Monthly Archives: November 2011

Addiction, Alcoholism, Gastric Bypass Surgery, Nutrient Deficiency and the Brain

In my last blog, I wrote about how they recently showed that gastric bypass surgery significantly increased your risk of developing alcoholism and substance abuse as well as suicide attempt and depression, much more so than merely restrictive procedures such as the lap-band.

Early on this was attributed to a psychological phenomena they called addiction transfer – theorizing that once a food addict could no longer eat they would “switch” to another substance in order to feel good.   It seemed to make sense.   Except to those of us who were experiencing it.  We knew things were different.   We felt “different”, “wrong”.  If this were truly psychological, we should see similar rates of this transfer among all weight loss surgeries:   duodenal switch, sleeve gastrectomy, lap-band, etc.

Many chemicals in the brain are responsible for that sense of well-being, your ability to feel happiness:  serotonin, dopamine, norepinephrine, endorphins.   But what about all the other nutrients your body must have in order for these chemicals to function properly?  They all work together.  Now what if those nutrients started to slowly diminish over time?  Say over the next 12-14 months? And longer?  How would you feel then?

What if you’ve suddenly achieved something you’ve yearned for, perhaps your entire life, and now find yourself having difficulty finding pleasure in things you know should find pleasure in?   Trying on new clothes?   Meeting new people?   Peoples reaction to the new you?   And what if that ability experience pleasure and joy just is not there.   You know it should be and it isn’t.   What if you start having trouble sleeping, maybe having anxiety, and you have no idea why?

And then you experience something and you feel “good” for the first time in a long time.   Maybe that something is alcohol, which if you’ve had gastric bypass, even a little bit might feel really good where before it was no big deal.   Or maybe your doctor writes you a prescription and you pop that pill and feel “good” again.  Or it might be shopping, etc…..   Or maybe you’re just one of those people that just tough it out and slog through and continue to feel awful.   The brain is incredibly amazing at associating what you need to not feel awful and is very crafty and effective at convincing you to keep it from feeling like crud all the time.

But I’m convinced that if the “feel good” chemicals in the brain had not been so deteroriated by the many months and months of depletion, so many people would not have vulnerable in the first place to this scenario.     There seems to be more understanding about how addiction works these days – the pleasure/reward pathways.   What I am hoping the scientific community starts to explore is where the breakdown is occuring.   How is this surgery creating the bio-chemical changes in our bodies that make a signficant population more vulnerable to addiction?

If this sounds at all familiar to your story, let me know.

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Why Is Gastric Bypass Surgery Causing Addiction, Alcoholism and Suicide but the Lap-Band Procedure Isn’t?

There was a study done by Dr. Magdalena Plecka Ostlund of the Karolinska Institutet in Stockholm showing that those people that had weight loss surgeries that bypassed the intestines had much higher rates of problems with addiction, depression, alcoholism and attempted suicide than those that had the Lap-Band (or similar type).

“The gastric bypass surgery cohort had higher Hazard Ratios (HR) than the restrictive surgery cohort for substance abuse (HR, 3.8), suicide attempt (HR, 4.1), alcohol abuse (HR, 4.0), and depression (HR, 2.4). For the restrictive surgery cohort, these HRs were, respectively, 1.4, 2.4, 1.2, and 1.8, she said.”

This report has been getting quite a bit of newspaper attention regarding the alcoholism component, and though indeed alcohol abuse is a big problem, there are also significantly large increases in problems in substance abuse, depression and suicide attempts. However, the important element in this story seems to be getting lost, Why isn’t this happening to the Lap Band group? I now would like to ask, can the data be further broken down among folks that had the sleeve gastrectomy without intestinal bypass? Would the Hazard Ratios still hold then? How about for duodenal switch?

Another factor is that the data is reported using Hazard Ratios. I don’t know about you, but I wasn’t exactly familiar with the term Hazard Ratios and what they meant in medical reporting, so of course I had to look it up. How I’ve come to understand hazard ratios is that after gastric bypass surgery, there would now be a 3.8 times increase in your risk of developing substance abuse over the control group (ie., those that didn’t have surgery). A Hazard Ratio of 1 would be the equal to the control group. So, the Lap Band group is only slightly greater than the normal population with regards to risk of alcoholism and substance abuse but not nearly like the gastric bypass group is.

For those suffering from any of these, I think it certainly bears more scrutiny as to why there is such a difference between procedures, both for the sake of prevention and treatment. If the cause could be pinpointed and studied, then perhaps the tragedies could be avoided.

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Gastric Bypass Surgery: Post-Operative Care with IV Nutrient Therapy and Injection Nutrient Therapy

I came across this interesting article.   I posted a similar one earlier when I found a local Naturopathic Doctor and started doing IV Nutrient Injection Therapy after gastric bypass surgery.

Gastric Bypass Surgery: Post-Operative Care with IV Nutrient Therapy and Injection Nutrient Therapy

By DR. Susan Williamson, NMD

With the rise of obesity in the U.S., more patients are turning to gastric bypass surgery to produce fast and dramatic weight loss. According to the Mayo Clinic, gastric bypass surgery is the most popular weight loss surgery in the United States. With gastric bypass surgery, the stomach is made smaller by reducing it to a thumb-sized pouch (15-30 mL or 1-2 tablespoons in volume), which considerably restricts the amount of food that can be eaten, as well as provide less surface area for the absorption of vitamins and minerals from food. In addition to this, the amount of hydrochloric acid (needed to absorb calcium and iron) and intrinsic factor (needed to absorb vitamin B12) produced by the stomach is greatly reduced due to its size, which also contributes to nutrient deficiencies. In addition to this, the duodenum, a major area of nutrient absorption within the intestinal tract may be bypassed depending on the type of procedure performed, further contributing to nutrient deficiencies.

Common symptoms of nutritional deficiencies are:

fatigue and weakness
hair loss and/or dry brittle hair
thin and brittle fingernails
difficulty thinking/concentrating
thinning of the skin/dry skin
softening/weakening of the bones (osteopenia/osteoporosis)
bone pain and bone deformities
muscle spasms
tooth discoloration and increased susceptibility to tooth decay
bleeding gums
increased tendency to bruise and bleed
anemia
sleep disturbances
neurological problems
pins and needles sensations in the body
permanent nerve damage
diarrhea
skin disorders
sore or swollen tongue
cracks at the edges of the mouth
swelling, usually in the legs
dehydration
decreased immune system strength, making an individual more prone to infections

Some nutrient deficiencies, if allowed to progress, can result in serious life threatening complications, so it is very important for gastric bypass patients to continue supplementing with nutrients and the best way to do this is via intravenous administration where the digestive tract is not a factor in the absorption of nutrients. With IV nutrient therapy, high doses of vitamins and minerals (much higher than what can be taken orally) can be delivered straight to the bloodstream where they are readily available to the cells for absorption and use by the body. People who have had gastric bypass surgery may also benefit from having specialty testing done at Bodhi Body Integrative Medical Centers to detect their specific nutrient deficiencies so that their particular nutrient deficiencies can be detected and therefore appropriately treated.

Common deficiencies of the fat-soluble vitamins (Vitamins A, D, E, and K) are common and these can be supplemented via intramuscular injection. Patients are at risk for developing anemia secondary to deficiencies of iron, Vitamin B12, and folate, all of which can be replenished easily via injection or IV. Calcium is a common nutrient deficiency as well due to the decreased stomach acid production in the reduced sized stomach. It is unknown whether gastric bypass patients can absorb the micronutrients selenium, zinc, and chromium, however these are included in the nutritional IVs as well as vitamin C, B12, B complex, B6, folate, calcium, magnesium, and electrolytes. Another benefit of the nutrient IVs is treatment of dehydration, which is another common symptom many suffer after gastric bypass surgery.

Patients who have nutrient deficiencies usually notice an immediate effect of feeling better after receiving a nutrient IV. If you or someone you know has had gastric bypass surgery then please contact Bodhi Body Integrative Medical Centers today so that we may assist you in replenishing your body’s nutrients and help prevent serious complications from developing and progressing. Taking oral vitamins and minerals will help some with nutrient deficiencies, however the severe deficiency that normally results after gastric bypass surgery is best treated with intravenous nutrients where gut absorption is not a factor and 100% of the nutrients is absorbed and available to the body.

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