Before the decision for obesity surgery is made, the person with obesity goes through many analysis processes. One of these is psychological control. The main issue we attach importance to when performing psychological control on the patient is; It is what kind of meaning one attributes to food, that is, what meaning food means to the person. Is food a tool for living for the individual, or is it the purpose of life and has the person formed a serious bond with food and actually become addicted to food?
Cross dependency; It is the replacement of one impulsive behavior with another impulsive behavior. Addiction transition that may occur after bariatric surgery: It occurs when impulsive eating behavior is replaced by another type of addiction. These; It can be alcohol, cigarettes, coffee and painkillers, as well as behavioral addictions such as gambling, shopping, sexuality, exercise or religious rituals.
After bariatric surgery, the patient's relationship with food begins to change. Although he/she may initially resort to food to relax and distract, as a reward or escape, the surgery removes the association of pleasure with food and tends to fill this gap with another behavior or substance. Figures show that cross-dependence cases occur between 5% and 30% after the operation.
There are some factors that pose a risk for cross-dependence. The patient's addiction to alcohol or painkillers before the operation, whether there is substance abuse in his family, whether he has childhood trauma, depression or anxiety problems, his tendency to isolate himself from society and his behavior to avoid emotional experiences are signs of cross-dependence developed after the operation. For this reason, before the decision for surgery is made, the obesity patient must undergo detailed examinations. In this context, the thing to pay attention to is that the doctor he consults must work with a team.
When we use brain imaging methods to understand how the addiction process works, we see that there is a decrease in the amount of the neurotransmitter called dopamine in the regions associated with the feeling of reward. This finding; alcohol, cigarettes etc. It works with the same principle in food addiction as it does in addiction to substances such as drugs. In addition, when looking at people with food addiction, it was revealed that dopamine levels decreased as body mass index increased. When animals were used to study food addiction, they quickly began to consume too much food and show withdrawal symptoms after being fed excessive amounts of fat and sugar.
This similarity between the working principles of food addiction and other addictions is of great importance in the occurrence of cross-addiction. The person feels negative emotions due to low dopamine levels. This abnormal lowness forces the patient to tolerate these sensations. But there are many ways to increase dopamine. It should always be preferred to proceed with a team that works correctly in these directions.
Another element that is used instead of food in cross addiction is; are games of chance. While the tendency to gamble is suppressed with food, it is observed that after obesity surgery, those suffering from obesity replace the food element with gambling and games of chance.
Another common aspect of patients who develop addiction is that they use it as a strategy to escape from stressful situations. It has been observed that people who have a low ability to cope with adversity and difficulty tend towards cross-addiction.
Cross-dependence that occurs after bariatric surgery is not the patient's only problem. However, insomnia, depression and anxiety may occur. Problems such as ulcers, high blood pressure, vitamin deficiency and weight gain may occur. For these reasons, it is important for the person with food addiction to consult a psychologist before and after bariatric surgery.
It may not be enough to prevent material or behavioral addictions from replacing eating, which is of great importance for the patient's life. This huge gap must be filled by habits that will pave the way for the individual to make peace with himself and society. Exercise can also serve as a reward due to its effect on dopamine release. k is one of the important ways. Working in organizations based on volunteerism can help the patient both feel valued and improve their social relationships. These examples can be developed and changed according to the mental state and environmental factors experienced by the person at that time. Considering that cross-dependence emerges in the first 2 years; If the therapist makes significant progress during this period and continues to meet with the client at regular intervals after 2 years, it enables the individual who has undergone obesity surgery to live a healthier life with an increased quality of life.
Remember; life is based on decisions or choices. Take the first step for yourself and your loved ones and get support from your psychologist.
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