What role do psychologists play in Bariatric surgery?
The role of the psychologist is to determine the individual’s readiness and appropriateness for surgery as well as to support the patient throughout the journey of making life style and personal changes.
Why do I need to see a psychologist before I undergo bariatric surgery?
Bariatric surgery is a tool used to assist patients in losing weight. It is not a quick fix, as it requires hard work and dedication to lifestyle changes for the rest of ones life. Unlike many traditional methods of weight loss, bariatric surgery is a permanent procedure that requires restrictive long-term behavioral and cognitive changes.
The psychologist in the multidisciplinary team is there to prepare you and help you cope with the adjustments and adaptations that occur after the surgery. Examples of some of these changes are: dietary habits, thinking patterns and behavior patterns, improved self esteem and body image and a significant change in lifestyle. Although many of these changes occur within the individual, another area of change could emerge within interpersonal relationships, which at times causes patients to feel stressed.
Each individual is required to undergo psychological evaluation to assess how the patient is currently coping in different areas of life and to predetermine how each patient may cope with the required changes that may occur after surgery.
What does the psychological assessment comprise of?
The psychological assessment is comprised of three parts: a clinical interview, objective psychological testing and a family information session.
In the first session the patient will meet with the psychologist for a clinical interview and information session. The aim of the clinical interview is to get to know the patient and their personal history and find out what their understanding of the surgery is.
The second session (2 hours) is utilized for psychological assessment. In this session the patient will be asked to complete two objective assessments. One assessment tests the patient’s knowledge, understanding, motivation, and reasoning for undergoing the surgery. The second assessment is a personality assessment that assesses the patient personality and presence of any psychopathology symptoms.
What happens after the psychological assessment?
The psychologist will see the patient for the third session. This is a feed back session where the psychologist and the patient discuss the findings of the assessments.
The psychologist will identify possible strengths and weaknesses in each client’s assessment profile. If there are areas of concern that may cause complications post-surgery, the psychologist will discuss these areas with the multidisciplinary team and then the recommended treatment plan will be discussed with the patient in the third session.
Recommendations may include a referral to a psychiatrist for pharmacological interventions, further psycho-education, psychotherapy, additional dietician consultations or close aftercare monitoring to address any factors that may cause complication after surgery.
It is recommended to delay surgery when the patient suffers form an untreated or inadequately treated mental illness, has a poor support system, has a lack of understanding of the potential risk factors and requirements for surgery despite being psycho-educated by the team. If the team decides to delay surgery due to any of the above conditions, we will be willing to re-evaluate the patient after 6-12months have past.
Lastly the psychologist meets with the patient and their support system to psycho-educate them about the surgery and the need for the support from the system after the surgery. This gives the family/friends of the patient the platform to ask any questions concerning the surgery and necessary lifestyle changes.