Anorexia after Bariatric Surgery

How much weight loss is too much?  When do you put the breaks on weight loss and find a balance of weight maintenance?  It's often a slippery slope that isn't properly monitored by surgeons, nor does the internet properly provide enforcement of good behaviors.  We like the "positive" feedback received from people "Liking" our photos on Facebook or Instagram, but sometimes, social media has a way of encouraging negatives. Self perception that your waistline needs to be piddled down to nothing, social media only serves to enable poor health as positive successes, the smaller the waist line gets.  The cognitive work necessary to develop a new, healthy body image is not being properly executed in treatment plans across the board in Centers of Excellence.  If you're seeking "Likes" on the internet for your latest side shot post, and your waist is so tiny that you appear sickly, you *might* be struggling with anorexia. Contrary to popular belief, anorexic behaviors include eating restrictively in both food types, timing, and content, and keeping secrets about food/refusing to talk about eating behaviors as problematic.

When patients come to a bariatric surgical center, they are often battling the exact opposite of anorexia, they are frequently binge, emotional, or inconsistent eaters.  They are often so anxious to have surgery, they become offended that a professional counselor might suggest treatment planning for counseling services.  The stigma of counseling and psychology is often met with resistance, and the notion that, "They are not crazy!"
No one said you're crazy, sometimes preparing yourself for the road ahead, understanding what a healthy self-concept is and how to execute that without developing more cognitive distortions, and learning healthy lifestyle behaviors needs a trained professional.

Obsessing over anything is harmful to your cognition.  If you can't stop thinking about your weight, if you're unable to let go and enjoy life, the cognitive work needs to be address. Cognition and Transfer Addiction are the two most under-utilized treatment options for obesity.

I have said it many times, but I will say it again. *This is worth repeating.* 

The difference between a coach and/or trainer and therapist is that the therapist can recognize and treat depression, anxiety, eating disorders, cognitive distortions, and severe mental illness, whereas a coach might approach things with a solution-focused training philosophy, a therapist is processing the behavioral patterns and diagnostic criteria while remaining non-biased, compassionate and discerning of a client's intentions.  We are A LOT more liable for *your actions* when you leave our presence, than an online coach or trainer.  We must take precautionary measures at all times to insure our client's safety and intention to themselves and others. 

"Body image assessments tend to vary focus, ranging from an evaluation of the cognition related to body image disturbance, affect and/or behavior to other others that focus less on subjective dissatisfaction and concentrate instead on perceptual disturbances that may contribute to body image distortion." More research is needed on the effects of online social media bariatric communities and their affect on, and relationship with disturbances in self image and eating disorders.