A report published in The American Journal of Medicine (AJM) lends additional support to the discovery that people who receive bariatric surgery have a suicide rate that is greater than the average.
This is not to imply that weight-loss surgery itself is a catalyst to suicide, because there is no convincing evidence to support this. The fact is that at this point in time there is no concrete explanation to the increased prevalence of suicide in obesity surgery patients.
What was established in a prior study, unrelated to the AJM study, is that two-thirds of the subjects who desired weight-loss surgery had a psychological disorder. A somewhat logical assumption that is being investigated is that the higher than average suicide rate among bariatric patients is due to conditions that existed prior to the weight-loss surgery procedure. Depression and anxiety are common among people who seek any weight-loss surgery.
What need be understood at this point is that there is not a landside of suicides among bariatric patients. Of the more than 16,500 individuals who had bariatric surgery in a nine year period, thirty-one committed suicide. While this is not an overwhelming percentage, suicide is always tragic and oftentimes preventable. One of the thoughts to decrease this sad outcome is to extend the follow-up period after weight-loss surgery. The current follow-up period is about six months after weight-loss surgery, and most suicides among bariatric patients happen after that length of time.
Psychological testing is done prior to any bariatric surgery. A candidate's history of psychological illness does not constitute immediate preclusion. Even those who have such disorders as schizophrenia, bipolar disorder, or anxiety disorders may be allowed bariatric surgery provided the illness is reasonably controlled and is counseled by a mental health professional before and after the bariatric surgery procedure.
Psychological Evaluations for Bariatric Surgery: What to Expect
If you are considering weight-loss surgery, a psychological evaluation will be done; therefore, here is an overview of what you can expect:
The evaluation will be administered by a qualified professional.
Testing instruments may include an Audit-C alcohol screen to determine if the person seeking bariatric surgery has any hazardous drinking habits or active alcohol disorders.
A drug abuse screening test to determine if a prospective bariatric patient is abusing substances other than alcohol may be conducted.
A Millon Behavioral Medicine Diagnostic (MBMD) test will assess a person's psychological preparedness for bariatric surgery. The MBMD test was created specifically for medical patients and is divided into the five domains of psychiatric indicators, coping styles, stress moderators, treatment prognostics, and management guide.
In addition, a Multidimensional Health Locus of Control (MHLC) test measures either general health conditions or specific health conditions using rating scales. The conditions measured are dependent on the form that is used (form A, B, or C).
And there is a questionnaire on the prospective weight-loss surgery patient's weight and eating patterns.
Psychological Evaluations for Bariatric Surgery: Criteria for Exclusion
Criteria for considering patient exclusion from bariatric surgery are as follows:
An active psychosis defined by current evidence that the psychosis is, in fact, current, or hospitalization for the psychosis within the last year may exclude the prospective patient from receiving bariatric surgery.
The prospective bariatric patient also may be denied weight-loss surgery if there have been multiple suicide attempts in the last five years.
Evidence of an alcohol use disorder in the last five months or evidence of a substance use disorder in the last five months may rule out the candidate from getting any weight-loss surgery approved.
And a person with borderline personality disorder or a history of inability to adhere to a medical regiment may be ruled ineligible for any weight-loss surgery.
Psychological Evaluations for Bariatric Surgery: What to do if You're Disqualified
"Do they think I'm crazy?" No; they do not. If you are seeking weight-loss surgery and any of the above scenarios pertain to you, hope should not be abandoned. In most instances, the solution is correction. The greater possibility is that any necessary corrections can be made with the assistance of mental health professionals and a support network.
If you engage in the necessary labor then the possibility for the desired bariatric surgery approval increases dramatically. In other words, you will get from it what you make of it. In my opinion, it is worth the effort. I suffered greatly from depression for a very long time. And now my life after weight-loss surgery is wonderful. Good luck to all.
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You can read about my decision to have weight loss surgery back in 2003 and my journey to maintain a lifetime of obesity disease management since that time. My wish is to help you on your own journey of lifetime obesity disease management with shareposts along the way to help you navigate that journey successfully.
Published On: February 16, 2012