Mental Health and the Bariatric Patient

Patient Expert

There are a number of issues that the bariatric patient will need to address before and after gastric bypass surgery. Prior to gastric bypass surgery, there will be an evaluation to determine the patient's overall physical condition and assess whether the individual is an appropriate candidate for weight loss surgery.

The patient will not only establish an intimate relationship with the surgeon but also will interact directly with a team of professionals who will address nutrition and diet, vitamin supplements, and a program of exercise.

A mental health professional also may be a member of the treatment team due to the point that many individuals seeking gastric bypass surgery may have pre-existing psychological issues that gastric bypass surgery cannot address. Weight loss cannot remedy major depressive disorders, bipolarity, or schizophrenia although any of these disorders may accompany a condition of morbid obesity.

I myself suffered with depression and disordered eating prior to having gastric bypass surgery. For me, making significant lifestyle changes that included the surgery, a support group, a new healthy way of eating, exercise, plus a few other small changes, completely turned my life around. My life after weight loss surgery truly is wonderful.

Psychopathology and the morbidly obese

Research has shown that psychopathology is no more prevalent among the morbidly obese than it is among the general population with the exception of binge eating. Three percent of obese individuals meet the criteria for binge eating as compared to 1.5 percent of the general population.

While there is no criteria for screening out gastric bypass candidates with psychological disorders, those who may be denied surgery or experience delay are people who engage in illicit drug abuse, those who use alcohol heavily, those who suffer from severe mental retardation, those who have uncontrolled symptoms of schizophrenia, and those who lack knowledge about surgery.

People seeking a gastric bypass operation will be required to have a psychological evaluation. While contraindications to surgery are a reality, pre-surgery assessment and consultation also provide insight regarding barriers to success and what need be done in the post surgical follow up.

Mental health issues hardly constitute immediate denial for gastric bypass surgery.

Psychological health issues

Bariatric patients may have limited social support due to limited interaction with cohorts because of social stigmas associated with obesity. Social isolation contributes to a life stress that promotes depression and diminishes a sense of identity among the shared community.

Poor coping skills may also be an issue for bariatric candidates. Their loneliness and boredom are triggers for overeating, and when the food is no longer an outlet, the potential for mental illness increases.

Counseling for bariatric patients

Professional counseling of the bariatric patient can help improve mood and establish functional coping skills. Stress management techniques can also be taught to the patient.

The non-judgmental support given by the counselor can serve to establish and enhance relationships among those who share an understanding of what it is to be a bariatric patient and the issues it involves.

A sense of belonging can be promoted to provide the purpose and sense of community the bariatric patient needs to best address the challenges of post-surgery maintenance as well as any comorbid mental health issues the patient might have.

Support groups

Although psychological issues need be addressed with a qualified healthcare professional, support groups can be a good adjunct to therapy. Just about all bariatric surgeons offer a free support group for people seeking or who have had weight loss surgery. And many online support groups exist for weight loss and bariatric surgery. Overeaters Anonymous is another free or low cost support group for people who desire to stop compulsive overeating.