Does WLS Cause Eating Disorders? 5 Questions & Answers.

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Does WLS Cause Eating Disorders? 5 Questions & Answers.

“Is there any connection between bariatric surgery and eating disorders? I’ve heard you’re at higher risk for getting an eating disorder if you have weight loss surgery. Is that true?”

First, there’s a lot of information about WLS that is anecdotal—or based on a personal story, not evidence-based research.

As a health professional, I’m obligated to share information that can be backed by science and not opinion.

I checked in with the ASMBS (American Society of Metabolic and Bariatric Surgery) and a leading researcher in the field of eating disorders, to find out what links, if any, there are between WLS and eating disorders.

Here’s what we know so far:

  1. BED or Binge Eating Disorder is the most common eating disorder for patients with obesity.


  1. BED is defined as regularly eating a large amount of food in one sitting, (or a two-hour period of time) and feeling a loss of control or inability to stop.


  1. About 20 % of WLS candidates have BED, that’s a much higher percent than in the general population.


  1. Post ops who can’t stop binge eating after WLS are at higher risk for complications after surgery.

“Is there some part of bariatric surgery that increases the chances of developing an eating disorder?”

Nutritional changes after WLS may negatively affect mood. How? Not taking vitamin and mineral supplements and/or not eating enough protein can make it impossible for the body to make the brain chemicals that allow us to be happy. If eating brought us relief, joy, comfort or escape before surgery, it’s likely we’ll do what whatever it takes to get that same experience with food after surgery.

“What’s the number of bariatric surgery patients who develop an eating disorder?”

The actual numbers of WLS post ops with eating disorders is unknown and hasn’t been measured.  Experts believe only a small minority of patients develop eating disorders.

Those who do exhibit signs of disordered eating, tend to be those who suffered from ED before surgery.


 “Can WLS cause you to develop addictions after surgery?”

5-30% of post ops with pre-op addictions develop another addiction after surgery. This is called cross addiction and it can occur after all types of WLS procedures.

Okay, stats aside, now here’s my chance to editorialize.

In my practice, I probe my pre-op surgery candidates hard for signs of current stress or trauma in their lives.

I believe clients who tend to emotional scars before surgery through counseling & developing new coping skills, are less likely to turn to misuse food after surgery.

But what if you’re post op and don’t know if you’ve got a toxic waste dump of painful emotions buried somewhere deep inside?

“I’m a post-op, how do I know if I have an eating disorder?”

Ask yourself the following questions:

  1. Do you have a history of abuse, neglect or trauma? Go all the way back as far as you can remember.
  2. Do you have a history of addiction in your family?
  3. Have you ever considered food your best friend?
  4. Do you obsess about what you’re going to eat to escape especially hard days?

A great therapist is as important after surgery as before. Run, don’t walk to a trusted professional.

Contact the National Eating Disorders Association to find contacts and help near you at: .

Reach out to the Obesity Action Coalition for peer and professional support at: .


It is NEVER too late to heal. If you’re struggling with weight regain or feel abandoned on a weight plateau without an end in sight, it could be emotional blocks holding you back.

Don’t wait another day.

Until next time, take good care of YOU!



About the Author:

Elizabeth began her career in… broadcast journalism as a reporter, producer and anchor in her native state of Maine. She decided to get a Master’s Degree in Nutrition after realizing health science was more her style than covering crime stories, snowstorms and (snooze-fest) board meetings. Elizabeth has been a registered and licensed dietitian for 15 years and loves every energizing minute. Her passion for weight management and bariatrics was born out of her own struggle with food, weight and that inner critic. Elizabeth strives to listen deeply, without judgment and help each person set free the glorious being held hostage by weight wars. Elizabeth's philosophy takes the best from evidence-based science and mixes it with love to make the world taste good!

One Comment

  1. Christine Robie April 14, 2017 at 4:13 pm - Reply

    Most of the people who I have known who had WLS (including myself) had an issue with compulsive overeating years before deciding to have surgery. They did not get it after the surgery! However, being told by WLS programs that they could eat after recovery from surgery like a normal person, albeit just in small “pouch sized” portions did not work for them after awhile because of their underlying compulsive eating disorder. I am a food addict! I want More –
    I am thinking of what I can have Next! What Else? I need to stay completely away from refined carbohydrates …sugar and flour… and then the compulsion is gone! Lifted!

    It seems we focus on amounts rather than the addictive nature of refined carbohydrates, in and of themselves. And for people like me who have abused food through years of overeating junk foods, having restrictive surgery is not enough. The phenomenon of craving has to be quieted. Once I start eating sugar (in particular) but more importantly sugar in combination with flour (and grease and salt!!) I am not able to easily put it down.

    And while the surgery restricts the MORE, it does not stop the ELSE or NEXT… and shortly thereafter I was eating again…small amounts? Yes! But calories are a physics equation… I consumed many more calories a day by 5 months after my surgery than I expended and so, slowly, insidiously… I stopped losing and indeed began gaining weight.

    This has been a familiar scenario for many after WLS. The surgery did not cause the eating disorder. It just does not fix the disorder. It is a TOOL I need to address the physiological reaction I have, particularly with sugar (by eliminating it) and the surgery makes it so much more doable, for me. I have no regrets about my surgery, now that I “get” that distinction.

    The weight is coming off. I feel great. I have no food thoughts, no cravings. I work a program which addresses all of my issues with my relationship with food… and I am, indeed, satisfied.

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