Reasons for the Bariatric Psych Evaluation
A report published in The American Journal of Medicine (AJM) supports the discovery that people who receive bariatric surgery have a suicide rate that is greater than average despite receiving a bariatric psych evaluation. This is not to imply that weight-loss surgery causes suicide because there is no convincing evidence to support this. At this point in time there is no concrete explanation for the rate of suicide among bariatric surgery patients.
What was established in a prior study that is unrelated to the AJM study was that two-thirds of the subjects who wanted weight-loss surgery had a psychological disorder. An assumption that is being investigated is that the higher than average suicide rate among bariatric patients is due to conditions that existed prior to weight-loss surgery. Depression and anxiety are common among people who seek weight loss surgery.
A bariatric psych evaluation is done prior to any weight-loss surgery. A candidate’s history of psychological illness does not mean immediate preclusion.
The suicide rate is relatively low among bariatric patients. Of the more than 16,500 individuals who had bariatric surgery in a nine year period, thirty-one committed suicide.
Suicide is always tragic and often preventable. One of the suggestions that might help prevent suicide among bariatric patients is to extend the follow-up period after weight-loss surgery. The current follow-up period is about six months, and most suicides by bariatric patients happen after that time.
A bariatric psych evaluation is done prior to any weight-loss surgery. A candidate’s history of psychological illness does not mean immediate preclusion. Even those who have disorders such as schizophrenia, bipolar disorder, or anxiety disorders may be allowed bariatric surgery provided the illness is reasonably controlled and the patient is counseled by a mental health professional before and after bariatric surgery.
What to Expect with a Bariatric Psych Evaluation
If you are considering weight loss surgery, a bariatric psych evaluation will be conducted. Here is an overview of what to expect:
- The psych evaluation will be administered by a qualified professional.
- Testing instruments may include an Audit-C alcohol screen to determine if the person seeking bariatric surgery has any hazardous drinking habits or active alcohol disorders.
- A drug abuse screening test will be given to determine if a prospective bariatric patient is abusing substances other than alcohol.
- A Millon Behavioral Medicine Diagnostic (MBMD) test will assess psychological preparedness for bariatric surgery. The MBMD test was created specifically for medical patients and is divided into several psychiatric indicators: coping styles, stress moderators, treatment prognostics, and management guide.
- In addition, a Multidimensional Health Locust of Control (MHLC) test measures either general health conditions or specific health conditions with rating scales. The conditions measured are dependent on the form that is used (form A, B, or C).
- There is also a questionnaire on the prospective bariatric surgery patient’s weight and eating patterns.
Bariatric Psych Evaluation Criteria for Exclusion
Criteria for considering patient exclusion from bariatric surgery are as follows:
- An active psychosis defined by evidence that the psychosis is current.
- Hospitalization for the psychosis within the last year may exclude the prospective patient from receiving bariatric surgery, as well.
- The prospective bariatric patient may also be denied weight-loss surgery if there have been multiple suicide attempts in the last five years.
- Evidence of an alcohol use disorder in the last five months or evidence of a substance use disorder in the last five months may rule out approving weight-loss surgery.
What to Do if You’re Disqualified
If you are seeking weight-loss surgery and any of the above pertain to you, do not lose hope. In most instances, the solution is to correct the problem. Corrections can be made with the assistance of mental health professionals and a support network.
If you are prepared to work at it then the possibility for being approved for bariatric surgery increases dramatically. It is worth the effort. I suffered from depression for a very long time, and my life after weight-loss surgery is wonderful.
Living larger than ever,
My Bariatric Life
