Gastric bands may lead to depression as patients can no longer overeat: researchers

[T_i_B]

Source: Daily Telegraph (UK)

Obese people who have a band fitted around their stomach to help them lose weight may end up thin but can suffer from low self-esteem, relationship problems and leave them struggling to cope, according to new research.

Gastric bands are placed around the top of the stomach and restrict the amount of food that can be comfortably consumed. Researchers at the Diabetes UK Annual Professional Conference (APC) said weight loss surgery should not be seen as a quick fix.

A team from the University of the West of England and Southmead Hospital, Bristol, followed 25 patients, aged from 30 to 58 years and recorded their experience 12 months after receiving a gastric banding operation. Two thirds of them had type 2 diabetes.

There were significant health benefits, as would be expected, but the majority also found there were strong, negative psychological impacts. Many patients struggled with the shift in mindset required to deal with their desire and ability to eat and some considered the band to be no different to dieting. They said losing the opportunity to eat as a coping strategy left them struggling to cope with distressing life events.


Read more: http://www.telegraph.co.uk/health/healthnews/7359507/Gastric-bands-may-lead-to-depression-as-patients-can-no-longer-overeat-researchers.html

[kstewart33]

1. I'm sorry, but tough noogies.

It looks like the surgery worked - isn't stopping overeating the whole point?

Of course, people in this situation would be 'struggling to cope' with addiction. Every addict does.

Looks like these folks were looking for an easy solution, and there is none. What addiction is easy to fix?

[Zoeisright]

14. Wow. How progressive of you.

NOT.

Do you also torture small children and kick kittens?

[activa8tr]

36. A real "progressive" accepts the fact that additions DO exist, and that

the most important part of treating addictions successfully is to have the patient recognize and deal with ALL aspects of the addiction.
Recovering alcoholics get depressed, too! Should be be "progressive" and understanding and offer them a drink?

Oh please, stop with your "holier than though, more truly progressive than though" mantra. Sometimes a cigar is simply a cigar, and sometimes an addiction is an addiction in need of treatment, even with the side-effects like depression. There is no perfect pill for every ill of society, nor for every illness of any individual. Let's accept that and move on and stop with the accusations that we, who accept the realities of life, are cat torturers,

[nightrain]

2. sure, underlying depression...

[Vinca]

3. Proof positive the underlying problem is not food.

Obesity is a complex problem and many surgeries fail because it isn't the cure.

[Donnachaidh]

4. the gastric band is a bandaid fix for a compound fracture

Years ago, when they first started doing the surgeries, I worked with a man who had the band. He had lost a great deal of weight, but nothing was done about his addiction to food.

He had such a severe emotional problem he would literally choke down his lunch, and then sit in the lunchroom and physically salivate watching others eat. He made lunch for everyone a painful experience.

The psychological attachment to food must be addressed too.

[T_i_B]

6. "The psychological attachment to food must be addressed too."

I can already see one problem here, which is that we all have an psychological attachment to food, because if we didn't then we'd starve!

As the nun said when thumping the grinning Psychic, "You've got to strike a happy medium!"

[Donnachaidh]

7. so sitting at a worktable physically DROOLING is okay with you?

This guy literally would do that, in hopes that someone would hand over their lunches to get him to STOP that nonsense. He knew what he was doing, and his tactic worked. People usually left the room in disgust, leaving their un-touched food which he would then inhale - literally.

It was a disgusting display, and he was totally shameless about it.

[Zoeisright]

13. Awwww, your poor widdle sensibilities were hurt???

Gee, I bleed for you. Your attitude is the disgusting display here.

[Bunny]

35. He "literally" inhaled the food?

Seriously?

[The Stranger]

11. Yeah, they already know about that.

The experts in the field who address food addiction realize that people starve without any food. Next question.

[eilen]

5. It appears that along with the stiff requirements of this surgery

there should be some major emotional/behavioral training and follow up therapy afterwards. Bariatric surgery is not for everyone but it is an effective way to reverse type 2 diabetes. I see repeat heart patients coming in the hospital for the same procedures over and over and yet they are not stigmatized like the obese are (although many are obese). Instead we feel compassion for them even though they suffer from a similar biochemical process-- inflammation and find it extremely difficult to modify their lifestyles. Overeating is often a compulsive behavior disorder that should be treated by qualified physicians and therapists. At it's source it is not very different from anorexic behavior except that socially the anorexic receives positive reinforcement to a certain degree.

[Jennicut]

12. I have heard that gastric bypass can be almost like a cure for type 2 diabetes and there is further

research about it eventually being done for people who are not obese. Something about the small intestines increasing certain peptides might stop the diabetes. If it really gets off the ground, we could see many people be cured of type 2. I am a type 1 but this would be huge for people who are struggling with insulin and meds.

[Missy Vixen]

21. There is already a requirement by insurance companies

and the vast majority of surgeons that those submitting to either bypass or the lap band meet with a psychologist.

Let's get even more graphic. Those that have the surgery can eat one cup of food or less at a meal. If you eat more, you're ill. Stuck in the bathroom ill. It's possible for food to get "stuck", which causes extreme pain. Also, those who submit to the lap band surgery sign a statement that they can no longer drink any alcohol whatsoever, due to the fact the body can't metabolize it any more.

I wonder how many here eat more than three cups of food a day right now. I wonder how you'd feel to know that you could only eat that three cups; any more that that would make you sick? Even more, I wonder how many of you could stay on the regimen for the rest of your life?

[pitohui]

25. this is a good post but there is also a second factor

some people are ready to give up the food addiction, i've before mentioned my friend who had the surgery at 68, he was frank abt the fact that when he was younger, he wasn't ready yet to give up eating as a social event etc.

however, there is another cause of the depression, not just "food addiction" -- many fat people aren't fat or food addicts, they have a metabolism issue --

however, if the person is larger or v. large, then there is a lot of loose, baggy skin left hanging after the weight loss -- sometimes MANY pounds of it -- the insurance companies claim that removing this excess skin is for cosmetic purposes and they won't usually cover its removal

some people suffer the depression because their bodies, although now slim, may look OK in clothes but because of the loose skin, they don't feel comfortable having sex, etc. -- i've heard at least 2 women tell me this was their circumstance

we had to fight to get insurance companies to cover reconstructive surgery after mastectomy, so women could get their lives/sexuality back...seems like we need to do the same for this

[hedgehog]

8. Sometimes the craving for carbs is a result of low seratonin levels.

In other words, the obesity was a result of self-medication in the first place.

[Chemisse]

28. Good point.

Until the medical community acknowledges that obese people may be eating for physiologically driven reasons, there is not going to be any help for the underlying causes.

I compare it to the way psychiatrists blamed a baby's development of autism on an unaffectionate or indifferent mother, up until around 1980 or so. Until they could recognize that it was a physical problem, not a psychological one, there was no help to be had for autistic children and their families.

Similarly, attributing overeating to a psychologically caused compulsion, pretty much eliminates any chance of help for the actual causes.

[eagertolearn]

9. Could be related to the nutritional problems they have with the sugery.

[FailureToCommunicate]

10. We're all rats in the experiment by the food industry to increase profit$. Instead of

blaming each other for bad habits, or bigotry, we should be looking at the 'Hand that feeds' us.

It is a real eye opener. We as individuals in this country spend billions on diet fads and related health costs while Agri-business makes billions.

Read Michael Pollan, see "FOOD, Inc" You may be shocked, but probably not surprised, to learn of the ways our food chain has become something that is literally killing us.

We are all basically on our own to resist lousy food and eat better, because our food lobby controlled legislators have little incentive to make an issue of the trend.

However, the real health care costs for treating our increasingly un-healthy food options is very much a factor in the current desperate need for HCR

[Zoeisright]

15. Yes, exactly. Thank you.

The callousness of some on this board is simply appalling. It's like they're channeling Jim Bunning.

[Big Blue Marble]

31. Also read "The End of Overeating."

by David Kessler. This is an inside look at how the food industry rewires our brains to get us to eat more of what is killing us,
more fat, salt, and sugar. This is really a war. And as long as we stay uneducated to the affects and the consequences,
the other side has most of the weapons.

It is only when we make the commitment to eat less, to eat consciously, and to eat only healthy foods that we prepare ourselves,
will we start to change ourselves and hopefully the systems that provide our foods.

[mudplanet]

16. Virtually all medicines and surgical procedures have a cost.

People who undergo surgery should be referred for psychotherapy, if needed. Simple.

[naaman fletcher]

17. Everyone wants to absolve fat people of responsibility

I used to have a lot of sympathy for fat people until I was in a business helping them. It turns out that while sure everyone would rather not be fat, most fat people would rather be fat then do simple things like eat less unhealthy things, and actually get up off of their asses every now and then.

It sounds harsh, but pay close attention to the behavior of very obese people and you will see that they choose to be the way that they are, and impose massive costs on the rest of us.

//Yeah, yeah, I am sure somebody has an example of a fat person we should all feel sorry for, so go ahead and post it as if the exception negates the rule.

[Missy Vixen]

22. Wow. I can't imagine what a joy you are IRL.

Perhaps you should find another line of work that you don't have to deal with those you obviously think so little of.

:eyes:

[naaman fletcher]

23. I don't anymore,

and i didn't not enjoy it, the people were as nice as any others, but I simply realized that they actively chose their lives. That's all ok with me, I just lost sympathy for when they complain about it.

[Dorian Gray]

26. What the hell job did you do

when you were in the business of helping them?

Seriously, I do think that we are cuturally ingrained with wanting easy answers, but your post is BS generalizations that are completely unfair. And it certainly doesn't apply to only obese people. You could make that generalization about everybody who needs to make changes.

Wrapped up in obesity are psychological, cultural, familial, economic, physical, medical AND sociological issues. There is no easy answer why each individual who is overweight is overweight. Each individual has a variety of factors, many of which they may or may not have an easy time dealing with. People are taught to eat a certain way. People use food as a psychological comfort. People are unable to find healthy alternatives in their neighborhoods. People don't have the time to cook.

Losing weight is a difficult process, one in which I am extraordinarily familiar with. I've lost 95 lbs., and I've done so through seeing a nutritionist, joining a gym and seeing a trainer, and joining WW. All of those things cost money and they all take an immense amount of time. I'm lucky that I could afford to put so much time and effort into the process and spend as much time in introspection dealing with my psychological issues.

It's not about laziness. There are a number of factors that people have to confront and overcome before they can be successful, and your post is so dismissive of these factors. It's like we forget that the overweight are human beings with real human reactions and real human problems.

[eShirl]

30. because depression is a choice?

[tinrobot]

33. It can be.

There are many factors that can trigger depression. Some factors can be controlled by choice, some factors cannot.

[Hell Hath No Fury]

18. Cutting back the calories is only half the battle.

Dealing with the emotional issues that will come up with band or bypass surgery is the other half.

I have seen it many times with friends who have gone through these surgeries -- the surgery is a "success", the pounds start dropping off, and then the emotions surface. The smart ones get counseling and deal with the issues that led them to over eating in the first place, the not so smart ones think the job is over and, too often, start back up on their old eating patterns. One friend who had gastric bypass just refused to deal with the REAL issue -- her loveless marriage and verbally abusive husband -- and is packing the pounds back on after losing 150 pounds. :(

[KittyWampus]

20. I'd also like to add- learning what food to get your calories from is also key. It's different for

different people.

[Dorian Gray]

27. Psychological help

is important for people who have done this. Self-image changes. Honestly, when I was overweight, I was more confident in many ways. I knew what to expect from people and it was almost like a veil covering me. People liked me but didn't pay too much attention to me.

Now I have to deal with other issues, and I"m much more insecure in a lot of ways. People are so much more responsive toward me, and I had a really difficult time dealing with that at first. Psychological support helps immensely with the many issues that arise with weight loss and changing self-images.

[dugaresa]

19. i have a dear friend who suffered horrid side effects due to the gastric band

and now has problems with acid reflux in her esophagus.

she got her band from a general surgeon who decided to cash in on a very lucrative business right now.

she learned that was a bad decision.

[pitohui]

24. this happened to someone i know but she has overcome the depression and now is VERY happy

so the main reason i'm leaving this post is to offer some positive thoughts to anyone has had or has considered the surgery

by all means, be aware of side effects, depression is life threatening BUT i wouldn't necessarily assume the risk of depression means you shouldn't risk the surgery

this lady had the surgery for medical reasons and is now in remission from symptoms of type 2 diabetes -- a significant result -- she told me that she was in bed for 3 months, depressed, not even wanting to wash her hair, but she's doing great now thanks to concerned surgeons etc. who helped her adjust

"it took me a long time to say, this is the best thing i ever did for myself, but it is" is pretty much her exact words to me

i don't know if it's necessarily "the loss of eating as a coping mechanism" -- in her case, she was lifelong heavy because of diabetes/metabolism issues NOT overeating -- i think it's just that losing that much weight, that fast, in a middle-aged/post menopausal woman can really screw w. your hormones

but WHATEVER the cause, if you're considering this surgery or know someone who is, be supportive of yourself, be supportive of yr friend/family member

anyone who is doing surgery to treat a significant health threat needs to know the side effects but they DON'T need a lot of negativity, respect their decision and if they do need some post-op treatment for depression, again, be supportive that changing your body is a lifelong work in progress not a fingersnap -- don't be all "i told you so" -- taking physical and mental challenges to change one's life requires courage and nay-sayers sitting on the side don't even know what courage is so why should anyone listen to their negative crap anyway

[WildClarySage]

29. I had my lap-band surgery in September last year.

I've lost 70lbs so far. I'm healthier now than I've ever been. I have more energy to do more and I don't have anything LIKE the pain issues I had before from rheumatoid arthritis. I exercise daily, and I follow a healthy, high protein diet. I've got a ways to go to be at my optimal weight, but I will get there. Before I had the surgery I really didn't believe anything would change for me. I didn't think I could lose the weight and keep it off- and statistics back that up, that its extremely unlikely I could have. Before the surgery I had to have extensive testing performed to ensure that I would be able to follow the program which includes regular checkups and band maintenance, visits with a nutritionist, and monthly support group meetings. The testing I had included an endoscopy, a psych evaluation, a sleep study, an EKG, and several rounds of blood work.

Its not a quick fix, I'm not 'cheating' to get results. Its a tool for becoming healthier, not a weight loss short cut for lazy fat people. I have to eat less at a time because of the band, but the surgery doesn't make me go swimming every morning. It doesn't pick what I eat, and it doesn't limit how many times a day I eat. I do those things because the surgery wasn't easy, and I don't want it to be for nothing. I do it for the same reasons anyone else does- because I want to be healthier. Because I want my girlfriend to wake up next to me every morning and think I'm cute. Because I want to keep up with my children. And because I deserve to be as physically well as I can be.

My ex-husband is having the surgery done as soon as he's approved for it because of my success with it. I would recommend it to anyone, but its not without its drawbacks. Sliming (saliva coming up the esophagus after overeating), malnutrition, the cost of the procedure, vomiting and food sticking, the amount of loose skin left over after weight is lost, and the physical discomfort of the surgery and band adjustments- as well as the risks of complications and death- are very real concerns and should be carefully considered before agreeing to the surgery. The possibility of depression as a side effect of the surgery was discussed with me before the surgery was performed.

It is the best thing I could do for myself and my kids. And if anyone has any questions about it, please pm and ask =D I'm happy to answer.

[activa8tr]

37. Looks like you are a wonderful example of how this is not just about

the surgery. It's about the whole person. CONGRATULATIONS!!! I think you can be proud of your choices and your accomplishments.

Thanks for sharing a very positive and healthy outlook on this whole phenomena.

I hope you can offer some other people advice and guidance so that they can do as well as you seem to have done.

[NickB79]

32. My aunt hung herself last year. She had undergone gastric bypass surgery 4 years before

She lost 100 lbs in under 2 years, yet became horribly depressed. She divorced my uncle, moved to another city, and remarried. Unfortunately, the depression remained. Her son found her in her bedroom, but she was gone.

My last memory of her was at Christmas a few months before she told my uncle she wanted a divorce. My grandmother is a fabulous cook and made a table full of food, but all my aunt could eat was a small bowlful. She looked so very, very sad.

[activa8tr]

38. Sorry for your loss. Sounds like she didn't get the support and

follow-through she should have.

She obviously had more to deal with than she found support to work through. Very sad.

[Manifestor_of_Light]

34. You're starving yourself.

I was on a medically supervised low cal weight loss diet, supervised by a bariatric doctor, M.D. with a Ph.D.

I was on 500 cals/day. I took a bunch of vitamins and supplements.

I finally realized I was starving myself and my metabolism had slowed down so I wouldn't lose more weight. That and the fact that I eat very little and have a dead thyroid.

After several thousand dollars and about six months, I had lost all of eight pounds. I need to lose about 40 pounds and cannot. I would not have a lap band surgery.

I should have just had liposuction. It would have been cheaper and the fat would be GONE.

[activa8tr]

39. To lose 40 pounds, a 500 calorie a day diet doesn't sound like

very reputable medical practice. Most people who can be moderately active can lose that amount of weight on a 1200-1500 calorie a day carefully supervised diet, combined with appropriate exercise. Even people confined to wheelchairs, people with other mobility problems, people who cannot walk/stand/swim.

500 calories a day is a deadly plan from the start, in my opinion. Sue them!