By Shiro Perera Torquato, Ph.D.
Surgical weight loss is an important decision that many people make to improve their health, appearance and self-esteem. After years of trying endless diets with little success you may have considered this as an option for yourself. Bariatric surgery, such as Gastric by-pass surgery or Lap-Band surgery are two of the most common procedures utilized today for surgical weight loss. However, before you make your final decision regarding surgical weight loss you may want to know some of the steps that need to be taken.
Prior to the surgery being scheduled, most bariatric surgeons refer the patient for a full physical exam with lab work and a consultation with a nutritionist. Also, some surgeons require that their patients attend an informational seminar where the surgical procedure and post-surgical life changes are reviewed. Occasionally former patients who had successful weight loss as a result of their surgery discuss their experience and answer questions during these seminars. Finally, most surgeons or medical centers also require patients to undergo a psychiatric or psychological evaluation prior to surgery. The purpose of this evaluation is to assess the patient’s current psychological status and ability to follow through on the dramatic life style changes required for the surgery to be successful.
A pre-surgical psychological evaluation for bariatric surgery involves an extensive clinical interview that reviews the patient’s history of psychological issues and treatment, substance abuse, family history, educational and occupational history, medical history, previous attempts at weight loss, emotional/family supports and a Mental Status Examination. This latter part of the interview involves discussing the individual’s daily functioning and any factors or stressors that may be contributing to problems with that functioning, such as severe insomnia. On occasion formal psychological testing is administered.
In addition, whether the patient fully comprehends the seriousness of the procedure and possible risks, as well as the lifestyle changes and follow-up that must take place post-surgically are assessed. For example, if a patient has unrealistic expectations about the outcome of surgery, such as a sudden improvement in their self-esteem or social relationships, then they may not be a good candidate for the surgery. Also, if a patient lacks the emotional/family support to follow through with the very strict eating requirements after surgery, the likelihood that they will suffer complications increases. So, weight loss surgery would not be successful or recommended for these individuals.
Are you wondering, “What are these complications?” Well, besides the medical risks associated with any major surgery there are the emotional complications. For example, if you are the type of person that is has a very busy schedule and is used to eating one or two large meals a day and you have to change your habits to eating many small meals throughout the day, this change in your lifestyle may be very difficult to consistently implement. Moreover, many individuals who have struggled with being overweight often use food to decrease stress or cope with problems in their lives. For some people eating is a way of “self-soothing” when they are depressed or anxious. If you are this type of person, and have not found alternative ways to cope with negative feelings, having bariatric surgery may cause more emotional distress when you can no longer use food to meet those emotional needs. With this in mind, it may be beneficial to seek therapy first to learn other coping strategies before pursuing the weight loss surgery.
So, before you make the final decision, educate yourself as much as possible about the surgical procedure and possible risks and complications. The more you know about the physical aspects of the surgery and life afterwards, the better your results will be. From an emotional standpoint, it is also important to understand the role that food plays in your life, before you embark on this journey to become a healthier you.