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The Psychological Evaluation For Bariatric Surgery

middle aged woman talking to psychologist

Bariatric surgery is a major medical procedure that drastically affects a patient’s lifestyle after surgery. Patients will lose an immense amount of weight, undergo significant dietary changes and need daily supplementation and possibly even additional surgeries, to remove excess skin or to perform additional gastric surgeries.  

Other research has indicated that undergoing bariatric surgery can alter relationships (usually for the better), and even affect the weight of family members.

In addition to ensuring that the body is able to physically withstand the surgery, recovery and physical changes, physicians must also determine whether patients are mentally healthy.

The Psychological Evaluation 

To determine whether patients are mentally fit for bariatric surgery, all bariatric surgery patients undergo a psychological evaluation. The mental health professional should be familiar with bariatric surgery procedures, in order to quickly spot any potential problems, including drug and alcohol abuse.

Though the psychological exam is not required by the National Institutes of Health, nearly all insurance companies which cover bariatric surgery require patients to undergo a psychological evaluation, before approving the surgery.

The psychological evaluation determines: If patients are depressed, whether they understand the risks associated with the procedures, how well they will follow the carefully outlined post-procedure diet and lifestyle changes and their expectations of weight loss and post-surgery lifestyle.

Specific Tests And Diagnostics

Mental health professionals may use a number of diagnostic tests to assess a patient’s mental health, prior to bariatric surgery. These tests may include:

  • Alcohol Use Disorder Test
  • Drug Abuse Screening Test
  • Millon Behavioral Medicine Diagnostic
  • Multidimensional Health Locus of Control
  • Questionnaire on Weight and Eating Patterns

The practitioner will also look for any signs of personality disorders, as well as determining the social support network of the patient.

Delay Or Denial Of Surgery

Approximately 15 percent of the time, psychologists recommend that patients be denied for the surgery, or delay the surgery due to mental health concerns.

Patients may be denied for a variety of reasons, including:

  • Suffering from undiagnosed and undertreated depression
  • Demonstrating the symptoms of psychosis and bipolar disorders
  • Not understanding the risks of the surgery
  • Abusing drugs and alcohol within the past six months
  • Attempting suicide multiple times
  • Showing an inability to follow the post-operative procedures
  • Exhibiting symptoms of a severe binge eating disorder
  • Having an unstable social situation, such as homelessness or lack of a support system

Going Against The Results

Sometimes, when patients show that they have undergone treatment for their psychological illnesses; whether they no longer abuse alcohol, or have taken control of their medical procedures, mental health practitioners will recommend that patients be allowed to undergo the surgery.

Patients who have been denied by one psychologist may seek a second opinion from another professional with experience working with bariatric surgery patients.

Because of the mental and physical stress that bariatric surgery places on a person’s body, preventative psychological tests and treatment are usually required before the surgery takes place.

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