Pre-Bariatric Surgery Evaluations
Frequently Asked Questions (FAQ)
Why do I need a psychological evaluation to get weight loss surgery?
Insurance companies ask for a psychological evaluation before weight loss surgery to make sure that you are making an informed decision about having surgery. Everyone who works with you wants to make sure that you are psychologically and emotionally ready to make the lifestyle changes that will ensure your longterm success for the years that follow your surgery. We do our best to make sure every evaluation is respectful and teaches you something about you or your surgery.
What kind of questions will I be asked?
Most questions are going to look at your motivation to lose weight, how much you understand about the bariatric surgery and the challenges you've faced with weight loss in the past.
Does having a mental heath diagnosis or past treatment keep me from getting surgery?
No. Having a psychiatric diagnosis or a history of psychotherapy/counseling or of taking psychiatric medicines doesn't mean you can't be successful with bariatric surgery. About 40 percent of bariatric surgery candidates have a history of depression. Depression is treatable with medication and/or counseling and should be controlled prior to weight loss surgery. Many people lose weight pretty easily after surgery, but they gain weight just a few years later. Sometimes it's because they're responding troubling emotions or relationships that affect the way they eat. If that is happening to you, then taking the time to learn about how to manage these factors can get you closer to the healthy life you're looking for.
Can I take back permission to send the results of my psychological evaluation if I don't agree with them?
No. Before your evaluation, you will be asked if you grant permission for us to send our report with recommendations to your surgeon whether you agree with them or not.
When will I meet with Dr. Foster?
After your testing is completed, you will have a face-to-face meeting with Dr. Foster, this interview usually takes 60-75 minutes. After that you are typically done. Sometimes the interview may lead to more testing, but the extra testing/screening is usually done that same day which is why we ask that you set aside 4 hours for the appointment when you're not evaluated online.
What if I fail the tests?
The types of psychological tests you'll be given are NOT PASS/FAIL. Sometimes they can be invalid (not usable), so please take your time and read all written test questions carefully.
Will I know what Dr. Foster's recommends to my surgeon?
Yes. In over 90 percent of the cases, if the testing is completed on the day of, or before your interview, the major recommendations that will be sent to your surgeon will be shared with you before you leave. If all the testing is not completed by the end of your interview, she will schedule a time to review the recommendations with you before sending them to your surgeon.
Can my surgery be delayed because of the findings from my psychological evaluation?
Possibly. If psychotherapy or a medication evaluation is recommended as part of your bariatric surgery preparation, you will be referred back to your surgeon with those recommendations. Sometimes the therapy is brief and may have no impact on your surgery schedule at all. Especially if you take charge of getting started right away. Less often, the recommendation is for longer-term treatment which could possibly delay your surgery. It's important to remember that there is a reason for each of our recommendations.
If I decide I want to learn ways to work on my eating behaviors, can I do that through Dr. Foster's office?
Dr. Foster has a developed a mindful eating program to help bariatric patients learn to respond successfully to cravings, to avoid emotional eating and to challenge the mindset that causes obesity. It might mean exploring things about the messages you received as a child about food and love and food and guilt. Everyone's history is different and holds s the keys to your relationship with food. Dr. Foster's program is structured and time-limited: it lasts 10-12 weeks. Dr. Virginia Longoria, psychologist with Arbol de la Vida psychological services also uses the mindfulness program and offers it in the same Mesilla office.
A personal note from Dr. Foster
"When Therapy is Recommended."
You have so many appointments already, it's hard to hear that still more has to be done before you can be approved for weight loss surgery. It can feel as if you did something wrong. As an evaluator who has conducted hundreds of these evaluations, I can tell you that it's hard for me to recommend MORE appointments. Especially since I know you've already taken a great deal of time to get GI studies, sleep studies, blood studies, and all the different appointments involved just to be approved for the procedure.
No evaluator that I've ever known, takes this responsibility lightly. By the time we tell you that you need therapy, it's really because there's a good chance you won't have long-term success with surgery unless important change happens.
Here are some of the ways that behavioral changes you learn in therapy can make a difference:
No evaluator that I've ever known, takes this responsibility lightly. By the time we tell you that you need therapy, it's really because there's a good chance you won't have long-term success with surgery unless important change happens.
Here are some of the ways that behavioral changes you learn in therapy can make a difference:
- Learn why you binge and how to stop– Patients with binge eating disorder (BED) don't lose as much weight after bariatric surgery as patients who can manage their eating behaviors.
- Lose weight before surgery – If you can get your weight down before surgery, you have a greater chance of keeping it off after surgery.
- Stop Alcohol and drug abuse - Addictive behaviors can take over your life and complicate the risks associated with bariatric surgery. It's best to get these problems under control, not just for your weight but your life.
- Treat Anxiety and Depression: patients who don’t address their mood symptoms can gain more weight back than those who do.
- Look in the Mirror: Some individuals with morbid obesity have a distorted body image known as dysmorphobia. While you may say that being fat is NOT beautiful, some individuals who suffer from obesity can't see any part of them as pretty or beautiful. I've seen patients with lovely faces lump their obesity and the rejection they've received from others in one big piece of baggage called, "Ugly." If you can't see the difference, between your fat and your beautiful smile, you might have dysmorphobia. And guess what? Surgery doesn't cure self-loathing.
Why Life-Style Changes Are So Important!
According to the LABS-2 study published in JAMA in October 2018, FIVE years AFTER losing their maximum weight, a percentage of patients still experienced negative health outcomes. For instance,
- 35% were diagnosed with diabetes
- 68 percent had high cholesterol
- 72 percent suffered from high blood pressure