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Psych Eval Question- Getting worried



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Hi everyone,

My husband and I are just starting our process towards the VGS (having the surgery a few weeks apart) and have a question that I am hoping that some of you can help me out with.

We have had our first pre-surgical meeting with the surgeon and have been given our list of pre-surgery tests we need to have done. Part of that is the psych evaluation. When I was first told that we would be doing the psych eval, I was not worried. Now, after emailing a bit with the therapist who will be doing the eval on Friday, I am much more worried.

He indicated that what he is concerned about, and the things that can prevent us from being approved for the surgery are that we are currently obese because any of the following reasons:

  • A history of binge eating
  • Poor adherence to prior diet and physical activity plans
  • Inadequate control of portion sizes in meals
  • Boredom eating, stress eating, or eating out of habit rather than hunger
  • Eating to self-sooth or as a distraction from stressors
  • Inability to control cravings for unhealthy foods/poor food choices

So guys, what’s the deal? Do they expect that we got fat be a freak accident? Or perhaps the surgery is only for people that stick to diet and exercise plans, have good eating habits with small portion sizes, never boredom or stress eat and still end up obese?

I want to be honest with the guy, but it sure sounds like pretty much like a history of any activity that makes people fat will disqualify you from having weight loss surgery. I know that my husband and I are both obese because we eat too much, eat the wrong things, and don’t burn enough calories. It is all related to bad habits that we need to break and the surgery is just one part of that.

Any advice or thoughts?

Thanks!

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I just had my Psych eval today and I wasn't asked anything about that. I understand that each doctor is different but really all I was asked was if I understood that this is a life changing process and that I had to change my ways in order for the surgery to work. I was also asked about my support system and any history of mental illness, alcohol use or smoking.

Hope that helps!

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Mine was back in February 2015 but I also wasn't asked about past weight loss experiences in such depth. I was asked about my past and how those things affected my eating patterns. And same as @@rwoods200, I was asked questions to make sure I understood what I was undertaking.

At the end of my eval the psychiatrist did mention that he wouldn't need to see me again. Maybe the psych is seeing if you need counseling or support for you to be successful or if you can do it on your own?

Good luck!

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I think they are just looking for overall attitude towards this surgery and your commitment to it. I got the feeling that they want to know you are ready to commit to a healthier lifestyle, not a fad diet or extreme behavior of any sort. Honestly my psych eval was the easiest part of my pre-op testing. They gave me a booklet with I think 4 pages of questions. Things like weight history, family weight history, support system, etc... Then when I met with the psych I think we just chatted for an hour or so.

Don't over think it. Be honest and let them know you are serious and ready for this change.

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I don't meet with the surgeon until Friday. But speaking with the Intake Coordinator yesterday, it is my understanding that they only have certain psychs that are approved for my clinic. They complete an MMPR2 or something like that. It seems to be only my state. But I too wonder what it is that they are seeking. It's a little worrisome to be told you have to wait 2 weeks to get the results.

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Perhaps you should find a different Dr for the psych eval. Those seem like illogical expectations. My psychiatrist asked if I understood the ramifications of a lifetime change, if I understood I would have to take Vitamins for life, we talked about my support system (lucky for me my husband and I have been her patients for over 3 years so she knows how stable my support system is). And she asked if I was aware that with my illness that I would get sicker right away before I got better. The eval is pretty much just making sure you understand this is a major surgery.

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You may want to go worth a different dr for the psych eval. When I was trying to get approved, the first psychiatrist told me I would have to have at least 4 appt with him before he would let me know if he cleared me for surgery. I was like uh hell no! I canceled that appt. The second one spoke with me for an hour and then he was done with me. It's only to make sure that you are prepared for this major surgery, I'm not trying to be your lifelong patient.

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With the psych I saw, those things would not have necessarily prevented you from getting clearance, but you may have had to receive counseling for a while prior to receiving clearance.

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  • A history of binge eating
  • Poor adherence to prior diet and physical activity plans
  • Inadequate control of portion sizes in meals
  • Boredom eating, stress eating, or eating out of habit rather than hunger
  • Eating to self-sooth or as a distraction from stressors
  • Inability to control cravings for unhealthy foods/poor food choices

Oh, come on, you've got to be kidding! Anybody on this Forum NOT answer 'yes' to pretty much all of these questions? If anything, answering 'yes' should be a qualifier for the surgery, not the other way around. Can't wait to hear how this one goes. And if it doesn't go well, find another therapist who understands weight issues. Good luck!

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Hi everyone,

My husband and I are just starting our process towards the VGS (having the surgery a few weeks apart) and have a question that I am hoping that some of you can help me out with.

We have had our first pre-surgical meeting with the surgeon and have been given our list of pre-surgery tests we need to have done. Part of that is the psych evaluation. When I was first told that we would be doing the psych eval, I was not worried. Now, after emailing a bit with the therapist who will be doing the eval on Friday, I am much more worried.

He indicated that what he is concerned about, and the things that can prevent us from being approved for the surgery are that we are currently obese because any of the following reasons:

  • A history of binge eating
  • Poor adherence to prior diet and physical activity plans
  • Inadequate control of portion sizes in meals
  • Boredom eating, stress eating, or eating out of habit rather than hunger
  • Eating to self-sooth or as a distraction from stressors
  • Inability to control cravings for unhealthy foods/poor food choices

So guys, what’s the deal? Do they expect that we got fat be a freak accident? Or perhaps the surgery is only for people that stick to diet and exercise plans, have good eating habits with small portion sizes, never boredom or stress eat and still end up obese?

I want to be honest with the guy, but it sure sounds like pretty much like a history of any activity that makes people fat will disqualify you from having weight loss surgery. I know that my husband and I are both obese because we eat too much, eat the wrong things, and don’t burn enough calories. It is all related to bad habits that we need to break and the surgery is just one part of that.

Any advice or thoughts?

Thanks!

We all had the same problems. We all got fat for the same reasons. I would admit to the problems, but explain that you think you are finally ready to make a change. Remember not to talk too much too. They will often leave a pause to just see if you will just keep talking.

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How did your evaluation go? Many of us were thinking of you yesterday.

Edited by emma4884

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Just checking for an update.

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My psyche eval was more about how I would follow through rather than how I got there. I had one visit pre-op and don't have the next one until my two years are up in December.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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