Edie0201

I’m a female military veteran who has been struggling with obesity for 10+ years. Over a year ago, i began seeing a weight management doctor through the vA. I started making healthier eating decisions with the help of my doctor and attending nutrition classes. I even began seeing a physical trainer through the VA. I still wasn’t losing weight. I was 211 lbs at just 5’0”. I finally decided that I wanted to consider weight loss surgery. I was given a checklist, which I completed over the span of 10 months. All that was left for my surgery was my psych evaluation. I even exceeded the weight I was supposed to lose to meet the pre-op requirement. I’m down to 190 lbs. I’m still considered obese, just not morbidly so. Upon my psych evaluation, I was told by the psychologist that she had a moral obligation to my child(I’m a single parent) to do what was in my child’s best interest as well and that there are some instances where bariatric surgery patients become suicidal. The psychologist stated that he didn’t want to see my daughter in a few years, coming into her office, asking how she could clear me for surgery, leaving her without a mother. The psychologist also stated that she’s sure my daughter would rather have me overweight than not have me at all. She went on to decide that she recommended I continue trying to lose weight with diet and exercise, and did not clear me for surgery. I was devastated. I do have PTSD, but have not been suicidal, nor have drug or alcohol habits/issues. I want a second opinion but prefer one by a non-VA provider. I do feel that her opinion was biased and for some reason, personal. Even in her clinical notes, she’s very vague with providing supporting evidence of her conclusion. She also never consulted with my actual therapist, whom I’ve been in therapy with for a year. Does anyone have any insight or words of advice? I feel so defeated...because of all the work I put in this past year to meet the requirements.

Hi, everyone! It's been 4 months since I last posted, but just wanted to update the folks that took the time to respond. Also, in case any other fellow vets might find something useful to take from this. I was devastated. And it's taken me this long to openly discuss it, but here it goes: Well, that "meeting" was exactly what I feared it to be...no, actually it was worse. Firstly, I went in and audio recorded the entire interaction from when they went to get me in the waiting area, until I passed the threshold of the doors, exiting the hospital. The psychologist started off with saying that I had gone against protocol and sought a second opinion from someone who did not have extensive access to my records as VA psychologists do, and therefore, the external psychologist was not able to consider pertinent information in the evaluation. I retorted: Actually, the external psychologist WAS provided my records from the VA, AND she had been the chief evaluating psychologist for bariatric surgeries at the biggest military hospital in my city. She then said that the issue was that the psychologist had never consulted with the bariatric team and because "standard procedure" is for them to do so, they couldn't consider her recommendation for surgery as valid. The VA psychologist then went on to say that because I didn't address my concerns about utilizing the psychologist she recommended, with her directly...that that indicated my lack of coping skills and possibly paranoia of personal vendettas. In a completely calm and objective tone and manner, I told her that I disagreed with that statement as well, and that I sought a second opinion from someone other than who she suggested because after listening to her unprofessional comments and anecdotal reasons for why she "didn't think" I was a good candidate for surgery, I didn't trust her professional opinion in any regard, to include her suggestion from whom I'd receive a second opinion. Her face turned red and when she began to speak, she was visibly upset. Her face started to twitch and she began stammering. The social worker sitting in saw it. The weight management doctor saw it. They looked at each other nervously, but didn't want to focus too much attention on it, so the weight management doctor tried to chime in, saying, "What I think Dr. Nutcase*(VA psychologist) is trying to say is..." Then the VA psychologist halfway stood up and put her hand in the weight management doctor's face, motioning for her to stop talking. Still stammering and with her hands starting to tremble beyond her control, she says, " I can see you're very angry and enraged. And you don't have any faith in my professional abilities, but I stand by my findings. You have proven to me, especially now, that instead of dealing with issues, you become paranoid and you run away from them. I do not think that someone in your mental state is ready for everything that comes with bariatric surgery. You've already proven you can lose weight on your own, by evidence of meeting the requirement for bariatric surgery. I suggest continuing what modifications you made to obtain that goal. But, no, I do not think you are mentally fit for this type of surgery. And I stand by that. I retorted: (Again, calmly, objectively, and with tact) Dr., if you suspected that I was so mentally unwell that I should be barred from bariatric surgery, but still managed to inform me of your decision over the phone(where as a supremely concerned psychologist you could not monitor my response) and I after I clearly told you I was driving...does that not doubly contradict what you're claiming? If I am so "mentally unfit" and your biggest cited reason is for purported fear that I'll commit suicide, why, as a professional, ethical, and morally responsible psychologist, would you risk putting me in harm's way? I mean, if what you say is true, and you're truly just concerned for my mental health and that I am alive for my daughter...why would you inform me of my denial, after 15 months of work that I put in meeting requirements...and you suspect me to be suicidal and mentally unwell, while I am operating a motor vehicle. Why would you do that? It's a rhetorical question, Dr. I merely want to show you yet another instance where you have contradicted yourself. Her hands were still trembling and she was still stammering. " I didn't realize you said you were driving. I'm sorry for that. I was wrong. I believe you that you told me you were driving. I'm not saying you're lying. I was wrong. I'm sorry." She then went on to say, " I can see how upset and angry you are. I am sorry for making you feel that way. I can see how distressed that situation made you feel. I'm going to let you have a moment with these other ladies because it seems as though you no longer are open to hearing my professional opinion, but I stand by it. I understand if you don't want to work with me, but always know that my door is always open." She nervously got up and with her back to the door, stepped out. In other words, she acted as though she was in fear. You guys...I couldn't believe my eyes. I couldn't believe this was happening. It was so crazy of a display, that I just sat there stunned, waiting to see how the social worker and weight management doctor would respond. After a bunch of bullshit "you should be proud of all that you have accomplished in these 15 months. You lost the 5% requirement. Just keep going", the weight management doctor said, "Unfortunately, she is my colleague and I have to support her recommendation of not allowing you to move forward with surgery." I kept my composure until I left the hospital, but as soon as I got into my car, I collapsed in tears. I felt so...failed. It didn't end there. Oh, no. The VA psychologist was apparently in a hurry to leave the meeting to rush back to her office to input her medical notes in my record. She stated that I was aggressive and verbally attacked and debased her constantly throughout the meeting. That I was unwilling to use proper coping skills. AND, that I was "mentally unstable to the degree" of not trusting my own ability to safely operate a vehicle when faced with a distressful situation. She closed with, "It is because of these observations and my concern for her mental health that I recommend the patient not be considered for bariatric surgery." This is a part of my medical record now...that all other medical professionals will see and take as truth just because it's endorsed by someone with a Phd. It's been really hard, everyone. Because what disheartened me the most was realizing that if she did that with me just because I challenged her, what else has she done? What other veterans has she screwed over with her "professional findings", which was really just an ego trip and abuse of authority. And, honestly, after seeing that awful display, I'm convinced she is probably no stranger to mental illnesses, in more ways than one. On the bright side, I'm still here...I haven't gained any of my weight back that I lost while meeting my requirements, I'm kicking butt being a great mama to my little girl, and my mom just had her bariatric surgery(the sleeve) done yesterday. I'll be taking care of her(she's 56), just making sure she doesn't have any issues for the first two weeks post-op. In solidarity, my daughter and I made a commitment to my mom that we would join her in completely changing our lifestyle to support her as a family. Thank you all for sharing your insights and for just caring. You all remain in my prayers and well wishes. <3

Okay, it’s been a few weeks, but I wanted to update you all with what’s going on. So, I found a very reputable psychologist in my city that is in no way affiliated with the VA, who actually used to be the chief psychologist conducting pre-bariatric surgery evaluations at a local hospital that sees both military and civilian patients. She runs a private practice now. I went to see her, and was honestly nervous, because I didn’t know what to expect after my experience with the VA psychologist. Thankfully, she was amazing! And I went to her letting her know that I wanted a completely objective evaluation and that I wouldn’t be disappointed or upset if she found I wasn’t a good candidate for bariatric surgery. After the conducting an hr-long interview/evaluation, she stated that she thought I was an excellent candidate for bariatric surgery and that she would compose an in-depth report of her findings and recommendation, and fax it to both my doctor and me. It was faxed 20 June. My weight management doctor didn’t contact me, but input notes on 20 June into my VA record, that she received the fax from “a community psychologist”, that included a pre-bariatric surgery evaluation report. 21 June, the VA psychologist input notes too. Her notes had a very ominous tone to them...almost like she was angry. She stated that I had gone against her recommendation of getting a second opinion from the specific VA psychologist she had chosen, that the “community psychologist” didn’t consult with my VA therapist(remember, neither did she, despite my therapist reaching out to her), that I “refused to consider alternate methods to bariatric surgery”, and that she was taking serious precautions because I am a veteran with PTSD, and had history of trying to commit suicide in my youth(twice, due to being sexually abused throughout my entire childhood). I’ve been yo-yoing between obese and morbid obesity for the past 10 years, mind you. And have been meeting the requirements for surgery the past 15 months...but she insistently suggests I’m being hasty and even insinuated that I’m being selfish because I’m willing to take the risk of suicidal tendencies after surgery instead of accepting my obesity and “being here” for my daughter. She and my weight management doctor have scheduled a meeting with me for Friday, and I can’t help but feel like I’m walking into a trap. It’s truly disheartening to feel this way...especially because it’s the VA, and they’re supposed to be helping veterans salvage whatever parts of their life they have left. It certainly doesn’t feel that way.

For candidates with sleep apnea, this is definitely standard procedure. I had to do my 30-day monitored use before they scheduled my psych evaluation. It really is in your best interest...especially if your sleep apnea is moderate to severe. They want to make sure it’s somewhat stable before having you ”put to sleep” while having surgery.

I just scheduled an appointment with a psychologist who conducts pre-bariatric surgery evals; she's completely outside of the VA(hell) umbrella, so I'm feeling hopeful. She's older, a mother, grandmother, and she is not a thin lady. The previous psychologist was a very tall and thin woman who I doubt could truly sympathize...PhD or not. I wanted to thank you all from the bottom of my heart. This has been so stressful and I felt as though I couldn't talk to anyone, because most people don't even know this has been something I've been struggling with. The first psychologist, who I feel was completely cavalier and nonchalant about pissing away all the work I had done for a year with a few keystrokes on her keyboard, truly needs to reassess her responsibility to patients. In my clinical interview, she said, "You're really not that overweight. And you have a beautiful face." I just sat there completely flabbergasted. I felt like telling her, "We are going by clinical facts, not opinions. And the fact is that I have serious health risks because I am CLINICALLY classified as VERY OBESE." But I knew she was gauging my responses and going to annotate any defensive or aggressive tones. So, I just told her "Thank you, but I'm still clinically overweight, have horrible back pain from the excess weight on my 5'0 frame, and have moderate-severe sleep apnea. I need help." After I get my surgery date(God willing), I'm going to report her to the state licensing association. What she did wasn't right. Especially because she didn't even provide clinical supporting notes and refused to speak to my therapist. Thank you all so much! I will keep you all updated! *virtual hugs* 🤗🤗🤗