Weight Loss and Psychiatric Disorders


The recent theme of Childhood Obesity News is, don’t become obese, because even if you somehow manage to lose an enormous amount of excess weight, life will not be a bowl of cherries. It would really be much better to not have the necessity for weight loss come up at all.

We looked at some of the physical results of massive weight loss. Granted, weight loss by dieting doesn’t have such a great record, but when significant slimming is achieved by bariatric surgery, the aftermath is a lifetime of strict rule observation, and awareness that several things could go wrong.

In either case, a patient who has poor psychological health before surgery will probably still have it afterward. Ed Cara, author of “The Dark Side of Weight Loss Surgery,” says studies have shown that…

[…] bariatric patients are more likely to turn to psychiatric medication and have higher rates of binge-eating disorder and alcoholism than the general public. The very nature of gastric bypass may leave people vulnerable to drinking problems, since it lowers people’s alcohol tolerance; […] a 2007 study found that 12 percent of patients used vomiting to control their weight. Even divorce rates shoot up.

Part of the reason for such severe reactions is that bariatric surgery means major rearrangement of interior parts that Nature had already configured to its satisfaction. Cara adds:

And more radical procedures don’t just shrink the stomach and colon, they also cause dramatic hormonal changes that alter the brain and gut, dulling a person’s appetite.

Of course, these problems don’t afflict every case. Some people sail through the rapid-loss “honeymoon phase” with a song in their heart. But the giddy momentum of transformation slows down or even halts, and that is when people are proven to need support the most. When the idyllically blissful era ends, all that’s left is the daily grind and the prospect of a life almost devoid of what used to be the most important thing: eating.

According to Dr. Sandra Aamodt, anxiety causes dieting and dieting causes binge eating and weight gain. She wrote:

Girls who labeled themselves as dieters in early adolescence were three times more likely to become overweight over the next four years. Another study found that adolescent girls who dieted frequently were 12 times more likely than non-dieters to binge two years later.

This suggests that, after weight loss, anxiety will probably still be pulling the strings, unless close attention is paid and unless psychological help is made available.

The post-bariatric surgery blues

We talked about the regrettable tendency toward recommending bariatric surgery at a younger age, and for less serious degrees of overweight, than was previously considered appropriate. People who are relatively young, and relatively un-obese, opt for surgical intervention with what Cara describes as a “troubling lack of focus on its mental health consequences.”

Perhaps it is not fair to cite an example of bad outcomes from the gastric band, a particular form of surgery that isn’t used much any more, but let’s go ahead and do it anyway. Cara mentions a small study which, in a diet-versus-surgery comparison, “tracked the mental health of patients many years after surgery.”

Over 10 years, the researchers found that despite their long-term success on the weight loss front, the patients’ mental health on average deteriorated past even their pre-surgery level. The dieting group, meanwhile, had largely stayed the same mentally.

(To be continued…)

Your responses and feedback are welcome!

Source: “The Dark Side Of Weight Loss Surgery,” Vocativ.com, 01/24/17
Source: “Why You Can’t Lose Weight on a Diet,” NYTimes.com, 05/06/16
Photo credit: Visualhunt

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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