The benefits of bariatric (i.e., weight loss) surgery are well documented. Significant reduction of excess weight is frequently accompanied by improvements in diabetic symptoms, hypertension, cholesterol levels, and obstructive sleep apnea. There are emotional benefits as well, such as improvements in self confidence and self image. In recent years, bariatric surgical interventions have advanced considerably and have become more widely prescribed. Most surgeons and insurance plans require prospective candidates to undergo a psychological screening evaluation as part of their presurgical preparation.
Why do I need a psychological evaluation?
There are several compelling reasons for undergoing a presurgical psychological evaluation. These include:
Ensuring that patients possess the basic cognitive capacity to comprehend and consent to the proposed surgery and any involved risks.
Ensuring that there are no untreated major mental illnesses that could interfere with post surgical follow through. Examples would include untreated and severe mood disorders, psychotic disorders, or addictions. Note that having a psychiatric disorder does not itself exclude people from undergoing bariatric surgery, so long as the disorder is reasonably well controlled.
Ensuring that expectations regarding the extent of weight loss and health improvement are in line with the current literature.
Ensuring a patient's readiness to comply with the rigorous post surgical regimen.
Identifying and treating presurgical worries and anxieties.
Discussing possible unexpected emotional responses to weight loss. Some patients experience an unexpected feeling of awkwardness or even vulnerability after significant weight loss.
Making recommendations regarding pre- and post surgical psychotherapy or psychiatric services.
"I've had mental health treatment in the past, will that exclude me from undergoing the surgery?"
No, it will not. Many bariatric candidates - like many other people - have sought mental health treatment to help them deal with life's difficulties or with emotional problems. Having a past or current psychiatric diagnosis will generally not exclude a person from undergoing bariatric surgery so long as the problem is well managed. Infrequently, surgery may be postponed until psychiatric symptoms can be treated effectively. Rarely, surgery is postponed indefinitely if severe psychiatric symptoms such as psychosis or addictions cannot be brought under control.
"What should I do if I experience uncomfortable emotions after my surgery?"
There is typically a sense of satisfaction and improved quality of life as patients begin to lose weight after their surgery. Sometimes, however, this is accompanied by unexpected and confusing anxiety or sadness. This is not uncommon, and it can be treated. If you begin to experience these kinds of feelings, you should find a mental health professional to help you cope with and manage them.