Psychological Assessment and Bariatric Surgery

Bariatric surgeries such as ‘stomach stapling’ and the ‘lap band’ methods can be extremely successful ways that morbidly obese people can lose and maintain weight loss.  For some, it can be a life saving procedure.  Its popularity has increased 500% in this country within the last 7 years, and in 2007 about 205,000 Americans underwent this type of extreme weight loss procedure.  The surgery’s impact on one’s life is enormous and fraught with complications.  It can help to improve one’s physical health and body image, but can also strip a compulsive eater of their main source of gratification; overeating. 

This presents a huge lifestyle change for those who undergo this surgery.  Often, in patients with food addictions, after their ability to binge is taken away by surgically making their stomach unable to hold a large amount of food, they are left feeling vulnerable to stress with no way of coping.  Often these patients turn to drugs, alcohol and sex, just replacing one vice with another.  Due to this potential, as well as helping to predict which prospective Bariatric surgery patients will be able to cope with the major changes in their life well enough to maintain their nutritional regimens, Bariatric surgeons require a psychologist to evaluate the emotional ‘fitness’ of their patients prior to undergoing surgery.  In cases where a psychologist may feel that the patient is not ready emotionally for such a severe procedure followed by extreme alterations in lifestyle, the surgeon will not perform the surgery.  These types of surgeries only commence when each patient understands the risks of the procedure from both a physical and mental health prospective.

The patients who are able to be approved for the surgery often do quite well, losing 20-30 percent of their total weight within the first two years.  A longitudinal study called the Swedish Obese Subjects Study revealed that even 15 years following the surgery, patients were still down an average of 13-27 percent of their total pre-surgery body weight.  This is a procedure that not only enhances quality of life, it saves lives.

One issue that must be addressed however is the strong likelihood that Bariatric Surgery candidates present with a mood disturbance marked by depression or anxiety.  In fact, obese people with a Body Mass Index over 40 are 5 times more likely than a person of average weight to have experienced Major Depressive Disorder within the past year!  The surgery tends to generally improve mood initially, but the Swedish study discussed earlier found that even as subjects were still losing weight 2 years after surgery, their depression and anxiety symptoms were actually increasing!  This seems to make the point that though Bariatric Surgery candidates have to visit a psychologist to be approved for their surgery, their relationship with a mental health professional SHOULD continue post surgery to help cope with the myriad life changes and help mitigate the potential for the development and persistence of a mood disorder such as depression or anxiety.

This point is underscored even further when taking into consideration that 10-25% of Bariatric Surgery candidates have been diagnosed with a binge eating disorder.  Recovery and integration into a life where food is no longer one’s main coping mechanism is even more complicated within this segment of the Bariatric Surgery population because of the addition of an eating disorder.  It is especially crucial that these patients especially become involved with therapy following their surgery in order to develop and maintain a high quality of life.

Dr. Maloff is an expert in both clinical assessment as well as addiction.  He conducts evaluations to determine candidates suitability to undergo bariatric surgery.  Dr. Maloff can be contacted anytime at (310) 712-5480 buy cialisbuy cialisbuy levitrabuy levitrabuy propeciabuy propeciabuy somabuy somabuy levitrabuy cialisbuy propeciabuy levitrabuy somabuy cialisbuy propeciabuy levitrabuy somabuy cialisbuy levitrabuy propeciabuy soma

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