Trading One Addiction for Another
Trading One Addiction for Another
Written by Ericka Sóuter, Ellen Shapiro, Vicki Sheff-Cahan
After Gastric Bypass Surgery, These Patients Found It Hard to Abuse Food—So They Turned to Other Out-of-Control Behavior
In late 2005 Barbara Thompson, the president of Weight Loss Surgery Center, a Web site for weight-loss-surgery patients, started getting e-mails asking if she'd heard of anyone "having a problem with alcohol after surgery—when they'd never had a problem before. Initially I discounted them." But now she and other members of the medical community are sounding the alarm about what has been coined "addiction transfer," a phenomenon in which patients who have undergone weight-loss surgery—and no longer abuse food—begin abusing, among other things, drugs, alcohol, money or even sex. Although experts stress that no more than 5 percent of such patients (who now number 177,000 a year) experience addiction transfer, as the three women in this story show, "it's something people have to be aware of," Thompson says, "because it can really get out of control."
Post-surgery, she turned to shopping—and wound up $15,000 in debt
It began innocently enough: As she went from 379 lbs. to 175 lbs. following gastric surgery in October 2003, 5'1" Marcy Rosenzweig Leavitt became a regular online shopper, on the lookout for new clothes for her new body. "I didn't have anything nice that fit," she says. But within weeks she found herself secretly bingeing on shoes and handbags the way she used to secretly binge on bread and cheese. "I couldn't see spending $2,000 on one thing," says Rosenzweig Leavitt, a doctoral student in psychology. "But I could do the $55 item—and buy 12 of them."
As her shopping compulsion grew harder and harder to control, she found herself with "boxes of stuff hidden under everything," she says, and an entire room in her Beverly Hills house filled with Disney memorabilia; soon she was replacing the quilt on her bed every eight weeks or so ("I just wanted another color," she explains). "It was such a rush, like a blackout high," says Rosenzweig Leavitt of her spending sprees, which, at times, ballooned to $3,000 a month. "It was like being drunk and waking up saying, 'Oh my God. What did I do last night?'" Newly married, she tried to conceal her behavior from her husband ("I could always justify things")—but she maxed out her credit cards and started using the one she shared with her parents, which was intended only for essentials. "It went on for about six months, and we finally said, 'This is it,'" recalls Rosenzweig Leavitt's mother, Silvia Rosenzweig, who closed the account and got a new one. But when the credit card company transferred the new number to many of Rosenzweig Leavitt's favorite online retailers, she was able to continue shopping undeterred, prompting her father "to just go ballistic," she recalls. "He called me a thief. It was horrible."
So horrible that she finally felt compelled to deal with her behavior. In August 2006 she sought therapy from Debtors Anonymous and today says she is "still in recovery and not debt-free." Indeed, Rosenzweig Leavitt—whose credit abuses have left her unable to qualify for a mortgage—figures it will take her five years to get her finances back on track. "There was a time when I loved getting those boxes delivered," she says. "But now I know the consequences."
After she lost weight, this married mother of two starting getting drunk every weekend
Katherine Ring, 29
In the months after giving birth to her second daughter in April 2005, Katherine Ring felt like she finally had her life in order. It had been three years since gastric bypass had taken the 5'3" mom from 307 lbs. to 130 lbs., and she had already lost most of her pregnancy weight. "I thought, 'I've done surgery, we got pregnant, things are going well,'" she says. "Then I started feeling, Is this it? And I was missing the crutch I always had—food."
She soon found a new one. Never much of a partier ("For my 21st birthday, I didn't even have half a wine cooler," she says), Ring started going out for drinks with other weight-loss-surgery patients she met through an online chat room. Within two months she was clubbing near her Richmond, Va., home every weekend, knocking back eight or nine drinks a night. "I'm freaking out because I'm home with the girls," recalls her husband, Walter, 41, who works in a plumbing supply warehouse, "and don't know if she's so drunk that we'd find her body in the James River." His fears weren't exaggerated: On Sept. 3, 2005, during a particularly wild binge, Ring threw back some 20 drinks in three hours and spent the night passed out on a friend's floor; at one point, her friends say she briefly stopped breathing. "I really thought," she says, "that I was going to die." A doctor later told her she could have—and that "I should never drink again."
But Ring didn't consider that advice until January 2006, after attending a conference for weight-loss-surgery patients. "It was a drunk-fest—people were puking off balconies," she says. "The conference was supposed to celebrate our successes, but we had traded one addiction for another." Sober for nearly a year, Ring says she has learned how to have an occasional drink without falling victim to bingeing. "Not a day passes that I don't think about the damage I did to myself," she explains. "But I'm here to talk about it."
Her 'oral addiction' shifted from food to cigarettes
Annette Hinton, 54
The eight months after her 2003 gastric bypass were, Annette Hinton says, "a honeymoon period," as she shed 50 lbs. from her 5'10", 289-lb. frame. "But then life goes on, with all the same stresses." Unable to binge on ice cream, the Atlanta resident took up smoking, which she'd quit eight years earlier—so successfully, in fact, "that the smell of cigarettes made me nauseous." But after surgery she found herself compulsively going 10 days in a row smoking five cigarettes a day, then taking a break—before feeling the urge to smoke again. "It's an oral addiction," says Hinton, an executive certified chef and registered dietitian who now weighs 173 lbs. It wasn't until Hinton grew worried that her disapproving husband might leave her if she didn't quit that she began applying the tools she learned in Overeaters Anonymous—like taking a walk when stressed—to kick her habit; she had her last cigarette on New Year's Eve. Looking back, Hinton, who is writing a book about addiction transfer, says, "I'd rewired my stomach, but didn't fix my head."
THE FACTS ABOUT ADDICTION TRANSFER
• Whom does it affect?
Any patient who used food to deal with anxiety is at risk, as the urge to overeat is still there even if the ability to do so is gone. "They substitute another behavior to get the same emotional effect," explains Madelyn Fernstrom, Ph.D., director of the Weight Management Center at the University of Pittsburgh Medical Center. "They need to resolve those issues and ask, 'Why am I using this to manage stress?'"
• What are the warning signs?
"When a patient says, 'As soon as I have the surgery, I'll be fine,' they are in denial," says Fernstrom. "They aren't acknowledging the tougher [diet changes]. If they don't address them, life after surgery is a big jolt."
• Is AT preventable?
"The trick is to switch to positive addictions," explains Fernstrom. "Walking, chewing gum; some people take up knitting because it keeps their hands busy."
• What is the best treatment?
"Join a support group," says Rick Shugart, a Narbeth, Pa., therapist specializing in gastric bypass support. "Often, conscious awareness and support can put people back on track."