Relapse after weight loss surgery

Folks need to leave Ms. Carnie alone!!!

Apparently, people have been buzzing about how Carnie Wilson re-gained a lot of weight after losing 150 pounds as the result of Roux-en-Y gastric bypass surgery. Actually, this is probably old news to most people, but I rarely see celebrity gossip. It's not exactly my favorite thing to do--keep up with the comings and goings of the rich and famous. I have entirely too much to do in my own life, mainly, trying to save it. And I mean that quite literally. But I do read web articles about morbid obesity quite regularly, and this one caught my attention. I have to take you back several years to explain why.


I remember going to an Indian food restaurant for my so-called "last meal" (what a joke) with my sister, my son Marc and my daughter Chenelle. While everyone was laughing and talking during dinner, my thoughts would wander off to the future that I thought I would have. For the very first time in my life, I was going to be thin. It was like Santa Claus, the Easter Bunny, the Tooth Fairy and my own personal genie all wrapped in one huge gift. To be thin--finally! I was standing on the verge of a brand new life, one that I could have never imagined only six months ago. Prior to that night, I was on the "fast track" to gastric bypass--I went through orientation, the requisite classes and the 10% weight loss that Kaiser Permanente requires of all prospective gastric bypass patients. I ate 100% low fat vegan meals and did the best I could with walking for the exercise requirement. Eating a vegan diet wasn't very hard because in my mind, it was only temporary. After July 11, 2002, I was never going to diet or go vegan again. I would be able to eat "normally", meaning whatever I wanted to eat, only in tiny portions because of the pouch. And I would never have to suffer through those intolerable hunger spasms that I got when I was on a diet. What a sweet life...I would weigh 130 pounds, and still eat pizza, macaroni and cheese and red velvet cake. Or Ben and Jerry's Ice cream with mix-ins. Or garlic French fries. And it would be possible because I would only eat a teeny-weeny bite or two, and be satisfied. I couldn't wait to have the surgery. It was going to literally be an answer to all of my "Please God, make me thin..." prayers.

Fast forward to 2003. I had been through hell. I have talked about what happened to me after weight loss surgery in a previous blog (My Story). I don't want to go through that pitiful story again, but I'll just say that I spent most of 2003 and 2004 on the couch in my sister's living room, staring vacantly out of the window or at soap operas. I was too weak and sick to even think. Sure I had lost a lot of weight, 140 pounds had come off in six months, along with huge patches of my hair. I was severely anemic, in constant pain, and unable to stand for longer than thirty seconds. Day ran into night, and night ran into day while I sat on the couch. This was NOT the future I had visualized for myself.

I was diagnosed with major clinical depression, among the myriad of extenuating health issues that I had, none of which were complications related to gastric bypass surgery. Everything that was happening to my body had been going wrong for years before I even thought about having gastric bypass. Those problems were surfacing with a vengeance, and with them, the cravings for food that I was warned to avoid like the plague. But I didn't care. I felt like crap, and I was tired of feeling that way. I wanted solace. I wanted pleasure. I wanted my food, the food I had been missing ever since I passed the three month post-op period. By late 2003, I was eating bread and pasta.

I celebrated the New Year in 2004 with several bags of Hershey's and Mars Miniatures and Reese's Peanut Butter Cups. I didn't even make it to midnight--I passed out on the couch around 9:30 from sugar "dumping", which is a mixture of nausea, dizziness and a sudden rush of body heat. It is not pleasant. But still, I didn't care. After everything I had gone through, my addict brain rationalized, at least I had a few moments of ecstasy with dozens of little Snicker's bars, Reese's Peanut Butter Cups and Hershey's Kisses.

It was a swift downhill drop from there. No matter how sick I felt, or how much the French bread or pasta made me throw up, I continued to eat whatever I wanted, whenever I wanted it. My pouch stretched, the repaired hernia tore open, and I began packing on the pounds again. My highest weight in relapse was 306 pounds, according to my medical records. The only sense of relief and gratitude that I have about the relapse is that I didn't inch back up the scale to 365+ pounds. That could have very easily happened, if I wasn't a Baha'i and didn't believe that God power, grace and mercy was greater than my addiction, and in order to recover from such a potent disease of the mind, body and spirit, I would have to call on His Healing Mercy. I did that, and that led me to the recovery program that is currently working miracles in my life right now.

But why did I go back to the food, after a lifetime of obesity and chronic health problems. I don't have an answer for that. I can only quote a group of old alcoholics, who came together and prayed for God to heal them from the ravages of drunkenness. Their prayers were answered, and Alcoholics Anonymous, otherwise known as AA, was created. Here's what those old drunks have to say about not only alcoholism, but every single hardcore, life-draining addiction that robs people of their dignity, occupations, income, health and family relations:

(I am taking the liberty of substituting food for alcohol and food addiction for alcoholism so that the similarities between the two afflictions are obvious.)

We doctors have realized for a long time that some form of moral psychology was of urgent importance to food addicts, but its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge.

Many years ago one of the leading contributors to this book came under our care in this hospital and while here he acquired some ideas which he put into practical application at once.

Later, he requested the privilege of being allowed to tell his story to other patients here and with some misgiving, we consented. The cases we have followed through have been most interesting; in fact, many of them are amazing. The unselfishness of these men as we have come to know them, the entire absence of profit motive, and their community spirit, is indeed inspiring to one who has labored long and wearily in this addiction field. They believe in themselves, and still more in the Power which pulls chronic food addicts back from the gates of death.

Of course a morbidly obese food addict ought to be freed from his physical craving for flour, sugar and excess portions of food, and this often requires a definite hospital procedure, before psychological measures can be of maximum benefit.

We believe, and so suggested a few years ago, that the action of certain food on these chronic food addicts is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average eater. These allergic types can never safely use flour or sugar products in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.

Frothy emotional appeal seldom suffices. The message which can interest and hold these alcoholic people must have depth and weight. In nearly all cases, their ideals must be grounded in a power greater than themselves, if they are to re-create their lives....

....Men and women eat addictively essentially because they like the effect produced by flour and sugar products along with excessive portions of food. The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their food-addicted life seems the only normal one. They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few bites—bites which they see others taking with impunity. After they have succumbed to the desire again, as so many do, and the phenomenon of craving develops, they pass through the well-known stages of a spree, emerging remorseful, with a firm resolution not to eat like that again. This is repeated over and over, and unless this person can experience an entire psychic change there is very little hope of his recovery.

On the other hand—and strange as this may seem to those who do not understand—once a psychic change has occurred, the very same person who seemed doomed, who had so many problems he despaired of ever solving them, suddenly finds himself easily able to control his desire for flour, sugar and excess portions, the only effort necessary being that required to follow a few simple rules.

Men have cried out to me in sincere and despairing appeal: “Doctor, I cannot go on like this! I have everything to live for! I must stop, but I cannot! You must help me!’’

Faced with this problem, if a doctor is honest with himself, he must sometimes feel his own inadequacy. Although he gives all that is in him, it often is not enough. One feels that something more than human power is needed to produce the essential psychic change. Though the aggregate of recoveries resulting from psychiatric effort is considerable, we physicians must admit we have made little impression upon the problem as a whole. Many types do not respond to the ordinary psychological approach.

I do not hold with those who believe that food addiction is entirely a problem of mental control. I have had many men who had, for example, worked a period of months on some problem or business deal which was to be settled on a certain date, favorably to them. They ate a few donuts or had some pizza a day or so prior to the date, and then the phenomenon of craving at once became paramount to all other interests so that the important appointment was not met. These men were not overeating to escape; they were eating excessively to overcome a craving beyond their mental control.

There are many situations which arise out of the phenomenon of craving which cause men to make the supreme sacrifice rather than continue to fight.

The classification of food addicts seems most difficult, and in much detail is outside the scope of this book. There are, of course, the psychopaths who are emotionally unstable. We are all familiar with this type. They are always “going on a diet to lose weight for keeps.’’ They are over-remorseful and make many resolutions, but never a decision.

From "The Doctor's Opinion" by William D. Silkworth, M.D.
http://www.alcoholics-anonymous.org/bigbookonline/en_doctoropinion.cfm

Dr. Silkworth has very accurately described what happens to me when I eat things like Nestle's Tollhouse chocolate chip cookies, triple chocolate 911 cake, deep dish pizza or chili cheese fries. I can't stop. I won't stop. A Power outside of myself, much Greater than me, has to intervene and stop me. But I have to sincerely ask for the help, every day and every night. That Divine Assistance is always granted, and I am both humbled and grateful. The 70 pounds that I re-gained through relapse is now gone. But I don't ever take this malady for granted. It's beat me down way too many times. I now have established routines that I follow each day to ensure that the beast that resides in my brain is kept at bay in chains. One tiny lapse of attention, however, and the beast will slip out of its fetters and attack with unmitigated vengeance. I know this will happen. It has already, on several very instructive occasions.

I don't know if Ms. Carnie Wilson is a food addict like me. I suspect that she is, but I can't say for sure. I can only attest to my own powerlessness over addictive foods. But if she is like me, God help her. She will definitely need it. And other people need to leave her alone. This battle is tough enough without the mocking chorus sitting in the peanut galley.