Get a psychological evaluation before deciding on bariatric surgery

A psychological evaluation for bariatric surgery is generally required before an individual will be approved for the procedure. It may be performed by a psychiatrist or psychologist. The purpose of the evaluation is to insure that someone has realistic expectations about weight loss, can follow post-surgery food protocols, and has the emotional skills necessary for a successful outcome, assess current mental status and determine emotional readiness for surgery. It also is important to assess the presence of any other condition such as eating disorders and substance abuse. The clinician also looks for the degree of social support an individuals has.

Here is some expert advice when it comes to the psychological evaluation.


Do

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  • schedule the psychological evaluation first
  • understand the importance of the psychological evaluation
  • be aware of your motivation for seeking surgery
  • discuss with the clinician your post-surgery emotional support plan
  • discuss your past dieting habits
Don't

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  • be dishonest about your past
  • expect automatically to be approved for surgery
  • forget to bring necessary documentation and/or personal items
  • start the surgical process until you are absolutely sure
  • miss your evaluation or cancel without prior notice

Christine Weber, Ph.D.‘s recommendation to ExpertBeacon readers: Do

Do schedule the psychological evaluation first

The evaluation is an important part of the bariatric surgery overall screening process. If a patient is not considered an appropriate candidate for surgery, the evaluation will reflect this. A patient who is not considered appropriate for surgery may be denied or deferred until a short period of counseling is completed. In the event the evaluation demonstrates that someone is not an appropriate candidate for surgery, some very invasive medical procedures can be avoided if the psychological evaluation is performed first.

Do understand the importance of the psychological evaluation

The evaluation is mandated by most physicians as well as health insurance companies. Physicians carefully examine the psychological evaluation and the recommendations offered. And not all individuals are approved. It is best to arrive on time and expect to be at the visit for one to two hours. Bring reading glasses to properly fill out forms and/or self-report questionnaires, which may be given.

Do be aware of your motivation for seeking surgery

The clinician is looking to see whether patients have done their homework. Have all non surgical options for weight loss been explored? What led someone to consider bariatric surgery? It is important to understand what is involved with the surgery and what the possible complications are. Patients are questioned as to their knowledge of the procedure, the risks involved, and what they expect to achieve.

Do discuss with the clinician your post-surgery emotional support plan

Bariatric surgery is a tool to assist with weight loss. Weight loss has a tremendous emotional component to it, and will change your life. Being proactive can make a tremendous difference in how successful someone is. The psychological evaluation is the perfect opportunity to discuss with a mental health professional strategies for staying on target.

Do discuss your past dieting habits

Most individuals who choose weight loss surgery have tried dieting with only limited success. In order to have the best outcome individuals need to be clear about what worked and did not work in the past when dieting. Are you an emotional eater, or a stress eater? Are you able to keep a box of cookies in your home without consuming the entire package? Understanding yourself and your food urges can help with planning the post surgery diet. Past dieting failures should be discussed to determine how to alter behavior patterns that may lead to failure.


Christine Weber, Ph.D.‘s professional advice to ExpertBeacon readers: Don't

Do not be dishonest about your past

Be upfront about any psychological history or substance abuse history. Someone may still be appropriate for surgery despite seeing a therapist or being treated for substance abuse. Being dishonest can casts doubts about whether someone is emotionally ready for surgery. Lying also allows the provider to question whether a patient is hiding something significant. Patients need to keep in mind that clinicians expect to see individuals who are not happy with their self-image. And being nervous is normal. Bariatric surgery is a major life altering event. It is natural to be fearful of undergoing surgery.

Do not expect automatically to be approved for surgery

Clinicians want to approve for surgery individuals who they believe have a high likelihood of success. Surgery candidates need to have adequate coping skills throughout the process. Choosing weight loss surgery is not akin to simply choosing a new weight loss plan. The body is being altered for the purpose of losing weight and in some cases the changes are relatively permanent. It should not be used as a casual method of dieting and is not appropriate for everyone. The clinician is making a determination of whether surgery is an appropriate option for a patient.

Do not forget to bring necessary documentation and/or personal items

As with any other specialist, bring a photo identification, such as a drivers license, and an insurance card if your provider accepts insurance. Have the name and address of your surgeon available so that the report can be sent out. If needed, bring reading glasses. You may be asked to fill our self-report questionnaires. Let the provider know about any difficulty hearing.

Do not start the surgical process until you are absolutely sure

Someone may wish to explore different weight loss strategies before making a choice of surgery. It can be informative speaking with others who have had dieting success with and without surgery. Many resources can be found on the internet. Consulting with a therapist for a period of time can help with deciding about individual needs and what might work best. The best patient is one who is well informed and understands what he or she wants.

Do not miss your evaluation or cancel without prior notice

This action can serve as a red flag to the clinician conducting the evaluation that a patient does not follow through with commitments, is disorganized and/or unreliable. Some clinicians will not reschedule the visit under these circumstances. Compliance with post surgery protocol is crucial to weight loss success. If someone’s presurgery behavior is erratic and inappropriate, it may cast doubt about a person’s ability to follow the required guidelines once surgery has been completed.


Summary

The psychological evaluation is an important part of a bariatric surgery work-up. An individual's eligibility depends upon a positive recommendation. The overall work-up is extensive and includes medical, psychological and weight loss history. Individuals should be aware of their motivations for surgery and decide if it is the best choice for them.

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