Pre and Post-Weight Loss Surgery Mental Health Care: The Impact on Patients
Pre and Post-Weight Loss Surgery Mental Health Care: The Impact on Patients
Abstract: It is imperative for patients to maintain their mental health prior to and after bariatric
weight loss surgery, including how mindset, mental wellness, and emotional health can help
maintain weight loss post-surgery.
For many, the decision to undergo weight loss surgery took a great deal of support and
courage, as it had been a lifelong struggle for others. Some weight loss surgery patients discover
that surgery is one of the few evidence-based methods for maintaining long-term weight loss and
combating life-threatening diseases. According to the Centers for Disease Control and
Prevention (CDC), about “42% of American adults were obese in 2017-2018” (2021). Patients’
decision for weight loss surgery is due to comorbidity relative to “obesity-related conditions such
as heart disease, stroke, type 2 diabetes, and certain types of cancer” (Centers For Disease
Control, 2021). Mental and emotional health can affect obesity pre and post-bariatric surgery.
Due to behavioral and emotional aspects that may affect mental health stability throughout the
weight loss journey and be detrimental to future outcomes; a patient with unstable mental health
or particular psychiatric histories may not be an ideal candidate for weight reduction surgery
(Snyder, 2009). Maintaining good mental health after weight loss surgery is essential for long-
term success.
The bariatric surgery psychological evaluation is pertinent to understanding whether a
patient is ideal for weight loss surgery. According to Dr. Berman, Ph.D., they are intended to
determine risk factors that might compromise a patient’s ability to have a successful surgery and
post-operative adjustment (Schulz, 2013). Bariatric psychological evaluations are important to
identify “contraindications for surgery” and “to better understand their motivation, readiness,
behavioral challenges, and emotional factors that may impact their coping and adjustment
through surgery and the associated lifestyle changes” (Snyder, 2009).
A patient’s mental and emotional health can improve if they engage in consistent mental
health therapy as needed or address any emotional and mental health concerns that may affect
their weight loss progress. Another approach would be to identify eating triggers in order to
learn healthy coping skills for managing emotions related to or coinciding with eating, as well as
to address any core issues that may be related to the patient’s emotional eating or mental health
stability. Post-bariatric surgery and emotional health are just as important as pre-bariatric
surgery. Bariatric surgery necessitates lifestyle changes for various reasons. As a certified
bariatric counselor, I find it is important to encourage patients to begin lifestyle changes pre-
bariatric surgery. This will assist with preparing and familiarizing themselves with transitioning
into post bariatric surgery lifestyle changes. Engaging in lifestyle changes early on can help with
mindset and tackling any emotional or mental struggles early on. Support throughout the process
can be helpful as well, not only in attending classes and meeting with a dietician, but attending
bariatric support groups, friends and family support, and attending medical appointments as
recommended.
One of the most important things in terms of mental health when working with patients
considering bariatric weight loss surgery is to gain knowledge of their motivation to engage in
weight loss surgery. A strong motivation for surgery or a patient’s “why” can help with being
consistent with lifestyle changes long-term. Usually, this will help with maintaining the lifestyle
changes needed to have the success desired. This is critical because weight regain was detected
in nearly 50% of patients within 24 months following surgery (Magro, D. et al., 2008). It is
critical to have a level of commitment to grasp the preparations and lifestyle changes required,
such as healthy eating, keeping medical appointments, exercising or moving, and other
commitments in accordance with medical advice.
Patients may have a misconception of what the bariatric psychological evaluation is and
its importance in the weight loss surgery process. The majority of patients who undergo bariatric
psychological examinations are approved for weight loss surgery. It can be helpful when they
have the evaluation following completion of classes, meetings with a dietitian and their surgeon.
The patient then has a better understanding of the lifestyle adjustments that come with bariatric
surgery and what they must do to keep the weight off after participating in the pre-weight loss
surgery requirements. This makes for a smoother conversation during the evaluation when the
patient explains their understanding of weight loss surgery and lifestyle changes needed to
maintain progress (Goodpastor, 2019).
Risk factors such as binge eating or severe depression can have an impact on a patient’s
chances of success, and in those cases, mental health therapy can help with the lifestyle changes
that are recommended, as well as the emotional wellness that the individual requires, which is
critical in the process (Schulz, 2013). Due to the emphasis on physical wellness, patients may
lose sight of their mental and emotional health during the process. In terms of processing
lifestyle changes, processing traumas or concerns that may have resulted in overeating, depressed
mood, or anxiety, learning healthy coping strategies, developing strong supports, and addressing
mental and emotional health prior to bariatric surgery can be a preventative measure.
Maintaining mental health and emotional wellness pre and post-bariatric weight loss
surgery is pertinent to ensure positive progress throughout a patient’s weight loss journey.
During the bariatric psychological evaluation, patients are provided education and
recommendations to support and encourage them in maintaining the weight loss and lifestyle
changes. Patients who seek mental health counseling pre and post-bariatric weight loss surgery
can be proactive in weight loss maintenance by addressing emotional wellness issues that may
relate to eating habits, emotional eating, learning healthy coping skills, recognizing triggers, and
healing areas of concern.
If you are seeking a bariatric psychological evaluation and reside in New Jersey, I can help. I provide same-week appointments and next-day approval status faxed to your medical doctor/surgeon. I am a certified bariatric counselor and licensed professional counselor in the state of NJ. Performing bariatric evaluations for weight loss surgery approval is my specialty and helping clients transform their lives is my passion. For more information visit my bariatric specialty page here . You can schedule your appointment directly from our website or give us a call at 856.441.5216.
References
1. Centers for Disease Control and Prevention. (2021, February 11). Adult Obesity Facts.
Centers for Disease Control and Prevention. https://www.cdc.gov/obesity/data/adult.html.
2. Schulz, K. (2013, September 13). Concerns about Psychological Evaluations for
Bariatric Surgery Patients. Bariatric Times. 2013;10 (9):24-25.
3. Goodpastor, K. Far from the Easy Way Out: Early Psychological Complications of
Bariatric Surgery. Bariatric Times. 2019; 16 (8):10-11.
4. Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight
regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008 Jun;18(6):648-
51. doi: 10.1007/s11695-007-9265-1. Epub 2008 Apr 8. PMID: 18392907.
5. Snyder AG. Psychological assessment of the patient undergoing bariatric surgery.
Ochsner J. 2009;9(3):144-148.
Author: Rosana Lamontagne, LPC, CBC
Author Affiliation: Ms. Lamontagne is a Licensed Professional Counselor and Certified
Bariatric Counselor. She is the owner and therapist at 4th & Grove Counseling in Sewell, NJ
specializing in trauma therapy and bariatric psychological evaluations.
Funding: No funding was provided
Financial Disclosures: The author has no conflicts of interest relevant to the content of this
article.
