Bariatric surgery may shed kilos, but it doesn't cure addiction

Bariatric surgery is currently touted as the ‘only known cure for diabetes’. The physical facts are simple. Bariatric surgery limits the quantity of food the person can eat and the results speak for themselves – the kilograms normally melt off, but the real underlying problem may not have been addressed.

The biological need to eat is right up there with sleeping, drinking fluid and mating. We need to do these things to survive and the brain has developed complex neurochemical ‘rewards’ programmes to compel us to eat.

It doesn’t take much to push them into the realm of addiction. And unlike other addictions, you can’t simply refuse to eat food – so the treatment is different. Many obese individuals suffer from a food addiction. The addiction is normally triggered by underlying psychological problems. If these are not dealt with and the person undergoes bariatric surgery, they become at very high risk for other forms of addiction as an outlet or expression for these needs. This is known as ‘addiction transfer’ and is commonly seen in other areas of substance abuse. Addiction transfer occurs in around 1-in-5 people who undergo bariatric surgery.

Fundamentally this outlines that excessive eating is a complex behaviour involving elements of socialisation, habits, psychological make-up and often food addiction. Simply wiring up someone’s jaw, sending them to a fat camp or cutting off half their stomach may change their weight, but not the addiction.