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Psychological Factors


By Dr. Mike Oliver

Many patients are surprised to learn that a psychological evaluation is a requirement for bariatric surgery. It may seem like an unwelcome, unnecessary detour on the journey to a new you.

Surveys indicate that 88 percent of bariatric surgery clinics require a mental health evaluation. This is because many of the variables associated with readiness for surgery and ability to adhere with postoperative requirements are behavioral in nature. Nevertheless, patients may feel nervous about meeting with a psychologist and may be left with a number of questions. I wanted to share some information regarding the purpose of the evaluation and what you may expect during the evaluation.

Perhaps it is most important to clarify what the evaluation is NOT intended to do. We are not interested in uncovering psychological problems or conflicts which may have “caused” obesity. The evaluation is also not intended to “pass” or “fail” patients for surgery. A recent review article indicated that fewer than 4 percent of patients are declined for bariatric surgery based on findings from the psychological evaluation.

Patients with very severe psychiatric disturbance are not considered optimal candidates for bariatric surgery, but these patients will almost always have been identified by other means and are never even referred for psychological evaluation.

So why are we doing this?

The main purpose of the evaluation is to learn about you as an individual so that Dr. Pinson and other members of the team can best assist you to achieve success! We all have strengths, weaknesses and preferences, and information from the evaluation helps us to approach patients in the most effective way. We use standardized “tests” because they generate a profile for comparison to large reference groups of bariatric surgery patients.

Formal measures help identify areas which may warrant increased monitoring or intervention. Patients may be asked to address potential barriers to success as a component of their preparation for surgery.
For example, a depressed patient who has become discouraged and stopped his antidepressant might be referred for resumption of medication therapy or to see a counselor.

The evaluation involves an individual meeting followed by completing a number of survey forms, questionnaires and true/false inventories. Some of the inventories are lengthy and may have items which appear odd or irrelevant. Unusual items may be present simply to make sure patients are carefully attending to item content. During the evaluation, keep an open and honest approach. Feel free to ask questions and remember that feedback from the evaluation is always available. Having the evaluation available at the Bariatric Clinic is a great advantage.

Remember, we are all on your side and want to help you achieve a fantastic outcome!