Binge eating and stomach reduction – Do I qualify for surgery?

“It doesn’t matter anymore, now it’s ruined anyway.”
Ms. S. is a patient at WeightWorks and describes her thoughts during a binge.
She is embarrassed about her eating behavior and the fact that she cannot control what she eats.
She is highly motivated to modify her lifestyle and wants to know if she qualifies for gastric bypass surgery. Msc.
Angélique Vijghen, GZ- Psychologist at WeightWorks , has been treating (severe) eating problems, including binge eating disorder, for more than 10 years. She knows that binge eating and emotion eating are common in people who are severely overweight. ”
If severely overweight people want to qualify for gastric bypass surgery, it is important that they get a grip on their eating behavior so they can benefit from gastric bypass surgery in the long run. If these people use food to push away feelings, for example, they may also overeat after surgery. It is therefore necessary to explore before surgery how they can deal with tension, anxiety or sadness in a different way.”

In this article, we explain what binge eating is, its causes and how it differs from emotion eating.
We explain why questions about binge eating (and emotion eating) are asked during gastric reduction screenings/intakes and why it’s best to be honest about your eating habits.
We also explain if binge eating makes you eligible for gastric bypass surgery and what steps you can take if binge eating does return after your gastric surgery.

What are binge eating?

Binge eating is when a person eats a large amount of food in a short period of time, often faster than normal and usually to the point of discomfort or even pain.
During these moments of overeating, there is loss of control over eating and feelings of shame or guilt afterwards.
Binge eating is common in people with eating disorders such as binge eating disorder (Binge Eating) or bulimia nervosa.
In binge eating disorder and bulimia, eating behavior has become so disrupted that daily life suffers.
Also, eating or thinking about food (and/or body) takes up a lot of time.
The disorders lead to unpleasant feelings and self-image or body image problems.
Binge eating can also occur in people without an established eating disorder diagnosis. 7 Characteristics of Binge Eating:

1. Large Amounts of Food: During a binge, more food is eaten than what most people would eat within the same time, under similar circumstances.
2. Loss of Control: The feeling during binge eating of not having control (=brake) over eating
3. Fast eating: Food is eaten quickly and in a hurry, often without really enjoying it.
4. Nausea/ Overcrowding: So much food is eaten until an unpleasant feeling or nausea occurs.
5. Head hunger: Large amounts of food are eaten without a person’s physical appetite.
6. Sneaky eating: Many people try to hide their binge eating; they eat only out of shame for how much they eat
7. Negative feelings afterward: After a binge, feelings of shame, guilt and disgust may surface.

Binge eating can be divided into “objective” and “subjective” binge eating.
In both, the main characteristic is that a person feels he or she has little control over eating behavior.
Objective binge eating is when a person eats a lot in a short period of time (e.g., whole packages) and cannot stop properly.
Subjective binge eating feels the same, but the amount of food is normal or small.
It can happen when you snack throughout the day (snacking binges) without being able to stop it.
Both types of binge eating can cause feelings of shame and guilt.

Can I get a stomach reduction if I binge eat?

If you regularly suffer from binge eating, then you will not qualify for gastric bypass surgery right away.
You will first receive counseling sessions to help you get a better handle on your binge eating. During the screening appointments, you will be asked questions about binge eating (how often, how much do you eat, etc.).
The reason questions are asked about this is because the treatment team wants to know if you are experiencing loss of control over your eating.
If so, a plan will be developed with you, often with the dietitian and/or psychologist.
You will then learn how to gain more control over your binge eating.
If this does not work within a few conversations, you may be referred to a treatment unit (for example, at a mental health facility) that will work with you to increase control over your eating behavior.
Sometimes this is a disappointment because you had already set yourself up for the gastric bypass.
It then takes a little longer before you qualify for the surgery.
The reason you need to learn to get a grip on your binge eating first is to ensure that you can recover peacefully after the gastric bypass and not keep eating when your smaller stomach is full.
You want to maintain your weight loss in the long run, and that works much better without binge eating.

Is it better not to tell at an intake interview that I binge eat?

We understand that you would like to be considered for a stomach reduction and that you don’t like it if surgery takes longer.
Still, we encourage you to be honest about your eating habits. The treatment team wants you to be able to achieve and maintain long-term weight loss.
They can best help you if they know before surgery what you are up against and what the triggers (causes) of your disinhibited eating behavior are.
We also want to prevent you from seeking other substances, such as alcohol, after surgery if your gastric bypass prevents you from eating as much.
It is not helpful if binge eating is then replaced by another substance.
By being open, the treatment team can best guide you toward a long-term healthy lifestyle.

What causes binge eating and what can I do about it?

Binge eating can be caused by several factors.
We describe the 3 main causes, also called triggers of binge eating.

1. Physical (=physical) cause: If you eat too little for a long time, you get strong fluctuations in your blood sugar levels.
   You can maintain eating little for certain time, but at some point the body takes over: you eat more than planned and cannot stop it.
   So this is due to a reaction of your body to get enough in.
   At screenings, we often see people eating too little at basics, and therefore suffering from binge eating.
   Solution: You can solve this by eating a good basic diet (3 meals and 3 snacks), so that you feel more satiated.
   Your sugar levels will not fluctuate as much and your body will have less urge to eat a lot at once.
2. Psychological cause: Binge eating can be triggered by emotions such as stress, sadness or boredom.
   You use food to numb these feelings or discharge tension.
   Solution: If you want to get rid of this, it’s important that you learn how to deal with emotions in other, healthy ways.
   We call these healthy coping strategies.
3. Habit: Binge eating can become a habit.
   If you do something a certain way for a long time, then it becomes a habit.
   So for example, if you always snack after dinner, you will automatically crave something sweet when your dinner is finished.
   Also, certain places may be linked to eating.
   Like for example a certain place on the couch, or for example your bed if you eat in the bedroom.
   Solution: The context (= situation, time or place) must become neutral again if you want to get rid of your eating binges.
   In other words, the link between eating and that place must be removed.
   For example, sit on the couch in a different place; stop eating in your bedroom, etc.
   It will take some time before your “binge spot” is no longer a trigger, but eventually you will have fewer cravings for your binge food in that spot.
   So don’t underestimate how big the trigger to eat can be at a certain context or place!

Is emotion eating the same as binge eating?

Emotion eating and binge eating are similar but not the same thing. With emotion eating, you eat when you experience feelings of stress, sadness or boredom to feel better.
You may not dwell on eating as much afterward (no shame/ discomfort) and you may not experience loss of control over eating.
This is different with binge eating.
You do experience loss of control, and often feel guilty afterwards.
Binge eating can also occur if you eat irregularly or too little.
Eating too little can cause fluctuations in your blood sugar levels.
Then, when you start eating, you may experience little brake because your body wants a lot of nutrition at that time.
So in that case, binge eating is unrelated to emotions.

Do binge eating disappear after your gastric bypass surgery?

A stomach reduction helps you eat less, but it is no guarantee that binge eating will disappear.
Because your stomach is smaller you will be able to eat much less.
If you were binge eating more often before surgery because you did not feel a sense of satiety, binge eating may not return because you now experience a feeling of fullness.
If you binged before surgery to numb stress or emotions, it is important that you have learned other ways to cope with your feelings.
If this is not the case, you may find that agitation makes you want to eat again.
It may also be the case that – because you are quickly full – you will look for other substances, such as smoking or alcohol.
This is why it is important to learn how to discharge tension and deal with negative feelings in a way that is not harmful to you even before surgery.

What can I do if I start binge eating again after gastric bypass?

If you experience binge eating (again) after gastric bypass and cannot control it yourself, contact the practitioners at the department where you had the gastric bypass. Eating problems or emotional eating after gastric bypass surgery can occur, even when your stomach is a lot smaller than it was before gastric bypass surgery.
Binge eating can make you feel insecure or anxious.
You fear that you are stretching your stomach and that you will get heavy again.
Earlier in this article, we described what you can do to get more control over your binge eating.
Then, if you can’t manage to get rid of your binge eating by yourself, ask for help.
At WeightWorks the psychologist is the one who can help you.
Together you make a plan to get more grip on your eating behavior.

I now know more about binge eating and gastric bypass; can I attend intake if I binge eat?

You’ve read a lot about the causes of binge eating and how to get rid of them.
You would prefer to qualify for gastric bypass surgery in the near future, but you now know that you cannot undergo gastric bypass surgery right away if you suffer from binge eating on a regular basis.
At WeightWorks, we understand that you want to move to a new phase in your life.
You want to lose weight with gastric bypass surgery and feel better about yourself.
This is what we wish for you as well, of course, which is why during the screening appointment we want to look with you at how you can change your eating habits so that you can get the gastric bypass surgery.
So you can just come to our screening appointment if you are binge eating.
Thinking about gastric bypass surgery, and wondering if you qualify?
Then do the quick scan.
If you qualify, discuss a referral to WeightWorks with your doctor.