Weight loss surgery and mental health.

[Eumoirous 3]

I have schizoaffective disorder that is maintained by ECT treatments once a month. I haven't spoken to a surgeon yet because I am terrified of being denied surgery because of my mental health and how it's maintained. My dream is to be healthy and for how extreme my obesity is this may be the only way to achieve that. Can anyone offer some advice?

[sbg224 318]

My advice is, go see a surgeon. He/she is the only one that can tell you if your mental health and the treatments you receive have any bearing on the surgery. Don't be afraid to have a consultation with one or two, or three. I met with either the surgeon or went to a seminar about 6-7 times before I decided on the one I wanted to do my sleeve. Most of them have heard it and seen it all, so since they are the ones who will determine if bariatric surgery is right for you, then that is who you need to see. Most of them are really nice and very compassionate, let us know what happens, good luck.

[animallover1247 249]

Many people who have WLS have mental health issues prior to surgery. What they are looking for is to see if your are addressing the issue (which you are) and if you are stable. Additinally that is also the purpose of your psych evaluation. They want a professional to determine if you are stable. If there are issues, they may want you to address them before surgery. They may require some ongoing counseling or at least a few sessions. Of you are self pay, the surgeon may still want the evaluation.

[BLERDgirl 6,417]

Go see the surgeon. Be upfront about your mental health issues. If you are approved make sure to have supports in place in case the rapid weight loss makes causes a spike in your MH issues. This could be anything from increased therapy sessions to a change in meds.

[WLSResources/ClothingExch 3,444]

@Eumoirous--

Being “terrified” of being denied surgery won’t help your preliminary exploration. Your situation is tricky, but not necessarily insurmountable. My first bit of advice, easy to give, but not necessarily to put into practice, is to view each step as a task unto itself. If you do, I think you’ll be calm and comfortable enough to continue with the next steps. Feeling terror now, when you’ve barely begun, makes no sense.

I’m not a medical professional, but I’m happy to give you my thoughts with the hope that they’ll help you compose your list of questions for the professionals.

It’s my understanding that it is the med insurance plans that require a psychological evaluation to determine whether a prospective patient:

• has realistic expectations of surgery
• understands that he must follow through with the usual means of losing weight, primarily changing eating habits and food choices and exercising
• understands and is capable of following instructions given by the surgical practice
• who has out-of-the-ordinary circumstances, such as a mental health disorder, the insurer may want documentation of a significant period of stability and statement of ongoing treatment and the patient’s adherence

Because of the last, it’s possible that your own psychiatrist or psychologist should do the eval. Statements from them to the insurer in support of your having surgery probably would be appropriate documents in your application package.

Consult with a surgeon as well as your psychiatrist. If you see a psychologist, that person, too. Your well-being apart from weight loss is an important part of the equation. For example, does something about surgery and/or the healing process indicate that an ECT treatment be postponed? If so, is it advisable? These are things that need to be determined by your “team” in consultation with each other -- and you, of course.

If, after all that, you’re self-pay rather than insured, being accepted probably will be much easier. In such case, I think it important for you to consider some of the possibilities. You want a surgeon who possesses professional ethics and human decency. If, in your desire for surgery, you would consider a trade for an SAD episode, consider again. I don’t know the answer, but I do know that the decision shouldn’t be casual.

Anyone who has surgery can benefit for a support network all along the way. It's built in at the surgical practice, here at BP and in the support groups that most practices offer. If the practice that you use doesn't have a group, try other hospitals in your area. Most welcome all patients.

I respect and admire your wish to be healthy. For what it’s worth, I’m rooting for you.

Edited November 21, 2015 by WLSResources/ClothingExch

[CowgirlJane 14,261]

I don't know anything about the condition you mention or the treatments, but I applaud you for seeking to improve your physical health too!

I think you should consult with surgeons and have frank discussions about your situation. I have observed, both in myself and over the years of reading this forum that WLS/rapid weight loss of massive weight is a HUGE blessing and can bring some challenges. Some people use food as a crutch. In my case, I was quite surprised to find that obesity itself had been a crutch/ a way of dulling feelings. While perhaps not a diagnosable condition, this whole process has forced me to look at my inner life and find new ways of coping, of interacting of living actually. I mention this as more of a forewarning - the thrills and excitement of tackling obesity is beyond your wildest dreams, but, it comes with some unsettling things at times too.

[pink dahlia 2,513]

If this is any help, you're awesome whether you end up having WLS or not. That is all. End of story. Good night.

[allenjf 16]

I've got some issues myself (pretty significant depression and anxiety), and the second person I talked to was my therapist. She's really helping me a lot with the decision. So like what others have said... talk to your docs.

[James Marusek 5,244]

I never heard of schizoaffective disorder so I looked it up. It is referred to as a combination of schizophrenia and mood disorder - either bipolar disorder or depression.

Several individuals with those types of mood disorders have undergone WLS and have posted on this website. As others have already said, talk to your surgeon, be open, and see what they recommend.

[mskami77 295]

Keep communication open between your psychiatrist and your surgeon. My psych was key in getting my approval and making sure my meds would be tolerable after surgery. Don't be afraid be open and express your concerns. It lets them know you are concerned about all the right things and are willing to address it appropriately. Good luck to you!

[Joz31 90]

@@Eumoirous

I am a psych nurse and very familiar with your question. I don't foresee any way that would impede your surgery. I also have depression, as well as prior substance abuse issues. I was terrified that my history of substance abuse would prevent me from having surgery, but I was totally wrong. I was upfront with my surgeon about my history and the fact that I am active in my recovery and clean for over a year. Totally opposite of what I thought would happen did, my surgeon was highly supportive and said since I had proof of my sobriety and what treatment was working for me, he had no reservations whatsoever. I thought for sure because of the high instance of cross addiction I would be up a creek and not a candidate, but I was completely wrong. Just be honest about your history and treatment method and you will be fine. To my knowledge, ECT should not interfere at all, however, each surgeon varies. Keep searching until you find a physician that is willing and trained to help you through the process. Trust me, they are out there and are compassionate and understanding. The caviat being that you have been stable on this treatment for at least 6 months to a year for most surgeons. Good luck on your journey!!