Cross Addiction

Crossing The Line To Cross Addiction

December 15, 2014

You've had your weight loss surgery and reached your goal or are well on your way to your weight loss goals. Finally! Shouldn't it be smooth sailing from now on? Then, all of a sudden, you notice some behaviors of cross addiction such as consuming alcohol, gambling or shopping are becoming more than just habits. No big deal because you've had surgery and have lost weight. You're just indulging a little bit, right? They are just little things that aren't a real problem. Or, are they? Something about these habits feels familiar. You feel the same pull toward your new indulgence that you did for overeating.

Some weight loss surgery post-ops are reporting problems in replacing compulsive eating to other addictive compulsive behaviors such as alcoholism, gambling, increased cigarette smoking, or shopping. Awareness of the issue is beginning to surface and come to the forefront by post-ops concerned about these arising new addictions.

When post-ops replace compulsive overeating for another addictive-prone behavior such as consuming alcohol to an excess, gambling, chain smoking, or binge shopping, it is commonly referred to as a "Cross-Addiction" or a "Transfer Addiction."

The label of an "addiction" creates many feelings and concerns for people. For many, the mere mention of addiction has a very loaded charge and a stigma unfortunately exists. However, if you are concerned or suspect that you are addicted to a particular behavior, it is unhealthy to avoid dealing with your behavior because it is uncomfortable to consider cross-addiction exists.

The biochemical causes of compulsive eating are very similar to the other self-destructive addictions of alcoholism or cocaine. Alcohol use, in particular, is a concern for bariatric patients because some of the weight loss surgery procedures change the way patients metabolize alcohol, making its effects far more powerful. Those powerful effects can be a lure to develop an addiction to alcohol.

For an addictive personality, the tendency is to cope by diverting a person's attention and lose themselves in a substance, person, or activity. There is a sense of relief for a short period of time, but it is not fully satisfying. The primary reason for the addiction is to escape and not deal with or face whatever it is that is going on. There is an instantaneous reinforcement to continue in this behavior because of the immediate relief, plus a diminished desire to face difficulties without the use of something to bring about that calming sense of relief.

Why would someone that has undergone bariatric surgery and lost weight along with regaining their physical health turn to another addiction? Cross addiction or transfer addiction occurs for some weight loss surgery patients when they seek new coping strategies for filling an inner void. Unless new healthy habits are made a part of your life with along with strategies for coping with feelings, relationships, and navigating the daily ups and downs that we all have, you can be vulnerable for weight regain or addiction transfer.

It is unclear how frequently post-surgery addiction replacement actually occurs. Many post-ops that are struggling with a replacement addiction feel guilt and shame for turning to another form of escape to replace food. There are estimates among clinicians and therapists that range from 5% to 30% of post-ops develop a cross-addiction. Studies are ongoing to determine how widespread the issue of addiction transfer actually is. Regardless of the statistics, if you suspect you have a cross-addiction, the time to address it is NOW.

Struggling with Cross Addiction

If you are struggling with the pull from an addiction transfer, you have not failed. You are not a failure! All it means is that you need to deal with the underlying issues internally. Use this opportunity to protect yourself from returning to unhealthy habits that can make you regain weight or be vulnerable to a cross-addiction.

Having weight loss surgery is about more than losing weight. It is an opportunity, or second chance, to develop healthy lifestyle habits. An addiction, whether to food, alcohol, or any other destructive behavior, is an attempt to fill an inner void. You can fill that void with healthy habits that reflect who you are, your interests, and the passions in your life. You can fill that void by dealing with any personal issues and feelings that you are suppressing with food or another self-destructive habit. If you need assistance, attend a support group to share with others. For many post-ops, talking with a mental health professional is a powerful, positive step you can take for your long-term physical, mental and emotional health.

Knowledge is power! The awareness of the possibility of cross-addiction is imperative. If you are concerned or believe you might be facing a transfer addiction, be proactive for your own best interests.

If you believe that you have an issue with a transfer addiction, there are a couple of first steps to do:

First step -  Admit to yourself that you either have a problem or are concerned about your behavior. You don't have to lose everything in the backlash of alcoholism; experience financial hardship from binge shopping or gambling, or become dependent on another self-destructive behavior.

Second step - There are self-help support groups that can assist in overcoming alcoholism, gambling, binge shopping, and other destructive behaviors. Talking with a mental health professional about your concerns and destructive behaviors can be invaluable and make a tremendous difference in your quest to overcome addiction. You can also work with the professional on how to incorporate healthy coping strategies to maintain an addiction-free life.

It is very important to be aware of your situation regarding any addiction and to reach out. You have many resources that are available to you. The first step is usually the most difficult. When we had weight loss surgery, many of us believed that would solve so many of our problems. However, the surgery is not a magic bullet that does all the work for us. Learning new ways to replace what food used to do for us and not turn to another self-destructive habit is the way to long-term health and success from weight loss surgery. Turn to skills and activities that are life-affirming and not destructive to your life. If you have regained some weight and are feeling the pull of food addiction or another addiction, you can get back in control and overcome the obstacle of addiction.

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cathy wilson


Cathy Wilson, PCC, BCC, had RNY surgery in 2001 and lost 147 pounds. Cathy is a regular contributor to the OH Blog and authored the "Mind Matters" column in ObesityHelp Magazine. Cathy is a licensed pilot and loves flying. She is a member of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Obesity Action Coalition (OAC).

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