Ep 11 – Will a gastric sleeve or Saxenda injections help my binge eating?

In this episode, I share my thoughts on pursuing weight loss when you struggle with binge eating. In particular I talk about bariatric surgery (including gastric sleeve) and the latest weight loss injections.

READ MORE: BLOG: Binge Eating and Bariatric Surgery, BLOG: Why you shouldn’t comment on someone’s weight loss

Episode 11 Transcript

Hi, and welcome to the Food Freedom Podcast with me, Claire Feldman. I’m a CBT therapist, hypnotherapist, and eating disorder practitioner. And having recovered from my own history of disordered eating, I wanted to create a podcast where I could bring bitesize episodes to help you with tools, techniques, and strategies to overcome your own food, weight and body image issues. 

Hi everybody. And in today’s episode I’m gonna be talking about I guess the, the complications and potential dangers that might be involved in pursuing weight loss. If you struggle with binge eating disorder and in particular, I wanna focus in on something that’s been coming up much more in my practice and just in general that I’m saying through conversations and through posts on social media. And that is the use of weight loss injections and also weight loss surgery. So why this has come up today as topic of conversation for the podcast is that there was a, a Facebook post within a, a group that I’m in last week, and it was a lady kind of in a local area who was saying that she was really struggling with her weight and that she was considering getting weight loss surgery done. 

And she just wanted some opinions and some advice around kind of prices and the procedure and things like that. However, in the post she had also really, really clearly indicated that she had binge eating disorder. She said that she was kind of regularly binging to the point of complete discomfort, and that on occasion she was making herself sick. So straightaway, like a alarm bells obviously for me are ringing that someone is kind of pursuing weight loss whenever they have binge eating disorder. There is a belief or, and a perception out there that having an issue with binge eating means that you have an issue with food, you have an issue with willpower, you have an issue with greed, and this is simply not true. That binge eating disorder is a psychological issue. It is a serious mental health issue, and it needs to be addressed from that perspective. 

And so what was really kind of concerning and, and generally I try and avoid Facebook groups as much as possible. I try and avoid making comments because we all know what it’s like. All the Karens in Facebook. Apologies if your name is Karen and you’re listening, but I just can’t, I cannot be bothered. I don’t have the time, the head space or the energy to be arguing with strangers on Facebook, but on in this particular situation because obviously it’s something very close to me and my area of expertise that I did go in and comment and give advice that really they need to address the binge eating disorder issue. And what was really, really concerning is that in amongst kind of my comment, there was loads of other people giving their opinions. And I, I’m well aware that this lady posted asking for advice. 

So she was asking for opinions, but Facebook is not the place to get opinions on something as serious as as this. And, you know, it was just horrifying to see what some of the comments were. Some of the comments were recommending doing keto. Some of the comments were recommending going to Slimming World. Some of the comments were just track your calories and use MyFitnessPal. And it’s like, come on. Like if it was that easy and that simple to do, do you not think someone would be doing it already? You know, if you’re struggling with binge eating disorder, oh, I know I’ll just track my calories in an app that is not going to resolve anything. So I appreciate that their comments may have been well-meaning, but it is just not helpful at all. But in and amongst those kind of diet recommendations, there was also quite a lot of comments of people saying that either they had or they knew people that had been taking these weight loss injections. 

And just as I’m about to start talking about the weight loss injections, the name of them has completely and utterly went outta my head. I know it’s something beginning with s like Saxenda or something or other. It’s totally and utterly left my head. But anyway so the, these weight loss injections, they’re pretty now, they’re really easy to get. You can get them in. Like I’ve seen them advertised in like beauty Anesthetics studios. You can, you can pretty much get them anywhere now, which does kind of, it worries me, it concerns me. These weight loss injections, they were initially actually created as a medical support for people with type two diabetes because it helps to slow the release of glucose in the body, helps to control blood sugar levels, helps people to feel fuller for longer. So it was originally actually created to be a medical intervention and support for people with type two diabetes. 

And I believe that it is, it can be very effective when used for that purpose, but basically because because of the feeling fuller for longer and the blood sugar regulation, that what they were finding is that people were actually then type two diabetics we’re actually losing weight using this injection. And so it became rebranded and repurposed and stuff. As a, a weight loss thing, it, I think it used to be quite like stringently prescribed by a gp, but it seems to be that you can go online now. You can answer, sorry, I’ve still got a little bit of a cough if I’m crooking a little bit. Apologies, you can still go online, answer a couple of questions on an online pharmacy and still get prescribed this, which just blows my mind because it is just open to misuse and abuse. You know, people who they perceive themselves to be overweight but are actually in a very healthy body and you know, at a very healthy size are, you know, the potential abuse that could happen in there. 

Not just that, but also the expense of that. I think it’s something around like 90 pounds a month perhaps for these injections. And whilst absolutely with taking these injections, you are gonna lose weight. Like, I don’t think there’s any bones about that. You’re gonna lose weight using these injections. The question I have is, well, what happens when you stop? Because what these injections essentially are doing are suppressing your appetite, helping you to control, regulate your blood sugars. So while you’re taking them, yes, absolutely weight may drop off. What happens when you stop actually taking the injections? You know, is your appetite going to come back with complete ferocity and, and you potentially just swing back into these huge overeating behaviors? Again, does weight just basically you start, you know, your appetite increases, you start overeating again, and you start regaining weight. Do you then start telling yourself that you’re a complete utter failure failure and that you try and engage in some other alternative means of, of weight loss? 

And this kind of perpetual cycle just continues. People buy into the things like the weight loss injections because there’ll be amazing promotion around it. There’ll be advertisements around it. It will look very impressive because it will say, you know, clinical studies have shown that people have lost X amount of weight in X amount of time. And also we’ll go, oh my God, that looks brilliant and there’s clinical research, it’s medically approved, this is wonderful. But what these clinical studies will never actually show is the long term effects of using these things. So that’s what the studies will show is that they give a certain number of people these injections for a certain number of months, as an example, say three months that the people on the study took the injections for three months and at the end of the three months they’d all lost X amount of weight. 

So that research is classified as being successful, that it’s positive and this is the evidence that this intervention works. But what that research will never look at or, or, or explore is with those participants go back and follow up with those participants a year, two years, or three years down the line to say, have they maintained the weight loss that they had lost with the injections? I can pretty much guarantee you that the answer will be no. That they, as soon as they stop taking the injections, the chances are that their weight just started to kind of increase and go back up again. So my kind of philosophy and beliefs around the weight loss injections is really that if it seems too good to be true that it quite possibly is. And, and I suppose like for some there will always be exceptions. 

There will always be people who have perhaps used these injections, have found them incredibly beneficial and have lost weight and maybe have even maintained and kept it off sometime later. I suspect for the vast majority of people, the experience will be some weight loss, some side effects. I actually just had an email from somebody there saying that they had horrendous kind of gastric pains and diarrhea and loads of issues whilst taking the injections. So I suspect that probably through majority of people, that there’ll be maybe some weight loss and some side effects and once the injections have, they’ve stopped taking them that they’ve basically possibly just regained weight or gone back to eating and, and having the same issues that they had before. So that’s kind of my thoughts and feelings around the weight loss injections. And I suppose for the, for the weight loss surgery, the kind of gastric sleeve and, and gastric bypass, this is coming up more and more because well people aren’t, for people who are local in my area, Northern Ireland, people aren’t really able to access these surgeries often on the NHS and may not be able to access them privately. 

So increasing number of people are going abroad to countries like Turkey to have these surgeries done. And you’ve maybe seen some kind of horror stories in the news recently of people having complications with their surgery and then having to come back and be admitted into emergency for emergency surgery when they’ve come back home. There was an awful case recently of one woman actually died whilst having the procedure done over in Turkey. What I would say is that whilst those stories are horrendous and and very, very concerning, they are actually in the minority. And I, I think that actually most people who go abroad and have the surgeries have it done, that the surgery is performed well by professionals and that everything is done as it should be. The big massive, however that I have around this is that there is not enough screening. 

And this applies to the UK as well, not just for going abroad. There is not enough screening, psychological screening for people going for these procedures. So if it is being done properly and, and appropriately the criteria for receiving weight loss surgery, that something that would automatically disqualify you from receiving weight loss surgery is if you have an active eating disorder. So if you have binge eating disorder or bulimia, you should automatically be disqualified as a suitable candidate for this surgery. I wouldn’t have any confidence at all that in clinics abroad are really appropriately screening for that. But I am also aware that some people who really want the surgery may be aware of that. They may know that and they may not be disclosing that. So I can’t lay complete blame at the at the service providers of that. 

But it, it concerns me how many people who struggle with binge eating disorder are seeing surgery as a solution because they believe that just getting the size of their stomach reduced is going to physically make it impossible for them to be able to binge. What often happens, and this is something I see with some of my clients that have had the procedure, is that they, they can go to great lengths then to find other alternative coping mechanisms. And the risk, if you have binge eating disorder and do pursue weight loss surgery, the risk of developing alcohol dependence increases massively. Because if you’re physically not able to numb out or suppress your emotions or cope with difficult situations using food, then people can quite often then turn to alcohol. So weight loss surgery is by no means an easy option. It’s no way a lazy way out, which I think often the general public without knowledge and understanding almost say it like this is a cheats way out. 

It’s an easy way out to lose weight. It is anything but that, it is life changing. Now. I have had experiences of people who have had this surgery who have lost weight, haven’t had any complications, and are incredibly happy with the results. So I am not saying it’s a good thing and I’m not saying it’s a bad thing. I’m pretty neutral about the process. And if somebody is looking for support around their binge eating disorder and they have had weight loss surgery I, I’m gonna equally support anybody ’cause it’s not, it’s not my place, it’s not my business to tell someone that they should get something done or they shouldn’t get something done. But it’s my job I feel to make people aware of the potential dangers and risks around it. But certainly if they have binge eating disorder, I will be very, very strongly expressing concerns about having the surgery and all my reasons why. 

And in terms of like, it, it not being an easy decision or it not being a quick fix to something, when I say it’s life changing, yes, for some people it’s life changing in an extremely positive way for other people it’s not. And everything in in your life changes post-surgery. Especially around just things like eating, you know, things that we might take for granted normally, like just going to a restaurant or socializing things like that. All the things that you potentially are important and meaningful in your life, that center around socializing or coming together or food that those things just may not be possible at all post-surgery. And so you know, a serious amount of consideration needs to be given as to what life would look like kind of after that. But if you have binge eating disorder and you are, and you’re listening to this and you have been toying with the idea of maybe going down the gastric sleeve route or looking at kind of surgical options abroad, I, I need to really stress and I hope I have stressed enough already that the binge eating disorder will not disappear. 

It will not go away through by reducing the size of your stomach. It will not go away by taking injections and losing weight. It is something that needs more appropriate support and there are lots of different ways and people will have lots of different kind of perspectives on, on what are the best therapies and what are the best ways of working with binge eating disorder. And you know, I think a holistic approach to it can be very helpful as well, but it is very much classified as a psychological issue and it needs to be addressed, I think, appropriately with someone who is qualified and experienced kind of in that area. So that’s kind of, that’s my, my thoughts and feelings around. I thought it would just kind of pop on and, and share that with you. And I think the thing that I’ve really kind of come to notice as well is just how much these interventions are actually being used. 

And I think that people maybe can be quite, maybe they feel shame around it, maybe they feel embarrassment around it. So there can be an awful lot of secrecy around the use of these things. But if people don’t start talking about it, if people don’t start sharing their experiences and sharing kind of the drawbacks or what things have gone wrong or the difficulties they they’ve had it’s, you know, if people start doing that much more, it’ll be so much more helpful, I think, for other people. And so I can see as more and more people potentially go down this avenue of maybe going abroad and having surgery, you know, the potential complications that they’re gonna get into post-surgery and that’s where people tend to then come to me that they’ve had the surgery, the weight is dropping off, but they realize like the, the, you know, they’re being physically prevented from eating, but the desire, the urges, the cravings, they wanting to deal with difficult emotions and difficult feelings, those things don’t disappear. 

And, and this is when people can get highly, highly distressed and experience really significant mental health problems kind of post-surgery as well. So I thought it was kind of important to come on to talk about and the more people can start opening up about this, being honest and transparent with it, I think the more helpful that will be as well. So I hope you have found this episode today helpful and interesting. If you have any personal experiences or thoughts on it, I would love to hear from you. So please do let me know and I look forward to talking to you again soon. 

So guys, that’s it for today’s episode. I hope you enjoyed it. And ’cause this is a new podcast, I would love to get your feedback on how you have found it and hear any suggestions you have either for improving the podcast or even topics that you would like to be discussed in the future. I really would love and appreciate to hear from you. So feel free to drop me a DM on Instagram or send me an email. And also if you would like to find out more about my services and ways that you can work with me, check out my website, which is www.eatology.co.uk

Otherwise that is it for now. Goodbye and I hope you tune in again soon. Take care.

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