What is Transfer Addiction and How Can I Avoid it After Weight Loss Surgery?

Do you imagine yourself as healthier, happier and lighter after the gastric sleeve procedure? Is a solid stress management plan a part of your treatment or are you afraid of returning to old behavior patterns that got you here in the first place? Transfer addictions after weight loss surgery can have a significant negative impact on health outcomes, but they can be avoided with education and preparation (1).

So what are transfer addictions after weight loss surgery and how do you avoid them? In this post, I'll go over risk factors for exchanging addictions since food can no longer be used as a coping skill. I'll also give you tips to avoid transfer addictions as well as what to do if you are already there.

What is Transfer Addiction

It is clear that weight loss surgery is no small decision, and it's important to have healthy stress management strategies in place for the best chances of weight loss maintenance. Food addiction is a pattern of unhealthy coping mechanisms. Generally, people with food addictions turn to high fat or sugary foods as it gives our brains a dump of happy chemicals. We might find ourselves compulsively eating or bingeing to provide some form of psychological security.

Transfer addiction after weight loss surgery is trading food compulsion for another compulsion. Often, this can show up as gambling, alcohol, or sex addictions (2). It could also present as a shopping addiction or return to smoking. In short, we have just transferred or exchanged one unhealthy behavior pattern for another.

Who is at Risk for Transfer Addictions?

Weight loss surgery is not an easy choice. There are many risks and lifestyle changes that we may not be prepared for. How do you know if you are at risk for transfer addictions? This list includes some, but not all the risk factors:

• Demonstrating a food compulsion or addiction previously
• Prior substance abuse in your personal or family history
• Using alcohol to destress prior to surgery
• Chronic pain and overuse of painkillers
• History of trauma, particularly childhood sexual abuse
• Depression and and/or anxiety disorders
• Feelings of isolation or limited support network
• Reluctance to express emotions
• History of self-sabotage

Mental Health After Bariatric Surgery

We cannot discuss transfer addictions without addressing the issue of mental health after bariatric surgery. It seems patients would be so happy after experiencing significant weight loss, but it's important to remember this surgery is a tool. Our happiness is not actually tied to our weight.

Over time, the high-protein regimen from the postop diet combined with nutrient absorption issues can lead to serotonin deficiencies in our brains (3). These low levels can decrease our moods, suppress our appetites and cause sleep issues. All of these can increase the risk for transfer addictions as we try to increase the levels of serotonin.

Just as following the diet regimen is vital to long-term success, so is preparing for the mental health impacts.

What to Do if You're At Risk for Transfer Addiction

Did you see yourself or your family history in the list of risk factors? If you feel you might be at higher risk for transfer addictions, you should know you are not alone and there are ways to keep this from happening.

It is highly recommended that you participate in therapy both prior to and after your bariatric surgery. Working with a therapist will help you address these negative pleasure-seeking behavior patterns and develop healthier coping skills. It is important to process any issues you have around food and other compulsions prior to the procedure as this will reduce your risk for transfer addictions.

Education and preparing for the mental and physical changes will be your biggest defense against trading out your compulsions.

If you are currently using drugs or alcohol, plan to be be sober for a year before you undergo weight loss surgery. Maintaining sobriety for this time period will give you the experience and confidence to know that you can handle it after the surgery as well. It will also give you time to develop stress management strategies before you are forced to make significant lifestyle changes that affect both your body and your mental health.

As part of your preoperative regimen, stop using food as a coping mechanism. It is vital to find other ways of releasing endorphins, those happy chemicals, and a good therapist can help you with this.

How to Avoid Transfer Addiction After Weight Loss Surgery

Understanding your personal health history and risks for transfer addictions will help you identify patterns of addictive behavior.

Avoiding transfer addiction means you have to recognize the early warning signs and know what to do about them.

If you have done the work prior to your weight loss surgery, then you should have a cohesive and inclusive stress management plan. An effective stress management plan will detail leisure activities, support networks and strategies for what to do if things go wrong.

What To Do If You Are Already in the Middle of a New Compulsion

Cognitive dissonance and denial are prevalent with addictive behaviors. If you are currently using other substances or unhealthy behaviors for an endorphin release, don't despair. There is help and support for you.

Shame oftentimes keeps us locked into these negative patterns because we can't believe we are in this position. It's embarrassing to admit our shortcomings to loved ones or to have our loved ones stage an intervention. If you find yourself in this scenario, know that you are not alone and there is a way out.

If you stopped going to therapy after your weight loss surgery, restart. A good therapist will help you work through these compulsive behaviors and get your stress management plan back on track.

Support groups will also reinforce the idea that you are not alone. If there are not in-person meetings in your area, then seek out these groups online. Your doctor or therapist will probably have recommendations for you. When looking for a support group, make sure the group culture advocates following doctors' recommendations and research. If the group culture is more about hacks to “cheat” the protocols, then it will not be a long-term healthy network for you.

Podcasts and books can also be very helpful to work on mindset and perspective. Choose materials that focus on positive thinking, stress management, and inner work.

Reach out to your family and friends to reduce feelings of isolation. Pursue social situations that are low stress and don't glorify poor coping strategies.

Transfer addictions are a real concern for people after weight loss surgery. Instead of trading one compulsion for another, take the time to meet with a therapist and resolve these underlying issues before you have the operation. Weight loss surgery is not a magic solution and you will have plenty of hard work ahead of you to make sure you are taking care of your physical and mental health. If you are educated and prepared, then you will have reasonable expectations and strategies to help you achieve long-term success.

Sources:

(1) Moorehead (2) Mitchell, et al (3) Wurtman