July 19, 2006 -- After a five-year boom in gastric bypass surgery, many people who lost hundreds of pounds find they've now gained something else -- an alcohol or drug problem.
Have they traded one addiction for another?
Patty Worrells and Jeannine Narowitz both had gastric bypass surgery, then found themselves battling alcoholism.
It's a common problem for people in substance-abuse treatment. Psychologists call the phenomenon of swapping one compulsive behavior for another "addiction transfer."
New Social Life, New Problems
Worrells, 5 feet, 4 inches, weighed 265 pounds. Narowitz, a mother of seven, weighed 274 pounds. Both women suffered from health problems because of their weight.
Worrells said she used food as "comfort," while Narowitz believed she had a food addiction. Before her surgery, Narowitz said she would often consume up to 4,000 calories a day out of boredom and depression.
"I woke up thinking about food. I went to bed thinking about food," Narowitz said. "I used it to solve many problems."
After undergoing gastric bypass surgery, both women lost about 130 pounds. They met and became friends in a support group for people who had lost a great deal of weight.
Worrells said the group met weekly and often got together socially for parties, camping and other events.
"We started doing things together," she said. "We were no longer someone who had to hide."
Because gastric bypass surgery shrinks the size of the stomach, alcohol hits drinkers much faster. Worrells said that at one point she was drinking 12 or more tequila shots at a sitting.
"I was able to accomplish in 10 months with alcohol what some people took 10 years to accomplish in a drinking career," she said.
Both women said they knew they had developed a new problem. Narowitz said she once woke up with a black eye and wasn't sure how she got it. Her teenage son was mortified, she said, and poured out all the liquor in the house, replacing it with water.
Addressing Emotional Problems
About 140,000 people have weight-loss surgery each year, and it is estimated that somewhere between 5 and 30 percent of them pick up new addictive behaviors afterward.
Dr. Keith Ablow, a psychiatrist and addiction specialist, said it's common for people to switch from one addiction to another. People who quit drinking may begin smoking, or they might take up some other compulsive behavior like gambling, shopping or exercise.
Ablow said there is usually an emotional problem at the root of addictive behaviors that needs to be addressed.
"Until people address the underlying emotional turmoil that makes them have to seek comfort from food or have to have 15, 20 shots in a sitting, they are not going to be able to overcome it," Ablow said. "You have to face your pain, not anesthetize it with shopping, food, gambling."
Gastric bypass surgery does not lead to alcohol abuse, but Ablow said that people who undergo the surgery need to be aware of and deal with emotional issues behind their weight gain.
Worrells and Narowitz said they continue to confront those emotional issues. Worrells has been sober for two years; Narowitz said she drinks occasionally but only has one or two drinks.
"If you're going to take a step to deal with addictive behaviors," Ablow said, "you need to get to the why of why you're doing it."
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