Choosing surgery as a method to lose weight is a difficult decision. Typically, surgery is not considered unless many years of failed weight loss programs have been attempted. Long term disappointment negatively affects self-concept and relationships with others. Understandably, mental health factors play a role in considering surgery and recuperating from it. Completing a bariatric surgery psychological assessment explores these factors.

Personality issues and bariatric surgery

Bariatric surgery psychological assessment helps determine if the risk of surgery is worth the health benefits gained. Psychological issues related to the surgery and about future adjustment to changes after the surgery can be discovered. A plan to change can be developed considering emotional, cognitive and behavioral factors. Subsequently, the pre-surgical assessment includes objective personality testing, which compares the patient’s personality characteristics with other general population adults. Possible personality issues that can be addressed are identified during the evaluation process.

Consequently, the bariatric surgery psychological assessment can be eye-opening as it explores issues related to coping mechanisms, diet and exercise. Specifically, the patient’s experiences with restricting calories or types of food, as well as their successes and failures with changes of their diet are detailed. Feelings about food and making changes that involve food are explored. The patient can mentally prepare for the changes they will be expected to make after the surgery is completed. The patient and the doctor will be better prepared for issues that may develop and start finding resources or options that can make adjustment easier.

Expectations and bariatric surgery

Additionally, during the pre-surgical interview and through questionnaires, the motivations for having the surgery and expectations of what the surgery will achieve can be discovered. The patient’s expectations need to be realistic as unmet expectations can be disappointing. Unfortunately, a sense of failure will lead to giving up and regret for having the surgery. Patients who understand that the surgery will support their efforts in changing their diet and modifying eating behavior will be better prepared for the changes they will have to take responsibility for in the future.

Mental illness and bariatric surgery

With the bariatric surgery psychological assessment, the patient can be educated about psychological issues associated with the surgery that may not have been considered. The patient may have been coping with depressive symptoms and attributing disappointment and stress to being overweight, but that may not always be the case.

Being in therapy or taking psychotropic medications does not automatically disqualify a patient from being approved for bariatric surgery. How a diagnosed mental illness may affect post-surgical adjustment is an important consideration in planning the surgery. The patient can start adapting to the team approach to surgery that will include the surgeon, nutritionist, and other representatives of disciplines that will demonstrate a holistic approach to change that the surgery will entail.

By Rebeca Bright, PsyD.

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