Many people seeking bariatric surgery have never used mental health services before at all and most don’t understand why they are needed before this kind of surgery. You may have heard that the evaluation was an insurance requirement. That is often the case now but was not universal 15 years ago. I met a surgeon who was interested in helping his patients get proper psychological care before, during and after surgery. He had seen severe medical consequences when patients could not properly follow instructions after surgery. Moreover, he had seen clients’ lives break down following surgery – divorce and depression, sometimes with suicidal thinking. I still remember the look on his face when the topic came up – sad eyes and a worried brow. He wanted all his patients to succeed and do well.
That’s how we feel as health care providers. We know that this surgery is a life-changer requiring commitment from patients and their families. When we psychologist perform an evaluation we are looking at readiness for the surgery and if someone is not ready psychologically we are looking for concrete solutions to help them get ready.
I remember one of my individual therapy clients was referred by another psychologist after “failing” the psychological evaluation. We spent about 8 sessions talking about how she began compulsive overeating when her mother became terminally ill. Several years after her mother’s passing there were still issues between her and her siblings over the modest inheritance. After talking through things she felt able to put emotional and eating issues to rest and was open to a new chapter in her life. She admitted being very angry at the psychologist evaluator in the beginning but planned on giving him a big “thank you!’ the next time she saw him.
I hope my stories help you understand why we do what we do as psychological evaluators. For more specific information, the Obesity Action Coalition has several articles related to bariatric surgery and other topics for coping. You may want to check it out.