Psych evaluation required?! Why?

[wndy2011 2]

One of my requirements is to have a psychologist/psychiatric evaluation. Anyone have this too?

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[daniotra 298]

Yes. It's pretty standard. They check for eating disorders, support structure, whether you are mentally ready to make the long term lifestyle changes needed to support your surgery.

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[Proud2BMe 1,016]

Honestly, its because insurance is paying for it and they want to know if you are just going to waste money. That's the brutal truth. If you do self pay you don't have to jump through all the hoops.

[wndy2011 2]

Thank you. No one really told me what it was for!

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[KristenLe 5,979]

I think a psych Eval should be done on everyone - I've seen a few post after surgery and clearly weren't a great candidate from a mental health, substance abuse or emotional/binge eating perspective. They should have had counseling beforehand. Someone who clearly has uncontrolled depression and anxiety with a binge eating disorder is not the best candidate for life altering, stressful surgery. Now when you talk about the 6 month supervised diet requirements - that's just the insurance making you jump through hoops. :-)

[becomingmandikaye 262]

They also want to know that you're prepared. My psych asked me to tell her about the procedure and what they physically do (removing 70-80% of the stomach), what the nutritional focus is after surgery (protein), how the diet is structured after surgery (liquids, soft foods, full food), and what Vitamins I'll need to take.

Other than that she just wanted to make sure I don't have any mental or physical issues that would preclude me from having the surgery.

It's relatively painless.

[Kindle 8,667]

If you ask me, 1 psych evaluation isn't even close to what SHOULD be required for WLS. Post op therapy/counseling should be mandatory. Cause in the end, long term weight loss maintenance is 90% mental and maybe 10% physical.

With very few exceptions of certain metabolic disorders, the folks that regain years after WLS do so because they never got to the bottom of why they got fat in the first place. And without knowing the why means you can't change it. Going back to old behaviors when life deals you shit is the #1 cause of regain. The sleeve/band/bypass doesn't fail, the patient fails because not enough attention gets paid to the psychological aspect of losing and maintaining weight.

[Valentina 2,642]

Not only mandatory therapy for post ops, but also for spouses/S.O.s.

Just think of how many relationships could have been saved if the sleeved and their main support person were on the same page going in?

My opinion.

[KristenLe 5,979]

I asked for counseling for emotional eating - which I am realizing I don't have as much of an issue as many others - and I'm finding that it's helping in other aspects of my life too. First time in counseling - should have done that years ago too! Lol

[2goldengirl 2,076]

Honestly, its because insurance is paying for it and they want to know if you are just going to waste money. That's the brutal truth. If you do self pay you don't have to jump through all the hoops.

No, that isn't the truth. The truth is that psychiatric evaluation is a standard set by the American Board for Metabolic and Bariatric Surgery. The health plans use national standards like these for virtually all their medical policies, not just for bariatric surgery, but for things like heart disease, cancer, and arthritis, for example.

It's been their standard since 2004: https://asmbs.org/resources/pre-surgical-psychological-assessment

[2goldengirl 2,076]

. Now when you talk about the 6 month supervised diet requirements - that's just the insurance making you jump through hoops. :-)

Really? Then why did Blue Shield eliminate this requirement in July 2015?

[KristenLe 5,979]

They didn't with all plans - that's what I have.

[2goldengirl 2,076]

FYI, ABFMBS released a position statement in non-support of pre-op diet/weight loss requirements. That's why Blue Shield (of CA, anyhow) changed their position. I'd expect other health plans to follow.

[Kindle 8,667]

I asked for counseling for emotional eating - which I am realizing I don't have as much of an issue as many others - and I'm finding that it's helping in other aspects of my life too. First time in counseling - should have done that years ago too! Lol

Me too. I actually never received (or thought I needed) therapy for my food/alcohol addictions. Successfully lost all my excess weight and was maintaining easily. I was a strong, confident, invincible woman! Then I lost my best friend to suicide. By refusing to drown my emotions with calories like I'd always done before, I sunk into a very deep depression because I never learned an alternative coping mechanism. I was actually FEELING my emotions for the first time and it sucked. So I started seeing a grief counselor. Like you, turns out its helping in all aspects of my life and wished I'd done it long ago. Maybe that would have helped me from getting so damn fat in the first place.

[Mystique2015 11]

I'm not sure how effective it is.. I personally just felt like it was step that didn't have much effort put into it. I passed my eval but still went through some major issues after surgery. But my surgeons office was there for me throughout the whole ordeal to help out.