Psychological Evaluation for Bariatric Surgery
Criteria for weight loss surgery include mental, emotional well-being
It is common for people who are candidates for bariatric surgery to also struggle with psychological disorders, especially anxiety, depression, trauma, addiction, and eating disorders. It can also be more challenging for people with multiple psychological disorders to lose weight or maintain weight loss after bariatric surgery. Before having weight loss surgery—a major life change that can present new challenges—it’s important to address underlying issues that may arise or worsen after surgery. This begins with a bariatric assessment by a psychologist on our bariatric team.
Having bariatric surgery is never a solution to life’s problems.
The importance of psychological evaluation for bariatric surgery
Through our bariatric program, you will be evaluated by a psychologist who is specially trained in obesity and weight loss surgery and the associated psychological and emotional effects. Psychiatric treatment before surgery may include a combination of cognitive behavioral therapy (CBT), trauma-based therapy, mindfulness, presurgical counseling, and in some cases, medication—all to help ensure you are in good mental health before having bariatric surgery.
Our psychologist will also explore your attitudes, behaviors and expectations to better understand your weight loss surgery goals and support you on your journey towards permanent, long-term weight loss. Keep in mind that having a psychological disorder does not disqualify you from getting bariatric surgery if you are otherwise a candidate for this type of procedure. We will work with you to help manage your emotional and mental health throughout the process.
Many patients also benefit tremendously from our bariatric surgery support group, which meets monthly to explore a wide range of topics and work through challenges with others who are having the same kinds of experiences.
Emotional effects of bariatric surgery
Obesity affects many areas of a person’s life and over time may serve as a type of “protection”—fat on the body becoming a safeguard from the outside world. When a person begins to lose the body fat, it may also feel like losing safety and security and coming out of a comfort zone.
Other psychological effects of bariatric surgery may include:
- Food obsession and addiction – While some people with obesity struggle with food addiction before bariatric surgery, others may find a newfound obsession with food along with fear of gaining weight. Whether it happens before or after surgery (or not at all), obsessing over food is a way to fill an emotional void that cannot be healed by bariatric surgery. As part of your weight loss journey, you’ll work with a psychologist and bariatric nutritionist to develop a new relationship to food and put in place healthy eating behaviors that will support long-term weight loss success.
- Stress and anxiety – Bariatric surgery has not been shown to improve anxiety for people with anxiety disorders. And because weight loss surgery is such an extreme lifestyle change, it can provoke feelings of anxiety, stress and overwhelm. A healthy approach to bariatric surgery includes developing healthy ways to manage stress in advance of your surgery and to get your anxiety disorder under control with counseling and medication, if needed. Our psychologist will monitor your progress after surgery to help you work through any uncomfortable feelings and challenges.
- Social acceptance – People who have obesity may have become accustomed to feeling isolated or socially removed, whether by choice or because of peer or family influences. As the weight begins to come off, a person who’s had bariatric surgery may start to feel newly accepted in social groups or may feel more attractive to a partner or someone outside the relationship. Self-confidence often improves and this could be a welcome change while also feeling unfamiliar. Working with a bariatric psychologist will help you better navigate your social environment and relationships.
- Self-consciousness about excess skin – After extreme weight loss, there is excess skin that may cause discomfort and could even lead to infection. For the person who’s lost weight, the appearance of the skin folds may seem unsightly and could lead to feeling self-conscious and wanting to hide parts of the body. For this reason, some patients choose to have plastic surgery after bariatric surgery, to remove and tighten up excess skin. Working with our psychologist will also help you manage expectations about weight loss surgery and your feelings about your body before and after.
- Alcohol abuse and sensitivity – People who are candidates for bariatric surgery are more inclined to abuse alcohol. This may be in order to deal with strong emotions as well as social and physical discomfort. If alcohol is a problem for you before bariatric surgery, it’s important to take on this aspect of your health and get help for alcohol recovery. Drinking alcohol after bariatric surgery is discouraged because even a small amount can cause intoxication.
If you’re a smoker, we encourage you to begin a smoking cessation program. Smoking cigarettes puts your body at great risk after surgery, making you more vulnerable to infection, ulcers and stomach irritation.
Life after weight loss surgery
Keep in mind that bariatric surgery is just the beginning of your weight loss journey and it make take up to two years to reach your ultimate weight loss goal. You will not suddenly wake up out of surgery a thinner person.
And while many patients experience bariatric surgery success, every patient is different. Your personality, mental health condition, and variety of life experiences and behaviors all influence bariatric surgery outcomes and long-term weight loss success. We’re here to help you mentally prepare for bariatric surgery and adapt well to your new body and image of yourself.
Join us for an upcoming bariatric information session and see if weight loss surgery is right for you.
You can also learn more about life after bariatric surgery through the American Society for Metabolic and Bariatric Surgery.