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Transforming Thoughts to Escape Emotional Eating After WLS

April 23, 2018

Patients who pursue weight loss surgery are motivated by common factors such as eliminating medications, remission of comorbidities such as high blood pressure or diabetes, and reduction in pain.

The process of preparing for weight loss surgery can feel overwhelming with the number of doctor appointments, tests, and absorbing all of the new information you receive. A natural emphasis is placed on the diet changes required pre-operatively and post-operatively. Meeting with a psychologist to discuss the emotional adjustments required after surgery is a part of your pre-operative preparation. The bariatric team is there to support you in all phases of reaching your goals, and to identify trouble areas that can compromise your success.

Decreased compliance may be partially due to a lack of psychological skills necessary to engage in healthy eating behaviors over the long term, especially as the hunger suppression effects of surgery decrease (Bradley, 2016).  There has been a lot of research documenting that patients who struggle with emotions and eating prior to surgery continue to struggle after surgery (Chesler, 2011).  While surgery and weight loss induce a number of life changes, all stressors you are experiencing in your life right now will not go away after surgery.

Patient’s sometimes have a misconception that surgery will take away their desire to eat, and while that is partially true, it is short lived and for some the restriction and results of poor eating habits does not override emotional eating responses.

Escape Emotional Eating After WLS

The first step to ending emotional eating is to be able to recognize when it is happening. Emotional hunger is much different than physical hunger in that it is characterized by intense cravings, feelings that need to be instantly satisfied and trigger negative emotions during or after the eating episode (TABLE 1). As a surgical patient, you become very in tune with your hunger.

How to Identify Physical Hunger and Emotional Hunger

Physical Hunger Emotional Hunger
Comes on gradually Sudden intense onset
Open to many food options Craving a specific food or meal
Satisfied when feeling full Not satisfied even with a full stomach
Does not trigger an emotional response Triggered feelings of guilt or shame

Am I Hungry Angry Lonely or Tired? (HALT)

Before making an eating decision, think HALT, an acronym used in by Overeaters Anonymous. HALT stands for: Am I Hungry Angry Lonely or Tired?

Since eating is a habit, emotional eating may not be easily identified.  You might not be aware that you are eating a bag of chips because you are angry, but, it might be that you automatically stop for a fast food on the way to work to prepare for a stressful day, or that if you have trouble falling asleep without having sweets right before bed.

Eating certain types of food affects our brain, we have a chemical response to food that provides a brief rush of energy or positive mood. Changing these behaviors is complex, and has more to do with more than just willpower. Eating is a strategy that you have developed to help you handle stress or other negative emotions.

So for emotional eating, what do you do? You’ve recognized that it is happening. That’s success! A key component of overcoming emotional eating is to recognize that it is happening and identify adaptive coping strategies.

It can feel frustrating and overwhelming, especially since you may have used food to cope with obstacles for most of your life.  The goal is to utilize strategies that help you feel a sense of emotional relief, without the negative consequences. The best kinds of strategies are those that engage your mind and keep you distracted.  Some examples are provided below:

Pick 2 or 3 distractions to try:

Emotional Eating After WLS

Remember that changing eating behavior is a skill you will have to continually practice. Don’t be hard on yourself, acknowledge your successes and recognize that change takes time. Rather than giving into self-defeating thoughts like “I completely blew it, I should just give up!”, try changing it into something less extreme. Psychologists call this “reframing.” This strategy helps to reduce the emotional response you are having to the situation.

Common Self-Defeating Thoughts and Reframed Thoughts

Self-Defeating Thoughts Re-Framed Thought
I am not losing weight fast enough, I totally messed this up I’ve come so far, I have more energy, I feel better, and I am committed to this. I will reach my goal!
I have no willpower, I just devoured that cookie without even thinking! What I am trying to do is hard, I can get through this by taking it one meal and snack at a time.
This is impossible! Maybe today just feels hard, what is the first step I can take to help me feel successful?
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Remember, your surgical team is there to support you! Self-Help books may also allow you to do some work on your own, and break through barriers to reach milestones that you have never done before.


Bibliotherapy Recommendations:

  • Breaking Free From Emotional Eating by Geneen Roth
  • 50 Ways to Soothe Yourself Without Food by Susan Albers
  • The Diet Trap by Jason Lillis, JoAnne Dahl, and Sandra M. Weineland
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ABOUT THE AUTHOR

Jennifer M. Duncan is a provider at Summa Health Bariatric Care Center, designated by the ASMBS as a MBSAQIP Accredited-Comprehensive Center). She provides pre-op evaluation of all patients and both pre- and post-operative evaluation and counseling to patients who need this support. She also works in behavioral weight loss management, mood disorders, preventive medicine, psychological assessment, psychology and weight loss.

Read more articles from Jennifer!