If you become a candidate for bariatric surgery, you will likely be referred for evaluation with a clinical psychologist. Although this may seem surprising, it has become a routine part of the preparation for many types of surgeries, and sometimes it is a requirement made by insurance companies. The American Society for Bariatric Surgery recommends that patients who are seeking bariatric surgery obtain a pre-surgical psychological evaluation.
Individuals with obesity are usually psychologically normal and do not fit any specific psychological profile. The purpose of a psychological evaluation is not to examine the underlying problems and conflicts that might have caused obesity or to exclude people from surgery. Research has found that only approximately four percent of individuals are found to be inappropriate for surgery based on their psychological evaluation results. The purpose of the evaluation is to examine an individual’s strengths, current coping strategies, understanding of the surgery, and ability to benefit from the surgery. Since studies have identified depression, mood disorders, and severe mental illness as possible predictors of failure to reach weight loss goals following surgery, a psychological evaluation assists in the diagnosis and treatment planning for individuals with these disorders. For example, depression is often treated with medication and counseling and is most often well controlled. While this situation rarely presents a problem following surgery, it is important that it is addressed and treated appropriately to maximize post-surgery success.
During the psychological evaluation, patients are offered time to ask any questions they may have about their surgeries. Fears or anxiety about having the surgery or related lifestyle changes may be addressed with pre-surgical stress management techniques. Studies indicate that individuals who can relax prior to many types of surgery heal faster and experience less post-operative pain. In addition, some patients are concerned about future feelings of deprivation, such as not being able to eat their favorite foods after surgery or ambivalence about their ability to make lifestyle changes. The psychologist can help patients to understand that if the feelings occur at all, they will usually be short-lived. Following the evaluation, patients can participate in pre-or post-surgical counseling.
At your evaluation, you will be asked to complete various forms and questionnaires in addition to psychological testing. You will be seen by the clinical psychologist for approximately one hour for an interview and you will be asked questions that assess your current eating behaviors, weight loss attempts, and overall health and lifestyle. The interview assists the doctor in understanding your motivation and expectations for the surgery, as well as gaining needed background information.
Following the evaluation, our office staff will contact you to schedule a feedback session. The psychologist will review the results with you and will discuss specific recommendations based on the results. A copy of the evaluation report, including recommendations, will be sent to your surgeon.