Psych consult

[Ruthie1974 34]

So I did my psych consultation yesterday, after working all night and staying up till 11am (my appointment time) If the doc did not find me a little off I am REALLY suprised! Did anyone else find the psych part of it a complete waste of time? I mean most of us don't go into this thinking it is a quick fix or one that does not require lifechanging eating and exercise....what is the deal with the psych consult anyway. I really don't get it.:cursing:

[mimi368 0]

Hi Ruthie! My psych consult is tomorrow and I have been nervous about it. I just don't know what to expect from it.

[cwm812 11]

I thought the psych consult was a complete waste of time and money. I spent an hour filling out a questionnaire with questions about whether or not I thought my hips were too big. Well of course they're too big, I weigh 350 lbs!!!. It really wasn't hard or painful, but I can't imagine any other demographic group having to have a psych consult to get corrective surgery. Does any insurance require a psych consult before a breast reduction? I have no problem with psychologists. I have even gone to them for various problems throughout my life, but as a condition of this surgery, it's demeaning to have to prove that you are competent to be of normal size!

I realize I'm ranting, but I hate when we waste our medical resources in this country. There are lots of people trying to schedule appointments with mental health professionals who are busy wasting their time talking to normal people trying to get healthy!

Cindy

[4Sammy 0]

"I hate when we waste our medical resources in this country."

AMEN!! I almost fell over when I saw that my sleep study was $3300. And I don't even want to know what the psych evaluation cost, since it was 2 hours of listening to the True Results psychologist (who admitted that he didn't even have to take Psych 101 in college!!) talk about his own struggles with weight and smoking.

Anyway, just trying to keep my eyes on the prize . . .

[shonette 9]

I feel the same way all of you ladies do about my psych appointment scheduled for tomorrow. It really is a waste of my time and money. Why in the world do someone need to tell me what my thoughts or feelings need to be concerning my over weight condition. I know that am over weight and that is why am doing something about it. In my own personal opinion, it is just a money thing. I really hate to feel that way but ladies I do. I refused to do my sleep study because it is not required by my insurance company so absolutely not! Am willing to do only those things that I have to do and nothing more. My doctor states it would help my chances of being approved. When they see my BMI and other weight related conditons that alone will be all the help I need to be approved. Once I complete the six month monitored diet, they will have to approve me no matter what. That is another thing that is truly a waste of my money and time.

[kagead 0]

My psych consult seems to have been very different than what many here experienced. I met with the Dr. for about an hour and we talked that entire time.

He asked general questions about my childhood, family relationships and social activities. He asked how I reached the decision to have surgery. He wanted to know if I had told anyone about my plans for surgery and if so, what the reactions had been. He asked if I felt I had the support network in place that I said I needed (I do.)

Then he asked me what my personal challenges were related to food and dieting. He asked me to tell him what I knew about the procedure (and was surprised I knew as much about the technical aspects as I did about the emotional ones pre and post op.)

We came up with a couple "immediate action" steps I could take to curb some of the worst habits (skipping meals, eating too fast when I actually do eat) and some longer term goals.

After we met, he did hand me a 20 question form, and I filled it out before I left the office. It asked somewhat general questions (IMHO) about my mood, confidence, activity level and the like.

As an aside, my insurance, which is covering the procedure, only covers 50% of mental health services, even when in-network. I am self employed on a individual plan with BCBSIL.

Hope this info helps someone out there!

kagead

[SoccerMomma73 1,867]

Just one more benefit to being self pay I guess, no psych consult! Woohoo!!! In medicine we call it CYA (cover your a--) medicine. I'm sure there's one person out there somewhere who had the procedure expecting the magic quick fix, didn't do what they were supposed to, got stuck, slipped band, etc and then tried to sue their doctor so they all freaked out and started requiring the psych eval.... Just a theory.

[vaneezy 0]

I too had a good experience with the psychologist. I believe the main goal of the psychologist is to see whether one understands the ramifications of the surgery. My psychologist went over the obstacles that I might face with family and friends. Sabotage and things of that nature. Additionally, some people are not realistic in their goals when they get this surgery. If you are an emotional eater, this surgery will not cure that. It will not make you feel better if you are a depressed person to begin with.

He also said that some people, women in particular, begin to feel vulnerable when they get this surgery. They are no longer ignored and receive a lot of attention as they start to lose weight. Some of the women began to take self-defense classes.

It might seem like a waste of time and money, but I think that there are some people who really need it. I didn't think I would need it, but I felt so much better after speaking with him.

[mimi368 0]

That makes me feel better knowing that some of you had such positive experiences. Hopefully mine will be too!

[Ruthie1974 34]

First, thanks for everyone's thoughts, ideas, and comments! I hope that everyone has a better experience than I did with the psych consult, but honestly I have had better support and information from this forum than I received by a "professional" and I really appreciate it. I agree that it is somewhat demeaning to have to jump through the hoops just so you can become healthier. But I am willing to change everything, so sitting in an office with a shrink and only part of my brain functional due to exhaustion....no sweat!

:thumbup:

[bigbirney 3]

My follow up consult was today. I had a great experience. I think people on this forum are far more advanced and educated than many people seeking this surgery. I have heard about and known a few people that thought the surgery was the answer to all of life's problems. A quick fix, or forced bulimia. My father had his stomach stapled 20 years ago, and I watched him eat and throw up daily as if it was normal. I have even met a few people that have had bands for almost 4 years and dont ever have them adjusted, eat poorly and drink a 2 liter of soda a day.

Many obese people such as myself have things that happen that start them eating poorly. Anxiety and or depression, stress. etc. I wasnt big until my mom died when I was 17, then I put on about 100 my freshman year of college. They want to know why you became the way you are, and your eating mechanics, to retrain your brain for the changes to come. The psych eval and follow up is to help people complete the whole life change. If you have the band and are still depressed or anxious then it will hinder weight loss.

Edited February 10, 2010 by bigbirney

[Spartan 4]

The subject of Psych Evals comes up here every once in a while , and I am always amused while reading the responses and reactions people have. And, I sometimes get a little angry as well, because of some of the comments I see people making.

The “psych” component is one that is REALLY overlooked and downplayed by people when they are getting weight loss surgery. They complain about having to do it, and I think that is a BIG mistake.

So….I have a few…(ahem)….”comments”.

I think that many people are missing the point entirely when it comes to the Psych Evaluation portion of the Lap Band (or any WLS) process.

While it varies from person to person, the problem of obesity comes down to a very simple equation: We eat TOO much of the WRONG stuff. And most of the time, we do that not because we are physically hungry, but because of the “head hunger” that so many of us experience. And, simply because it gives us physical pleasure to eat good tasting food.< /span>

Sure, there are segments of the Obese population that have some form of metabolic disorder, there are absorption issues, and some other elements that play a role in the path to becoming Obese. But MOST of the problem lies in the fact that we simply eat too much of the wrong food. And, of course, we don’t exercise our bodies nearly enough.

The fundamental mechanism of the Lap Band is to restrict our consumption of food. Plain and Simple. If you eat too much, you’re gonna suffer. If you don’t chew properly, it’s gonna hurt. It’s a valve. It’s a Spigot. It’s a throttle whose job it is to keep you from eating TOO MUCH (note to those engineer-types out there: I know it’s not technically a”valve”…it doesn’t open/close. I know…but you get my point…lol). There are some theoretical elements to the Lap band experience such as reduced appetite and hunger, but that does not occur in all people….it is more the exception than the rule.

The point here is that a HUGE component of the weight loss process is the MIND GAME. It is psychological in nature, and if that particular part of the puzzle is not dealt with, you will not be entirely successful in your weight loss efforts, with or WITHOUT the Lap Band. Some people get lucky and the band is all they need to lose all the weight, but they are really the exception. And, if the band stops working or needs to be removed, then you have a big problem if you have NOT dealt with the mind/emotional issues relating to obesity.

So many Lap Band patients see the Band as some magical device that is stuffed in their stomach and Voila! ….they’re not hungry any more. Nothing could be further from the truth, for MOST Lap Band recipients. It takes discipline, self control, patience, and a strong personal commitment to the process to make it work properly.

And THAT is why they make you go through the Psychological Evaluation. To make sure that you are up for it emotionally.

For those of you that are complaining about having to go through the process, I would say that your attitude is sorely lacking…big time. Particularly “Shonette”, who doesn’t seem to want to do ANYTHING to help herself in this process. She wants the band to do everything for her, and it’s too bad, ‘coz that AIN’T how it works. You don’t want to do the 6-month diet? Here’s a news flash for ya….the Lap Band IS a diet,,,one you’ll be on as long as you have it in you. So get used to it.

Personally, I feel very strongly that regular sessions with a Psychotherapist that specializes in bariatric issues (and I mean SPECIALIZES, not just as part of the practice) should be a requirement of getting a Lap Band, not just a single session before the surgery. This should be an ongoing process, designed to support you in your weight loss efforts, and help you identify and manage the issues that have driven you to overeat in the first place.

Now, on the other side of this, I do think that SOME of the consultations ARE a joke. The insurance industry really needs to do some “housecleaning” with regard to how they handle these evaluations. Some of it really is “going through the motions”, and that, honestly, doesn’t help anyone at all. But that doesn’t keep the PATIENT from taking a proactive stance and seeking out quality behavioral therapy to assist them in this process.

So, as a prospective Lap Band patient you should absolutely NOT be rejecting the idea of psychological intervention in your Quest for better health,,,,you SHOULD be wholeheartedly EMBRACING the idea that your problem with obesity is multi-faceted, and needs help from multiple resources, and NOT just a noose around your stomach.

Some comments on what some of you have said here:

Cwm812: “I can't imagine any other demographic group having to have a psych consult to get corrective surgery.”

Sorry, but what you are having is NOT “corrective” surgery. There is probably nothing “wrong” with you physiologically. You EAT too much, of the WRONG stuff. It is a CHOICE you have made. The surgery will NOT “correct” that. It MIGHT keep you from eating as much as you do, but there is nothing “corrective” about it. It is NOT the same as someone who was born with one leg shorter than the other, or someone who has a faulty hip. Or a bad heart valve. This surgery is about preventing you from following through on the Bad choices you are making.

In your case, it looks like you have lost most of your weight with just the use of the band, and that is terrific. But for MOST people, but problem is a little deeper. And you have to keep in mind that there may come a time when you will have to have the band removed. There is increased incidence of erosion, slippage, and other problems that can happen with the band. These problems are surfacing in people who have had the band longer than 3 years, and it is happening with greater frequency, and more people are having to have their bands removed. So, while you may have solved the “physical” component of your obesity by using the Band to limit your intake, based upon what you have said here it is unlikely that you have addressed the psychological component; and there may come a time when you will have to live without the advantage of the Lap Band and the restriction it places on your eating.

“I have no problem with psychologists. I have even gone to them for various problems throughout my life, but as a condition of this surgery, it's demeaning to have to prove that you are competent to be of normal size!”

The Pysch Eval has NOTHING to do with “proving competence to be of normal size”. What an absurd statement. What is has to do with is to make certain that you are aware what the challenges are post-surgery, and that you are capable of sticking to the rules, and willing to do the work that is necessary to reach your goal. And a GOOD therapist will want to work with you to help isolate issues in your life that might get in the way of doing so. THAT is what it is all about.

Cwm812 and 4Sammy: "I hate when we waste our medical resources in this country."

So, you guys see obesity as merely a PHYSICAL issue? Something that just “happens” to you? Something you didn’t play a role in? It’s nothing that you had a CHOICE about? That’s how you see it?

You know…there is a significant percentage of people who think that Weight Loss Surgery IS a waste of “Medical Resources”…..Many people think that we, as obese people, simply have no self-control or discipline, and that WLS is a waste of Surgical Talent that could be used on more “serious” maladies, like heart disease and cancer. As a Weight Loss Surgery patient, I do not entirely agree with that notion….but I UNDERSTAND it. I understand what they are saying. I recognize that obesity IS a self-inflicted wound. For the most part, we do it to OURSELVES. And wouldn’t it be great if we could find a way to solve the problem WITHOUT tying up Surgical Theaters and other resources? We all know that it is not that simple….BUT proper counseling and psychotherapy CAN make a world of difference to people who are struggling with weight issues. I have personal acquaintances that have been able to lose significant amounts of weight by seeking out a properly credentialed psychotherapist, and getting to the root of life issues that have contributed to large amounts of weight gain. Regular Psychotherapy played a HUGE role in my own transformation.

Christiemr: “Just one more benefit to being self pay I guess, no psych consult! Woohoo!!! In medicine we call it CYA (cover your a--) medicine. I'm sure there's one person out there somewhere who had the procedure expecting the magic quick fix, didn't do what they were supposed to, got stuck, slipped band, etc and then tried to sue their doctor so they all freaked out and started requiring the psych eval.... Just a theory.

“

Wonderful. “just one more benefit”….meaning just one less thing you HAVE to do that might very well make the difference between your being successful or failing in this process.

Shonette: “Why in the world do someone need to tell me what my thoughts or feelings need to be concerning my over weight condition. I know that am over weight and that is why am doing something about it. “

You really don’t get it, do you? It’s not about “telling you what your thoughts should be”. It’s about finding out WHY you feel how you do about eating and then coming up with methodologies to deal with those issues. And there’s other stuff involved too, but for you to discount something very fundamental to weight loss (and ANY behavioral Psychologist will verify what I am saying) is to dramatically decrease your chances for long-term success with ANY weight-loss procedure, surgery or otherwise.

“Am willing to do only those things that I have to do and nothing more.”

That is the purest recipe for failure that I have heard in a LONG time.

To kagead: It sounds like you have a Dr that’s “gets it”. I hope you keep Psychotherapy as part of your “band lifestyle”….I can guarantee that it will play a role in your success.

Ok, I have spent far too long on this.

If anyone who is reading this thinks that I have been insulting or something else, that is NOT my intention. But understand that I have been involved in weight Loss surgery-related areas for nearly a decade. I have undergone multiple Surgeries, have made many mistakes, and I have learned the HARD WAY what it takes to be a success at this. And one of the most important elements of this whole process is to pay close attention to the MIND element of this. Because THAT is where the success begins and ends.

So, when you are sent for your Psych eval, I would heartily suggest that instead of seeing it as a waste of time, think of it as another component of a successful Lap Band experience….embrace it, and consider making Psychotherapy a part of the process of becoming a Healthier person. It might be the difference between success and failure.

[bigbirney 3]

Great Post Spartan! I couldn't have said it better myself.

[Manda87 3]

Good job Spartan! Some people just don't "get it." I think a psych eval and psych appointments need to be required for all weight loss and plastic surgeries. I think it could have saved Micheal Jackson's life...

[shonette 9]

Sparta

I read the reply from Spartan who made a personal attack on all the opinions who opposed the Psych Evaluation. Maybe I have the wrong ideas or opinion about the individual post made by the Band members, because I did not know there was a Band Police who was standing at the door dictating what individuals were allowed to feel and say on this site.

First of all who died and made you God! Absolutely, no one did and therefore you don’t have the right to critic everyone’s remarks. What authority do you have to point out to anyone what they are entitled to feel concerning their personal choices? I do not respect any single thing you had to say concerning your reasons to have a psych eval. I really do believe that you have some DEEP, DEEP ROOTED EMOTIONAL ISSUES THAT DEFININATELY REQUIRE ON- GOING THEREAPY! You continued to make comments that included other banded individuals. That is very small minded because no one can speak on the behalf of every single person. All of my remarks were about my personal feelings because that is the only true opinion I can share.

Spartan: You joined this site on 1-7-10 and you are trying to do what? Why have you joined this site? Is it to only criticize others and to be an argumentative person! This is a support site and if you don’t like the way another person feels about their own personal opinions tough. “Get a life”. I truly feel so sorry for you. Maybe you don’t have any friends and I definitely can see why not.

Your personal cheerleaders that encouraged you: way to go you told them. How childish is that we all should be adults on this site who should respect the opinions of others even if you do not agree. Come on maybe this site is not for you. Maybe you were not taught: if you do not have something nice or encouraging to say just shut your mouth up!!!!!!!

Every single thing you have said on this site should be taken with a grain of salt. POOR YOU! I reviewed your post and you’re a very, very negative (individual). I see why you advocate so much for therapy. My heart really goes out to you. What you need is prayer and much of it.

My appointment was today and I spent 20 mins completing paper work and a total of 15 in the office. (Joke)! It was a waste of time away from my job and money. My MONEY!

Continue to curl up on the couch because you really need it. Happy banding. I love this site and all the wonderful people who is apart of it and maybe you need to find so where else to vent.

You are in my prayers! You are a JOKE!!!!!!! SAD.