Weight Loss Surgery and Behavioral Health

Weight loss surgery is a life-altering, stressful process and procedure that requires careful thought, considerable awareness, and adjustment. Changes occur both emotionally and physically. Weight loss surgery is not a “cure-all”. Instead, it is a tool to help you achieve a healthier weight. We want you to be as successful as you can with weight loss surgery!

In order to have a successful long-term outcome, it is necessary to make a number of permanent lifestyle changes. You will need to permanently change your eating habits and activity patterns. A behavioral health evaluation is required because many habits, behaviors, thoughts, and emotions can affect the success of weight loss surgery. Sometimes additional visits may be needed to complete this evaluation. The bariatric team member will make individualized recommendations to build upon your strengths and help you address challenges so that you can best lose weight and keep it off.

In addition to the behavioral health evaluation, our team can work with you both before and after surgery. It is sometimes necessary to have follow-up behavioral health visits, either individually or in a group, to change behavioral, emotional, or psychological patterns that would interfere with a good surgical outcome. For example, many patients need help from a Psychologist to reduce binge-eating behaviors prior to surgery. This eating pattern can reduce your ability to benefit from the surgery. Behavioral health can also provide additional support, stress management skills, assertiveness building, emotion management (e.g., anger or depression), assistance to stop smoking, and strategies for reducing anxiety or fears associated with having the surgery.

Further, after the surgery, many individuals are helped by behavioral health follow-up. These visits can help with your psychological and social adjustment to your new lifestyle. Finally, we also encourage you to attend a weight loss surgery support group. This lets you hear from others who have already had the surgery. Support groups also give you additional information about weight loss surgery and the behavioral changes that you will need to make in order to reach a healthier weight and maintain it for the rest of your life.

In summary, we want to help you achieve the best post-surgical outcome possible! If you have any questions or concerns, please do not hesitate to share them with us during your OPD visit.

• Though weight loss surgery physically reduces the size of your stomach, it will not prevent you from eventually gaining back weight if you do not learn how to reduce the amount of food you eat and increase your physical activity to promote calorie burning.
• It is entirely possible to “beat” the surgery by eating fatty foods or liquids (such as potato chips, milkshakes, ice cream, etc.).
• Having a diagnosable eating disturbance before surgery increases the chances of gaining back weight. Weight regain often occurs 2-5 years after surgery.
• Binge eating disorder and night eating syndrome are linked with a greater risk of weight regain.
• Cognitive-behavioral consultation/psychotherapy are often necessary to treat such eating disturbances.
• Individuals with mental health difficulties are at an increased risk of medical complications, emotional distress, and decreased satisfaction following surgery.
• There is a higher rate of psychological difficulties in individuals with obesity compared to the national norm.
• Clinical depression is the most reported illness.
• A prescreening for psychological difficulties is important so that proper intervention can be instituted, reducing the risk of post-surgery complications.
• Individuals who are eating to cope with negative emotions or stress are most successful after surgery if they have learned to replace eating with more adaptive coping strategies such as deep breathing, exercise, or developing a hobby.
• The majority of patients who have weight loss surgery report having a better quality of life after surgery and recovery.
• How you perceive yourself after surgery depends on more than just weight loss.
• This is especially true when an individual’s weight begins to increase or stabilize after surgery.
• The majority of patients also report improved body image.
• Individuals who have weight loss surgery often experience both positive effects in their marital and interpersonal relationships.
• Some obese individuals who also experience social anxiety (i.e., discomfort in interacting with others) have reported using their weight as an excuse to reduce social interaction. Once the weight is lost, there is the potential for increased anxiety as a result of increased social demands.
• Patients who have undergone surgery and returned to work have reported mixed feelings. This is due to individual differences in how one welcomes the new attention received.
• The majority of patients who have undergone weight loss surgery report an increase in energy after a brief recovery period. This new energy should be put to good use as soon as possible by exercising and being active.
• Those who have had prior substance abuse problems are at an increased risk for relapse. Substance abuse has also been shown to increase the risk of regaining weight 2-5 years following surgery. Ongoing awareness and support can help to reduce this risk.

These points for determining a successful post-surgical outcome are important to consider on an individual basis.

As you take personal responsibility for making permanent lifestyle changes to create a healthier you, maintain a close follow-up with our Bariatric team.

• Ongoing support and information about how our thoughts and beliefs can impact our ability to make changes in our eating and exercise patterns.
• Identification and treatment of potential problem areas such as depression, anxiety, or binge eating.
• The development of specific plans for how to cope with problem areas or stresses that can impede your ability to lose weight and maintain a healthier weight.