Gastric-bypass patient struggled with bulimia
By Sue Vorenberg
February 28, 2005
When Meg Jones was a psychology student at the University of New Mexico, she would have bet money that she'd never develop an eating disorder.
A few years after graduating - and a year after getting gastric-bypass surgery upon hitting 265 pounds - the 24-year-old would have lost that bet.
The weight-loss surgery, and her desire to please those around her, has turned her into a bulimic - a disorder in which people binge on food and then force themselves to purge their bodies of it.
"I never had a problem with bulimia before the surgery," Jones said. "In school, I even took a class on eating disorders, and I think I should know better. I've cut down from my worst - when I was throwing up 20 to 25 times a day - to once or twice a day, and I'm willing to stop on some level, but I'm not willing to give up my food."
The surgery reduced Jones' stomach to a small pouch able to hold only a few ounces of food. It is designed to make people who are dramatically overweight feel full with only a small amount of food and get to a more healthy size - in Jones' case, about 165 pounds.
Bulimia as a side effect of the surgery is rare, or at least rarely reported, but it's not unheard of, said Brenda Wolfe, an Albuquerque psychologist who specializes in eating disorders and patients who have had the surgery.
"We don't see a measurable number of people developing that behavior post-op, but some have," Wolfe said. "There are huge problems associated with that. Patients can rupture their pouch. They can ulcerate their esophagus and create electrolyte imbalances."
Jones suspects the problem is more common than most doctors - and most patients - will admit.
In her case, during the first few months, when she was on a highly restricted liquid diet, she says she got depressed and missed her pre-surgery eating habits - and the emotional crutch of food - more than she could have predicted.
"I think a lot of people who've had the surgery do make themselves throw up, but they don't like to admit it," Jones said. "I know a few other people in my support group who've admitted to me that they do it, but they don't want to come forward.
"There's not a lot of research or studies on it, and as far as the support group, most people don't want to bring up any negative connotations with the surgery because it's helped them lose so much weight."
Jones says she was comfortable as a teenager being a bit overweight as a size 14. But when she got into her 20s, her metabolism slowed, and she rapidly gained 60 pounds.
"I wasn't comfortable in my skin - my arms were heavy; it was hard to get around," she said. "I wanted a quick way out of it because I was miserable."
At the time, she had health coverage through the military from her stepfather, but it was about to expire. That made her rush a decision on the surgery, she said.
"The doctor told me diet pills were bad, but she said I should look at gastric-bypass surgery," Jones said. "I looked at it, but I was 14 pounds under the weight limit. The doctor said, `Do the math.' So I gained 14 pounds and went back so I could get the surgery."
Typically, potential gastric-bypass patients go through a rigorous psychological screening process, but the military didn't do that for Jones, she says, adding that's likely part of her problem.
"Before the surgery, part of the prep is that you want to screen for people with bulimia or binge eating disorder," said Bob Ferraro, medical director of Southwest Endocrinology. "Those sorts of people need to be in therapy before they have the surgery, if they have it at all."
Bulimics don't tend to get the surgery anyway, because in general they don't have problems with obesity, Ferraro added.
Jones says she wasn't mentally prepared for the consequences of the surgery, and the desire to be thin and please her doctor with her progress put even more pressure on her.
"I started compensating by going home and eating, then purging and eating some more, and it just sort of spun out of control," Jones said. "Later, I felt like I wasn't getting to the weight that I wanted to be. My doctor would frown at me, and I wanted to please him, so I kept doing it."
As the problem grew worse, Jones decided to see a therapist, who has helped her cut down on the behavior, she said.
"It's helped, but she's told me this will be a lifelong struggle," she said. "You know, I guess if I had the chance, I probably would do it all over again, but I'm not 100 percent sure about that. Healthwise, I feel better since I lost the weight, but in the end I wonder if I'm just going to end up becoming horribly sickly.
"I don't know at this point where it's going to go. I'm terrified I'm going to gain the weight back, but I'm also worried about my health. There's a lot of work ahead of me."
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Article: Gastric-Bypass Patient Struggled With Bulimia 
