Psych Eval.

[SteveT74 359]

Here's what you can expect. You're going to be asked a serious of questions from either the HAMD or MADRS test for depression. You can look up samples online. A lot of people that suffer from obesity and have a BMI that qualifies them for surgery also suffer from depression. Many also have addictive personalities and abused food, drugs and/or alcohol in the past (or may be presently abusing). Having a history of depression or addiction does not disqualify you from surgery, but the psychologist need to show that you are being treated and that you can handle this procedure. They need to know that you have a support system in place to help you with this transition. Having this surgery is not going to cure all your problems--it's just going to make you thinner and PHYSICALLY healthier. If you gained weight because you have underlying issues, those issues need to be addressed (and you need to show that you are continuing to addressing them).

That covers you for mood disorders, but they are also screening for other issues including personality disorders (borderline personality for example). People with borderline personality disorder (and other personality disorders) don't do very well with surgery or the changes that occur after surgery. If you are suffering schizophrenia, you may also have issues post-op. This will likely show up in your medical history, but you'll be screened anyway. If you have bi-polar depression, you can have problem coping with this surgery and many of the anti-psych drugs used to treat bi-polar depression cause weight gain, and that would need to be taken into consideration. I am not sure that any of these issues alone will disqualify you from surgery, but you're going to need to show that you're conditions (if you have one) is well controlled for at least a year and that your treating physician believes you are psychological prepared to handle the stress of surgery and the changes that it may bring.

Aside from questions that are probing for the above issues, you'll be asked specific questions to determine whether you have considered the consequences of having this surgery and how it may effect your life. I would just answer these honestly. This is what I said in my interview (paraphrasing)

1. Why do want weight loss surgery? (asking to make sure you have realistic expectations and have a healthy outlook on this process)

I don't want to have weight loss surgery. I wish I didn't need it, but I do need this surgery to become a healthier person. The cosmetic benefits are secondary. If the surgery just made me a healthy person, but I stayed just as fat as I am now, that would be fine too. However, that's not the way it works and I need to lose this weight to be healthy. Being fat is one thing, being sick and dead is another entirely.

2. If that's the case, Have you Tried Dieting and Exercise to lose the Weight?

Absolutely, I have been dieting most of my adult life (or was between diets). i can lose weight, but keeping it off has been a problem. Most recently I went on a strict doctor supervised diet where I lost 40 pounds, but could never get below a certain point. I did everything by the book but just hit a plateau. After two months, it became frustrating and I started to slip. Within another 6 months, I gained back the 40 pounds I lost and then some. That's been the story of my life. Dieting and exercise just doesn't work for me or almost anyone that has more than 70 pounds to lose. That's not my opinion, that's what virtually every study shows.

3. Why do you think you gained this weight?

Everyone is going to have a different answer, but in my case I gained the weight a little at a time. I was thin as a kid. Even in my early 20's, I worked out every day and watched what I ate. I even had a six pack for a while. Once I started working, that disappeared. I started gaining a few pounds every year. Then I would diet to lose the weight and it would creep back on quickly after I fell off the diet horse (with a few extra for good luck!). I am now 44, so if you take a normal person my height with a normal weight at 24 and add 4 pounds a year on average you end up being me. It wasn't noticeable at first, but it sneaks up on you and suddenly you realize you're the fattest guy in the room. (obviously, this doesn't apply to everyone--but that's how it happened for me).

4. Can you commit to changing your lifestyle after this surgery?

Absolutely. It's not going to be easy. Nothing about this process is easy, but I either commit to change or I am going to have a very short life. I have two little girls and they need their daddy to walk them down the aisle when their time comes. I also need to do this for myself. I love being alive and I want to feel healthy again.

5. How does your family feel about you having this surgery?

My wife is nervous, but supportive. My mom is behind this 100% and my dad is very nervous about it, but he supports me too. I have told anyone else in my family. I think they would support me, but I just don't feel like they need to know at that point in time.

6. This type of surgery can change the way you feel about yourself and the people around you. How do you think it will effect your relationship with your wife?

I believe it will improve our relationship. My wife is a thin person, who watches what she eats. I know she loves me, but she's not happy that I am heavy and she is scared about the effects that being a diabetic may have for me. Being heavy (and diabetic) also can, in my case, cause sexual side effects for men and I think that losing the weight can only help me in that regard.

I think you get the picture. Don't lie, but they want to know that you understand what you're getting into and will be able to handle the difficulties and changes that come from surgery. Good luck!