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What to say to the psychiatrist



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I’m guessing the last step is to see the psychiatrist. I heard this was the hardest part. And actually determines if your insurance will approve you or not. Can anyone give me any advice on this?

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I'm sure different psychiatrists have different approaches to this but some of the things my evaluator was looking for included:

  1. Understanding of the risks and possible consequences of surgery
  2. Commitment to making permanent changes to how I eat
  3. Realistic expectations
  4. Any pre-existing mental illness is being treated and managed well
  5. Any pre-existing eating disorder has been addressed medically and psychologically
  6. Any other addictions have been treated and managed
  7. The presence of an adequate support network

I really didn't get the feeling that she was looking for reasons to disqualify me. It was more like she was doing due diligence to make sure I was of sound mind and mentally healthy enough for the challenges of bariatric surgery. It took 30 minutes, tops. I wouldn't stress too much.

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Tell the truth. The head work on the weight loss journey is really important. You might get an immediate go ahead or they may offer strategies to support you. Your honesty will only help you be more successful on your journey.

The process is different in Australia, the psych evaluation is not mandatory but at the discretion of your surgeon’s recommendation. My surgeon said I didn’t have to go but sent a friend to one session. Another friend had two pre surgery sessions & continued to go after her surgery.

Good luck.

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I didn't think it was the hardest part. I thought the test I got was a little annoying (repetitive questions), but in the interview he did afterward, I think he was just trying to see if I had realistic expectations and was ready for this. I don't think this part had any more bearing on insurance approval than any other part did.

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I found the interview helpful. My psych had bariatric surgery 10 years ago so I had as many questions for her. About 30-40 minutes but basically just a chat.

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Just be honest. Admit your fears and past mistakes with weight. They'll want to know if your expectations area realistic. They'll ask if you have a support/encourage network of people to surround you.

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I ended up being really thankful for my psych eval. She went through my medical and personal history. Some of it was painful to bring up, but it is also necessary to understand how some of my habits came to be. Additionally, I had previously only seen my PCP for my anxiety and depression, but I felt like the psychiatrist was better able to understand my underlying mental health conditions and I have been seeing her ever since! I had some of the same thoughts/questions/worries, but I quickly came to realize that the psychiatrist genuinely wants people to be successful, so I hope you will also have a positive experience.

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I found mine to be a complete waste of time other than checking the insurance box. She just asked me dozens of questions with where I saw myself on a 1-5 scale. I felt like I was just answering some sort of online personality test. The only open ended question she asked was if I had a close relationship with my mother. I was completely confused as to what that had to do with anything. I asked for clarification as to what a close relationship meant and she said like do I confide in her.

I told her that it was difficult to answer that because my mom has dementia and multiple strokes so she wouldn’t understand anything I tried to confide in her and she quickly backpedaled and was like ok never mind then how about when you were a child. I was like, uh, yeah when I was a kid we had a good relationship. And that was the end of that.

I guess I passed her list of 1-5 rating scale questions and her one question about my mom. Very strange. I’ve never talked to a mental health professional before and I’m going to be honest it didn’t exactly inspire me to want to in the future.

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I was very unprepared for my psychiatrist visit. All they had me do was fill out a questionnaire and then leave. I thought we were going to take about my answers to the questions. I answered the question "Do you ever think about death?" with a yes. I didn't mean that I was suicidal or that I wanted to die, just that I have thought about whether or not anything happens after death. Since we didn't talk about my answers I did not get a chance to explain that. The psychiatrist recommended against surgery for me and I had to go to my PCP and my normal psychiatrist to get them to write letters saying I am not suicidal. It was a hassle.

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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