Reflections & Insight

Why I believe in Weight-Loss Surgery… for the right person!

The pre-surgical evaluation for anyone considering weight-lose surgery is a critical step in the process toward permanent weight loss. It is through this comprehensive Psychosocial Evaluation where it can be determined who “that right person is for weight-loss surgery”. And, believe it or not, many people are “that right person” for whom Bariatric Surgery is the best possible option for permanent weight-loss.

If you are considering weight-loss surgery, regardless of your surgical team, whether or not you are using insurance, or whether or not you are “required” to undergo a “psychiatric” evaluation, please consider doing yourself the best self-care favor and go through the pre-surgical, psychosocial evaluation process. For the most part, it’s painless!

Who is the RIGHT person for weight-loss surgery?

The right person for weight-loss surgery is someone who has spent his/her life trying to achieve and maintain a normal body weight. This person may be working against genetics, cultural traditions, metabolism, or societal expectations.

The right person for weight-loss surgery is someone who has made, in earnest, multiple attempts at weight loss programs, i.e. Weight Watchers, Jenny Craig, Nutri-Systems, HCG, Herbal Life, Phentermine as well as many other programs and drugs too numerous to mention.

The right person for weight-loss surgery is someone who has demonstrated consistency in education, career, volunteer work, or other aspects of daily living. This consistency demonstrates the predictive value of a commitment to the new post-operative regime.

The right person for weight-loss is someone whose motivation for weight-loss surgery is grounded in health factors, such as eliminating diabetes, lowering blood pressure, or other genetic concerns that are exacerbated by obesity. The right person for weight-loss surgery is NOT motivated exclusively for reasons of vanity and an obsession with attaining an unrealistic body weight, shape, or size.

The right person for weight-loss surgery is someone who has NOT significantly suffered with disordered eating OR is someone who has developed a very good, long-standing recovery from an eating disorder. As well, the right person for weight-loss surgery is someone who does NOT turn to food, alcohol, or drugs as a coping mechanism or does not use food for self-soothing or comfort.

The right person for weight loss surgery is someone who has a strong support system that will be available, post-operatively, to support his/her best efforts at developing a new relationship with food and will not attempt to sabotage the person’s best efforts.

Finally, the right person for weight loss surgery is someone who FULLY understands the dietary restrictions before and after the surgery so that he/she does not experience any unknown or unexpected surprises!

If it is determined that an individual is NOT ready to move forward with a surgical intervention for weight-loss at the time of the evaluation, psychotherapy along with nutritional counseling is recommended for a minimum of three months. Again, the individual, along with his or her treatment team, will periodically re-evaluate the best course of action.

Who will be conducting the evaluation?

Make sure that you are seeing someone who is qualified to conduct these critical evaluations. What does that mean? You will want to see someone who is skilled in gathering pertinent data through a clinical interview. This information becomes organized into a report that directly speaks to the predictive adjustment of the individual after surgery.

This qualified licensed therapist will have knowledge of the nature and mechanics of bariatric surgery, pre- and post-operatively. The qualified therapist will have an understanding of the physiological effects of obesity and extreme dieting, as well as expertise in the psychology of eating as well as the entire spectrum of eating disorders. Furthermore, an understanding of the complexity with which these factors combine, interact, and manifest in the postoperative patient is also essential. Additionally, the therapist will possess a thorough understanding of the psychosocial, financial, and physical stresses imposed on the patient who is struggling with obesity. Finally, it is imperative that the evaluator has a solid knowledge base on how certain psychosocial factors, such as mood disorders, substance abuse, trauma, sexual/physical abuse or victimization, and eating behavior, may affect surgical outcomes.

After almost 18 years of conducting psychosocial evaluations for individuals considering weight-loss surgery, I can safely say that bariatric surgery is an appropriate option for those wishing to attain permanent weight loss when all other options have been exhausted. The psychosocial evaluation is imperative to determine not only readiness for change, but also emotional and psychological preparedness for this life changing surgical intervention.

For more information, contact Sammi L. Siegel, Ph.D. at 305-613-1101.

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