Why I might need to see a Psychologist before or after my surgery?

Most patients (66%) have a history of psychological disorders, mainly depression and compulsive eating.  Substance abuse disorders have been diagnosed in a sizeable minority (8% illicit drug use, 11% alcohol use).  Some patients may experience the onset or recurrence of psychological disorders after operation. Uncontrolled overeating is related to weight regain at long-term follow-up.

Psychological disorders tends to improve after weight loss surgery. Severe obesity results from a combination of many factors that come slowly together like the “perfect storm” that never ends. Compulsive eating is a common eating disorder and plays a major part in gaining weight, but also in poor outcomes following weight loss surgery.  Just as many compulsive eaters can defeat diets, the nature of their eating disorder can defeat the purpose of the surgery. Weight loss surgery makes it more difficult to eat large quantities in this way, but it does not make it impossible and it does not make the compulsion to eat disappear. This is why some compulsive eaters will regain much of the lost weight at about ten years after their surgery.

With psychological screening, we can have a general sense of who is more likely to do well and who might do poorly after the surgery, but we cannot predict this with any certainty.

Individuals need to be stable from a psychiatric perspective defined by:

  1. No hospitalizations for psychiatric reasons for at least 1 year.
  2. No suicide attempts for at least 1 year
  3. Compliant with recommended psychiatric pharmacotherapy

The bariatric surgeon may decide to refer you to a psychologist before your surgery. The reason is to ensure that we have a baseline of your psychological state so as to better help you after the surgery.

After the surgery, may require follow-up with our bariatric psychologist for several reasons. These include compulsive overeating, body image dissatisfaction, marital and sexual issues, “Addiction Transfer”, and suicidal tendencies.