You’ve had vertical sleeve gastrectomy and are winning the weight loss war for the first time in years—or ever. So why do some patients feel anything but joyful? From simple explanations (it’s a big change) to more complex issues (losing your coping mechanism), one or a combination of several factors can contribute to feelings of sadness or even full-blown depression.

Reason #1: You can’t use food for comfort anymore.
I don’t have statistics regarding the percentage of overweight and obese people who’ve gotten that way, at least in part, because they use food as a comfort or to soothe emotional issues. But in my experience, that number would be very high. Please don’t read any judgment into that statement, because it’s easy to see why it happens so frequently. Food is always there for you, it protects you from attracting unwanted attention, and it never fails to make you happy. From abuse to rejection to unhappiness to loneliness…or any other negative emotion…food morphs into a lifeline for so many of us. But after your bariatric surgery in Mexico, that relationship changes. Physically, it has to. And that can cause sadness or anxiety.

Reason #2: Life doesn’t magically get better with weight loss.
Don’t get me wrong: Losing weight is probably the single best thing you can do to improve your life if you’re significantly overweight or obese. You know all about the health stats and gains in self-confidence, so I won’t go into those. But some patients mistakenly believe, usually subconsciously, that their spouse will treat them better, their career will skyrocket, or their parents will finally appreciate them. And then hopelessness sets in when they realize that they’re leaner and healthier but still stuck in a bad marriage, a dead-end job, and a dysfunctional family. Weight loss will improve your life, but it doesn’t cure everything (unfortunately).

Reason #3: Everything seems harder now—not easier.
You loved going out to dinner with your spouse or meeting friends for happy hour cocktails, but it’s just not the same now. It’s not like you can eat or drink the same way, so why bother? Or perhaps you figured, despite the admonition about the sleeve being a tool and not a magic pill, that losing weight would be a piece of cake. And that you could eat poorly and still lose massive amounts of weight. The change in your lifestyle, not to mention the amount of time and attention you’re devoting to being successful, can cause patients to become pretty blue. “Will the girls quit calling me if I’m sipping club soda while they’re sharing a pitcher of margaritas? Will I ever get to stop thinking about meal planning and prepping?” It’s all a big adjustment, and that’s just plain discouraging sometimes.

Reason #4: You’re eating the wrong diet.
I’ve mentioned in other blogs that one diet isn’t right for every VSG patient. Lots of my patients find success on a low-carb, high-protein regimen. It might not be smooth sailing all the time, but it’s sustainable over the long term for them. Others, like me, find that a plant-based diet makes them feel best. What many people don’t realize is that the food you eat—or don’t eat—impacts how your body and mind function. Some body chemistries simply don’t do well with incredibly small amounts of carbs. That’s not a license to go on a donut binge; that’s just an encouragement to consider switching from meat-heavy eating to the whole grains, legumes, and veggies of a plant-based eating plan. Similarly, if you’re trying to be vegan, but you’re white-knuckling it against constant cravings for chicken or eggs, that plan might not be right for you. And it could be messing with your head.

If you’re struggling with feelings of sadness, anxiety, or depression after VSG, your first step should be discussing these emotions with your physician. He or she can make recommendations regarding behavioral changes, therapy, and/or medications to help you dig out from the funk and enjoy life again. And while these struggles aren’t rare after gastric sleeve surgery, they don’t happen to a majority, either. Rest assured that plenty of people experience what Regina did. “I have battled depression for over 20 years with meds,” she shares. “My surgery helped me so much I went off my depression meds this past fall.”

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“Changing lives…one sleeve at a time”.