While many people are aware of the medical evaluation necessary to assess suitability for weight loss surgery the need for a psychological evaluation for gastric bypass surgery is often overlooked. But the psychological effects of gastric bypass surgery can be considerable and bariatric surgery psychological evaluation is increasingly being seen as a necessary pre-cursor to any surgery.
For many severely obese people gastric bypass surgery is the answer to shedding excess weight when a program of diet and exercise has failed to work, but it is certainly not an easy option and produces very different outcomes from one patient to the next.
There are many surgical options available today from a full gastric bypass involving the reduction of the size of the stomach and bypassing part of the intestine to both restrict the quantity of food eaten and the absorption of calories from that food to lap band surgery which merely reduces the size of the stomach to once again restrict the quantity of food which can be consumed.
Whatever form of surgery is performed the basic principle is to force the body to burn off more calories than can be absorbed and so to reduce weight by burning off the body’s fat reserves.
The real problem with weight loss surgery however does not lie in the surgery itself but is seen in the weeks, months and years following surgery when patients find that their lifestyle has to change dramatically and that they have to adjust to a whole new eating regime. For many patients this is hard work but for some it can bring severe problems which are simply too much for them to cope with.
There are many different reasons for obesity but two common problems serve to illustrate this point.
The first is the problem of those people whose obesity has been caused, or exacerbated, by emotional eating. In this case people turn to eating whenever they find themselves under stress or when their emotions are low. Emotional or comfort eating is a very strong habit which is difficult to break and the psychological pressures which frequently follow weight loss surgery are just the sort of pressures which will trigger the desire for emotional eating in sufferers.
The second is the problem of those people who are prone to binge-eating and the uncontrollable depression, disgust and guilt which often follows binge-eating episodes. It is only too easy to imagine the extreme difficulty that such people will experience in trying to cope with the major lifestyle changes following weight loss surgery.
When these and other factors are taken into account it is perhaps not surprising to discover that about twenty percent of people being considered for gastric bypass surgery are not suitable, or perhaps more accurately not ready, for surgery and this is where psychological assessments for morbid obesity come into their own.
A great deal of attention is paid to the need for patients to meet the physical requirements for surgery (in terms of such things as their body mass index and the presence of other medical conditions associated with their being overweight) but all too often only lip service is paid to very real psychological problems associated with surgery. If surgery is to be given the best possible chance for success then it is vitally important to pay close attention to the psychological needs of patients and to provide them with pre-operative assessment, counseling and, most importantly, psychological obesity treatment.