Weight loss surgery provides an opportunity for people to change their lives. It seems like the ideal opportunity to improve the quality of life and perhaps even extend a person’s life. Many people will find that they have to have a psychological evaluation before they can be approved for bariatric surgery, though. While that may seem limiting at first, there’s good reason for it.
Data shows that, on average, a person may lose as much as 60% of their excess weight during the first six months after bariatric surgery. By 12 months, you may have lost as much as 77% of that excess weight (according to the American Society for Metabolic and Bariatric Surgery). It is highly effective, with studies indicating people maintain that weight loss long-term.
Why the delay, then? Why do you have to prove you are mentally fit for this procedure? For those who are struggling with extensive weight loss, you may blame your weight for your depression, anxiety, and other mental health disorders. However, doctors must find out what is behind the way you are thinking and behaving because it can ultimately impact your safety and long-term success rates.
What Is a Psychological Evaluation Before Bariatric Surgery?
Psychological evaluations are a way for behavioral specialists to better understand a person’s mental health, leading to a life-changing experience like bariatric surgery. They involve meeting with a psychologist for a clinical interview, which often entails answering questions about your mental health, including about the way you think about food, relationships, and stress.
The goal of these procedures is to obtain an objective measurement of your psychological health so that doctors can ensure you are mentally healthy enough to undergo the procedure.
Reasons Why You Need a Psychological Evaluation Before Weight Loss Surgery
Nearly all bariatric surgeons and health insurance providers will require a psychological evaluation before they consider moving forward with this surgery. There are various reasons why:
Ensure you are making the right decision
One of the first objectives of this type of one-on-one support is to ensure you fully understand what the decision to undergo bariatric surgery will mean to your health and future. This includes talking about risks and potential rewards involved. Your psychologist will help make sure your life goals align with the benefits of these procedures.
Evaluate your mental health history
Also important is understanding your mental health history, including any history of conditions such as depression, bipolar disorder, and severe anxiety. These conditions do not mean you cannot get this surgery, but it may mean that you need a bit more support and preparedness before moving towards that procedure to ensure your mental health is aligned with your goals.
Your doctor will want to discuss any past conditions you have been diagnosed with, as well as any conditions you may have suffered without a formal diagnosis. It will be important for you to understand what your past history is because those symptoms may present themselves later, during your recovery from weight loss surgery. Your psychologist wants to ensure you will be able to recognize those symptoms and know how to handle them.
Keep in mind that proper management of your mental health symptoms is essential. Studies indicate that, for many, bariatric surgery can help to support improved mental health, including reduced instances of depression and anxiety.
Determine if you need help with severe psychological problems
Another reason why your doctors will require this type of evaluation is to better understand if you have any signs of severe psychological problems. Those suffering from conditions such as binge eating disorder or psychosis may need to treat these conditions first before moving forward with surgery.
Binge eating disorder is a mental health condition in which a person consumes a large amount of food in a short amount of time. This may be related to past trauma, emotional difficulty processing stress, or other types of emotional distress, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Preparing you for the changes to come
It is also important for patients to have a full understanding of what they can expect after the procedure. That includes discussing a person’s mental health but also their expectations and how life may or may not change. You will learn more about what the procedure will do and how you will need to change your dietary lifestyle and habits after the procedure to meet your new health needs.
This typically includes getting a better understanding of:
- The emotional changes you may face when you are tired or unable to eat
- Emotional challenges you may experience due to the loss of food as a comfort mechanism
- How you will need to find other outlets to support your mental health needs
- What specific strategies you will need to use to handle meal prep and eating a balanced diet
- How important it will be for you to eat healthy foods to get the nutritional intake your body needs
Preparing for mental health needs after your procedure
Most people will experience significant changes in mental health after their bariatric procedure. Some of the most common psychological effects that occur in individuals who have had bariatric surgery include:
- Mood dysregulation: Changes in insulin presence in the body will cause dietary changes, but also will lead to the release of more hormone. Because of these changes in hormones, it is likely that you will have some mood swings as your diet changes.
- Higher risk of depression: Bariatric surgery is a comprehensive transformation of your life, and for some people, that comes with a higher risk factor for developing depression. Those who have been reliant on carbohydrate and simple sugar-rich diets often become dependent on those foods to stimulate serotonin in the brain. Since insulin levels will change, there’s a higher risk of suffering depression from the lack of serotonin in your system.
- Personality disorders: There are some situations in which a person may begin to experience personality disorders. This includes conditions like multiple personality disorder and borderline personality disorder. The number of people with these conditions who are obese is high, and post-surgery, some of the characteristics of these conditions, such as overeating behavior, may be hard to control after the procedure.
- Eating behavior disorders: A person completing bariatric surgery is also at a higher risk for developing maladaptive eating disorders. Studies show that emotional eating and food addiction can become problematic in some people who have this procedure.
- Body dysmorphia: Yet another risk is the onset of body dysphoria, a condition in which a person normalizes their overweight body, which means seeing themselves thin feels strange. For some, it can create mental distress, leading to difficulty with controlling symptoms of needing to overeat.
Ultimately, this evaluation is designed to better understand your mental health conditions now and what could happen later. Your evaluation may show that you need some support from psychiatrists to improve your ability to deal with stress or emotional eating. In many people, this type of treatment before surgery is beneficial and may significantly reduce the risk of complications later. Your mental health is just as important as your physical health, and this evaluation will help to establish that.
