The necessity of a bariatric surgery psychological evaluation is not apparent to all patients and hence many of them feel stressed when it comes to this step of their bariatric assessment. I have prepared this article with the aim of helping you have a clearer understanding of this psychological assessment as one of the major parts of your pre-surgery experience.

Why Bariatric Surgery Psychological Evaluation Is Necessary?

Weight loss surgery is not an overnight decision. Most obese patients spend months and even years researching and evaluating in order to make the best decision. The more you know about bariatric procedures, the higher your chance of success is. But there is some information about you yourself that may not be easy for you to collect. This is when a psychiatrist comes to your help to better understand your aims in addition to your psychiatric conditions.

Are You Mentally Ready for the Surgery?

As I’ve said many times in all my articles, both the short and long-term success of your surgery depends to a high extent on your commitment to your new post-surgery lifestyle. According to a study by Dr. Allison G. Dynder, a clinical psychologist, psychological evaluation of candidates helps the psychiatrist and bariatric surgeon to better understand the readiness of patients.

During this clinical assessment, a psychologist, a psychiatrist, or mental health professional who is familiar with bariatric surgery procedures examines patients from a psychological perspective and realizes their motivation, readiness for surgery, and all the mental factors and behavioral challenges that could cause success or failure or surgery.

These factors reveal whether patients can make any required adjustment through surgery and the necessary lifestyle changes. Also, this includes psychosocial evaluation of patients as well. So, they might need to know about the social consequences of obesity in your life too.

Psychological Support Both Before and After the Surgery

In your pursuit of improved quality of life and mental and physical health conditions, a proficient bariatric psychologist must accompany you from the very beginning of this journey to months or sometimes years after it.

After examining your mental situation, their main responsibility is to target your mental worries and trying to take a load off your shoulder by educating you. The more you know about this psychosocial assessment and how you should handle its challenges, the more relaxed you will feel.

If bariatric surgery candidates need therapy prior to weight-loss surgery, they will be provided with psychological treatment to achieve the best bariatric outcomes.

Beware that this clinical assessment is not the same for all patients. But it is important that you have a positive experience and be able to build a trustful relationship with your psychologist because if you pass this state conveniently, later, when you will experience the psychological negative effects of bariatric surgery including mood swings, you’ll feel more comfortable to share your thoughts with them.

No one can provide you with sufficient psychological support like an expert.

Sections of a Bariatric Surgery Psychological Evaluation

Even though this test seems very frightening, it will lessen your stress if you know what it contains. The questions the psychologist asks helps them gather useful data on your behavioral and emotional status. In addition, your motivation and expectations must become clear during the assessment too as their necessary domains for assessment.

– The Behavioral assessment covers aspects mostly related to your previous attempts to lose weight and nonsurgical treatment of obesity, eating, dietary habits (like overeating), frequency of physical activity, and your capacity for taking risks when it comes to health and psychological issues. 

– To examine your cognitive and emotional readiness, the psychologist makes sure whether you know everything about weight-loss surgical procedures, alongside the associated risks. In simple words, they want to make sure whether you know what you are agreeing to or not.

Also, they will want to know how familiar you are with the dangers of severe obesity, the causes of morbid obesity, in addition to your reaction to psychosocial factors that could cause you emotional, mental harm.

– Some psychiatrists ask bariatric surgery patients questions about their developmental history. This information helps them discover your family history, the traumas of your life, history of depression, and your critical ups and downs. Many obese patients suffer from childhood traumas, like the history of abuse or sexual abuse in the early ages, which caused them eating disorders in their adulthood. These obstacles challenge patients when it comes o adjusting to their new healthy lifestyle.

– Ultimately, you are asked questions about your current life situation, the stressors that noticeably affect your life, and the emotional support you get from your family and friends. More importantly, what is your motivation and expectations?

Here’s a more detailed overview of what psychiatrists ask during the assessment of candidates:

bariatric surgery psychological evaluation

Who Might Fail a Weight-Loss Surgery Psychological Evaluation?

This question is basically wrong because this test is not a kind of pass or fail. Its main goal is for you, your surgeon, your psychiatrist, and the whole bariatric surgery team to recognize the potential challenges you, as a bariatric patient might face in the future and try to prevent them as much as possible.

If patients are excluded from surgery just because of eating disorders, no one can undergo weight-loss surgery because let’s face it, most of the obese patient population suffers from eating disorders like anxiety eating.

If there’s any serious concern, your psychologist will share it with you and work on a solution to prepare you for the surgery. If a specific treatment is needed, you’ll be given recommendations. However, there are some rare cases that surgeons refuse to perform surgery on until they are assured there is no danger for the patient and they’re mentally ready.

– Hospitalization due to mental health issues over the course of last year

– Previous suicide attempt, more than once

– Uncontrolled severe anxiety disorders

– History of not following medical instructions

– Not controlled, serious personality disorders

– Alcohol or active substance abuse within the last 6 months

– Not controlled mental illness

– Severe eating disorders

– Not enough self-motivation

Beware the final decision depends on your surgeon’s decision.

How to Pass a Pre-Bariatric Surgery Psychological Evaluation

That is the main question most patients have before their pre-operative psychological testing. But the truth is if you don’t have severe psychiatric disorders, there is no room for extra worries. And it is not like they want to fail you for no reason but they should be sure you are ready. For instance, if you have not controlled bipolar disorder, the aim of this evaluation is not to exclude anyone from the weight-loss procedure but to make sure they will be mentally healthy during their post-operative life.

The psychiatrists who are responsible for evaluation prior to bariatric surgery are usually specialized in health psychology and do their best to help you maintain healthy in the future and experience the best postoperative outcomes.

So, you only need to do one thing: tell them the truth. Do not hide your psychiatric history from your surgeon and bariatric psychologist. Even if they identify you are not ready for surgery, they will do their best to help you complete all the stages of preparation for surgery and become mentally ready for the procedure.

So, no worries. Just tell the truth and be yourself. Tell them all the difficulties that are affecting your life because of extreme obesity, all the psychosocial stressors that do not let you be as happy as you deserve.

And be sure everything will be ok!