on the faculty of Case Western Reserve School of Medicine’s Department of Nutrition confirmed that data on regain after weight loss surgery are sparse and not reliable. Still, here’s what he says we do know. The truth is not pretty.
1. One fact that everyone agrees on, even surgeons: weight loss stops between one year and two years after surgery. People do not lose weight continuously.
2. Sometime after the first year, people are able to eat more than 3 ounces of food that the pouch initially holds. By two years, most people are able to eat normal size meals. This does not mean that the patient “out ate” the surgery but simply that the body has restored homeostasis.
3. Given these two facts, everyone regains some weight. The rate of regain varies a lot between individuals. Many people return to starting weight. Ask around at a NAAFA (National Association to Advance Fat Acceptance) meeting. There are many people there who had weight loss surgery years ago and are over their pre-surgery weight. At this point, it seems that a majority of super sized people have had weight loss surgery at some point.
4. Surgical journals report highly suspect results, because they do not include drop outs. Studies show that anyone not showing up for follow up appointments has probably regained most of the lost weight.
5. Some people do not regain weight. Many of them are having severe side effects such as neurological and brain disorders related to B vitamin deficiencies. People in chronic pain tend to keep some weight off. People who vomit a lot keep some weight off. Weight loss surgery variants with the highest incidence of side effects are most effective in long term weight loss. This is not an accident –the complications and side effects are a major contributor to weight loss.
Not all the weight loss is fat. Some is water. Some of the weight loss is from depletion of bone mass from osteoporosis caused by poor absorption of calcium and magnesium. Some of the weight loss is shriveling of muscles.
If you are considering weight loss surgery of any kind, please know the facts, especially if you are a binge eater. Studies have shown that binge eaters tend to have the poorest results from weight loss surgery. That makes sense, doesn’t it? Surgery does not fix the need to use food to manage or “stuff” thoughts or feelings that drive emotional eating.
When it comes to the truth about weight loss surgery, ask your surgeon for long term results in his or her practice… at least five to ten years out…one year stats tell you very little as that’s still the “honeymoon” period for most. Also be sure to ask for drop out stats…as Dr. Ernsberger says, there’s good reason to believe those people have likely regained weight lost.
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Ellen Shuman is a Life Coach who specializes in empowering people who are working on emotional and binge eating recovery. She is the founder of A Weigh Out & Acoria Eating Disorder Treatment (1993-2005), a past President of the Binge Eating Disorder Association (BEDA merged with NEDA), and Co-Founder of the Academy for Eating Disorders Special Interest Group on “Health at Every Size”, ellen@aweighout.com
