June 8, 2007 -- Steffney Payne decided to have gastric bypass surgery after hitting a high of 420 pounds.
Payne, a 28-year-old student who works at a bariatric clinic in Charlotte, N.C., says she thought everything would be better when she was thin. But Payne's lifelong battle with food soon became a battle against something else … alcohol.
Many people who undergo this surgery discover that weight loss is just the beginning of the story, and that their struggles do not fall away along with the pounds.
After surgeons make their stomachs as small as a walnut, patients can no longer overeat. But many of them seem to be replacing food with a "transfer addiction," such as alcohol, drugs or even shopping.
Payne was overjoyed by the results of her surgery, and remembers the day she really saw her adult face for the first time.
"It came slowly, because you're losing the weight, but when I really caught it I caught it in a picture and I didn't know who it was," she said. "I was like, 'Oh my gosh, that's me!'"
From Food to Drink
Payne says she went out and bought a digital camera and couldn't stop taking pictures of her face from every angle.
"I had never seen my nose without my cheek out to here," she said. "I'd never seen my adult face. I'd never seen what I looked like. When I smiled, my eyes closed."
Payne was finally able to see herself clearly, and can now articulate what prompted her to undergo the surgery. At age 24, when she decided to have the operation, she said she was living "on the outskirts of my life, while everybody passed me by."
"I decided to have surgery because I was battling a compulsive overeating addiction. I was battling binge eating," she said, "and not just where … somebody goes to the grocery store and they buy a bunch of food for the weekend and they sit around and watch TV. I'm saying I would buy a whole loaf of bread and I would ball it up piece by piece by piece and eat a whole loaf of bread."
'I'd Never Been Drunk'
After the surgery, when overeating was no longer possible, Payne found herself craving something to fill the void.
"One day I went bowling with a friend and she said, 'Hold my drink.' And I took a drink of it. It was a Long Island Iced Tea. I was never a drinker," she said. "You know, I was 420 pounds, and … I'd have a drink, but a 420-pound body, you better bring a bucket of something."
Payne says she felt buzzed instantly.
"I'd never felt that before. I'd never been drunk. I'd never been high. I'd never felt that," she said.
But she said the feeling was familiar — it reminded her of how she would feel when she binged on food.
"I had [felt that] in a binge, I had," she said. "I just met my match, but in a different form, and it was quicker and it was fast and it was acceptable."
Payne began drinking a large bottle of wine every night — enough so that she would pass out. She kept this problem quiet from her friends and family but eventually went to counseling and now no longer drinks excessively. She is now very active in the bariatric community and is studying psychology.
'I Thought It Was Just Me'
For Rita Haas, the problem wasn't booze, it was Wal-Mart.
Haas lost 187 pounds after having gastric bypass surgery. When she was alone after the surgery, she started shopping to keep busy.
Haas says food was always her drug of choice, but after surgery it soon became shopping. Her new addiction had a devastating effect on her finances: She has hired a lawyer and is planning on filing for bankruptcy.
"I owe over $40,000 in credit cards, and I owe my mortgage — it's $63,000 — and my second mortgage is, I believe, $43,000," she said.
Haas and Payne both participate in a bariatric surgery support group in Charlotte, N.C.
Barbara Thompson, of the Weight Loss Surgery Center, tells members that after the surgery some patients go "from Twinkies to tequila."
Thompson publishes a newsletter with a readership of more than 10,000 gastric bypass patients. After posting a notice about so-called transfer addiction in the newsletter, she says she received a barrage of e-mails from people saying, "I thought it was just me."
There are no hard numbers on how many gastric bypass patients experience transfer addiction, but bariatric surgeon David Voellinger says it may affect nearly a third of the thousands of Americans who undergo the surgery each year.
Voellinger says the most common transfer addiction he sees in his practice is alcoholism, because the high is quicker, and patients absorb the alcohol faster because of the surgery. At his clinic he has seen patients become shopping addicts and sex addicts, and patients who've never smoked before become smokers.
Tammi Cooper says that she's always had an addictive personality, and that she had no idea she would have so many issues to deal with after losing the weight.
"I was told I might go through a mourning period," she said. "That food would not be there in the same way for me and I may experience some depression. That was it."
Haas agrees that that the medical community should warn patients that this kind of thing can happen.
"They didn't tell me," she said. "They operated on my stomach. They didn't operate on my head."
Voellinger says doctors are just now starting to realize the extent of this problem. Despite a recent editorial by a doctor at Harvard Medical School that argues that there is not enough evidence to prove the existence of transfer addiction, Voellinger is a believer.
Cooper says she currently has her drinking under control.
"I'm good right now," she said.
She also said that her sex drive came back like "a freight train" after the operation, and Payne, who works in a bariatric clinic, says that she hears that all the time at her office.
"Some people haven't had sex in years, you know what I'm saying? … And they might get a good feeling from it, and that's it," she said.
The women "Nightline" interviewed said they were willing to speak out about very personal issues to raise awareness about transfer addiction.
In the end, Payne, Haas and Cooper each agreed that if they had it to do over again, they would have the surgery, but they would have done a few things differently.