Aside from the very obvious ramifications of obesity on your physical health, appearance, activity level, etc., it also has a codetermined relationship with mental health. This means that obesity leads to an increase in a wide range of mental illnesses, while, at the same time, mental illnesses also often lead to obesity.

Obesity is becoming more widespread in society, especially with the COVID pandemic, as it increased obesity rates substantially across the developed world. And a substantial number of people who can’t lose weight through natural means of dieting and exercise are resorting to weight-loss surgeries.

The most effective weight loss surgery out there for obese people is bariatric surgery, but as obesity also has mental health dimensions and bariatric surgery is major surgery with a substantial recovery time that transforms the body of the patient, it has become standard in the industry to require a psych eval to make sure the patient is mentally prepared for the surgery.

In this article, we’ll go over what the psych eval will involve, what disqualifies a patient from undergoing surgery, and all other information necessary to learn how to pass a pre-bariatric surgery psychological evaluation.

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What is the Aim of Psychological Evaluation for Bariatric Surgery?

Although a psych eval has become standard (and in some countries, required by law) before bariatric surgery, there’s still no accepted standard regarding the substance of the psych eval. This means it varies substantially from one clinic to another, but you can predict how the psychological evaluation will be carried out if you learn what’s its purposes specifically: 

  • One of the aims of a psych eval is to pinpoint any psychosocial barriers to the surgery’s success and the post-op recovery phase. For example, if you have a binge eating disorder, you might have a lot of difficulty following the strict post-op diet prescribed by the doctor, and this will cause you a lot of discomforts. 
  • Another of its aims is to identify whether bariatric patients will benefit from psychiatric/psychological help before they undergo the surgery. If a psychiatrist can help a patient overcome their eating disorder, for example, this will only improve the results of the surgery. 
  • Lastly, a psych eval aims to identify the bariatric surgery candidates that will need additional support after the surgery. This is important to ensure the vulnerable patients’ mental health doesn’t deteriorate post-surgery ensuring better weight loss and improved lifestyle.

What Conditions Can Disqualify Bariatric Surgery Patients from Undergoing the Weight Loss Surgery?

A failed psych eval for bariatric surgery mostly happens due to the patient suffering from a specific disorder. If you suffer from any of the disorders below, you won’t be considered viable for the surgery:

  • Substance abuse: substance abuse makes it harder for post-op recovery to be successful, so people who suffer from substance abuse can’t qualify for the surgery. Seeking help months prior to seeking surgery will improve your chance of passing the psych eval substantially. 
  • Recent history of suicide attempts: the surgery can put substantial strain on you both mentally and physically, and if you’ve attempted suicide in recent history, you can’t undergo the surgery. Again, seeking help prior to the bariatric psych evaluation and making sure you’re no longer vulnerable will improve your chances. 
  • Having psychosis: people who have psychosis generally can’t think clearly about life-changing decisions, which makes it harder for doctors to get their informed consent on such an invasive surgery. 
  • Being admitted to a psychiatric hospital recently: most cases of people who have been admitted to a psychiatric hospital in the last year are disqualified from taking the surgery.
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Psychological Conditions You Might Suffer from After Surgery

Although weight loss surgery is safe, widely practiced, and extremely well researched, it still has side effects. For some people, they include psychological conditions/disorders. If you’re already prone to the conditions below, you have to take that into account: 

  • Body dysmorphia: the surgery will make you lose a substantial amount of weight in a relatively short period, and this might create incongruence between your mental image of yourself and what you’ll actually look like.  And although this often disappears with time, it can cause issues for some people, especially those who are already prone to body dysmorphia.
  • Mood disorder: there are many reasons people experience mood swings post-surgery. Just being unable to go outside or to work for two weeks might induce a temporary depressed mood in some people. Some people forget to take their daily multivitamin and mineral supplements (which are necessary for the production of mood-regulating hormones), and they experience mood swings this way. Others will suffer from mood disorders simply because they have to follow a strict diet for months. Regardless of the reason, if you’re already prone to mood swings, you need to be careful. 

How to Pass a Mental Health Evaluation

If you want to pass the bariatric evaluation, there are some easy steps you can take to improve your chances: 

  • Make sure you read up on what the psych eval will entail: since you’re already reading this article, you’re on the right path. By learning the reasons for the psych eval and what it entails, you’ll be less nervous and better able to respond when the time comes. 
  • Take care of your mental health starting today: since the biggest impediment in front of you not passing the psych eval, you should make sure you take care of your mental health right now. By learning to regulate your mood better and getting a better handle on your disorders, you’ll substantially increase your chances of passing. 
  • Make sure you’re mentally prepared and aren’t nervous before the eval: as with most tests, being in the mindset and adequately preparing does influence whether you pass the test or not.

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    Author: Mgr Katarzyna Dera-Szymczak

    Katarzyna Dera-Szymczak, MSc, belongs to the Bariatric and Laparoscopic Surgery Team. She is a specialist in the field of clinical psychology

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