Post-Surgery Stress

Having bariatric surgery is one of the greatest ways to help save your life from the grip that obesity, and its related issues, have on it. A key result of having the operation is substantial weight loss, and being a healthy weight contributes to fewer health conditions such as diabetes and heart disease among many others. This leads many to emote genuine excitement at the thought of being approved to have bariatric surgery. 

Sometimes, however, you may feel emotions that you didn’t expect after surgery. Suddenly, you may experience such feelings as sadness, fear, anxiety, or overall stress. Why does this monumental moment in your life seem to flip-flop into something you never anticipated? Let’s take a deeper look.

For one, any kind of surgery has the potential to cause post-traumatic stress. According to VISTAS Online (2013), there can be long-term traumatic effects resulting from medical procedures, hospital stays, or illnesses that include PTSD, grief, depression, anxiety, or somatic symptoms. So for some patients, having bariatric surgery can be a scary moment. You must go under anesthesia, which is a potential risk, especially in obese patients. Then, there is a recovery stage that may include pain. It can leave an imprint of PTSD symptoms simply from the procedure itself. Those symptoms then can manifest in other areas of life, leaving us to wonder why we are suddenly irritable or hypervigilant. It’s important to process what you have been through every step of this journey. Post-surgery is a big part of this.

Another issue that may cause post-surgery stress is any comorbid mental health conditions that existed before the bariatric surgery. Those who are diagnosed with binge eating disorder or are obese have a higher risk of being diagnosed with depression. According to the CDC (2014), adults living with depression were also more prone to be obese than those who weren’t, and of the adults diagnosed in the US, 43% were obese. Complex trauma, such as childhood sexual abuse or neglect, can also play a major part in PTSD before and after surgery (Papaikonomou & Liebenberg, 2010). Those who have suffered this kind of abuse without properly healing from it, have often learned to use food to cope with the horrific moments they have lived through. When that food is suddenly not on the diet plan post-surgery, some may feel as though they do not have any way to cope, leading to panic and distress. 

Regarding diet changes, it can be very hard post-surgery to let go of the food that you have been accustomed to eating. This happens for numerous reasons. As mentioned earlier, food may be a source of comfort for that person, so losing that comfort due to a strict diet post-op can feel restraining, isolating, and hurtful. There is also the mental struggle of breaking a habit that has been a way of life for a lot of people dealing with obesity. If your brain and stomach are accustomed to grabbing a snack at night or having specific foods, it takes conscious effort, avoiding triggers, and retraining of habits to break that feeling. 

Also, there is always the looming fear of gaining the weight back. According to Women’s Health (2015), if exercise and diet routines are not followed correctly, the most common time to gain the weight back is the second or third year after bariatric surgery. Before this, the gut hormones that regulate hunger, ghrelin and peptides, are lower after having the procedure. However, the body starts to adjust after the first 18 to 24 months post-op, and that causes the appetite to reemerge. This is where we see people start to indulge the cravings they once had. There is so much weight loss in the beginning that it’s easy to feel like a little cheating will not be harmful. This can cause a person to fall back into old habits, and suddenly, weight gain can occur. 

Weight gain after surgery is a huge trigger for feelings of stress, anxiety, and depression. It can send a person back to old feelings and trauma from before their surgery. Having everyone tell you how “great you look” while you are losing weight can make you feel paranoid that everyone may notice weight gain. That anxiety can send a person to food for comfort, and the cycle begins all over again. This is why it is imperative that you never look at bariatric surgery as a magic trick that will end all of your problems with obesity-related issues. It is not the “end all, be all” of weight loss. It is also crucial you deal with your mental health just as much as your physical health and properly heal from any past trauma. Overeating is typically part of a root issue that needs to be addressed and treated. 

Lastly, seeing your body go through tremendous changes can be psychologically challenging, even if the weight is dropping. You may have to now deal with looser skin, and that can be a shock to many. You may also feel like you are losing the “old you,” and there may need to be a grieving process with that. When your body is drastically losing weight, it can affect hormone production, sleep, moods, and vitamin intake. It’s important to talk to your doctor about this because communication is key. Your doctor can lead you to the help that you need so you don’t turn to the wrong ways to self medicate, such as overeating. 

Remember, bariatric surgery is a part of the journey, but it is not the end stop. Post-surgery may present its own set of obstacles you want to be prepared for. What it comes down to is remembering that being healthy is the main goal, not just wearing a certain size. Being healthy means wellness in all areas: physically, mentally, and emotionally. So make sure you are utilizing every resource at your fingertips through your journey. 

You can be successful post-surgery.

Resources:

Hall, M. & Hall, S. (2013). When treatment becomes trauma: Defining, preventing,

and transforming medical trauma. VISTAS Online. https://www.counseling.org/docs/default-source/vistas/when-treatment-becomes-trauma-defining-preventing-.pdf

Papaikonomou, & Liebenberg, H. (2010). “Complex trauma”: reflections on the effect of early childhood abuse among a small adult group of bariatric patients. South African Journal of Psychology, 40(3), 327–337. https://doi.org/10.1177/008124631004000311

Pratt, L. & Brody, D. (2014, Oct.) Depression and obesity in the U.S. adult household population, 2005–2010. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/nchs/products/databriefs/db167.htm#:~:text=Forty%2Dthree%20percent%20of%20adults,obese%20than%20women%20without%20depression.

Worth, T. (2015, Dec. 4). Bariatric Surgery’s emotional risks for women. Women’s Health. https://www.everydayhealth.com/news/bariatric-surgerys-emotional-risks-women/