Failed My Psyche Eval

[SunnyinSC 137]

I'm throwing this here cause it's more of a rant than a question. Just wanna complain to some people who may get it. To get it out of the way, I am not mad at the psychologist, or the clinic or anything like that. I understand why I need more therapy prior to getting surgery and I fully agree that addressing problematic behaviors is important for long term success. The support of bariatric psychologists and support groups is why I decided to go with a hospital close to me that offers that stuff as part of the program instead of going to Mexico where it'd be much much cheaper as a self pay patient.

All that being said, I can't help but feel a bit down trodden and frustrated. I go to therapy frequently, and have for years. The past few years I've felt like I was doing really well. I hadn't had any major bouts of depression or anxiety that lasted for notable periods of time. There had been a few hiccups but they were promptly addressed and such. I thought I was gonna pass this thing with flying colors. Alas, nope. My psychologist that was evaluating me asked if any of the doctors or surgeons I had visited over the years had asked about my relationship with food cause she was seeing some concerning things, and honestly they haven't. That isn't to say I haven't talked with my therapist about my weight, it's just that eating patterns and behaviors themselves weren't ever really discussed. It was more just acknowledgement that depression and anxiety had contributed to weight gain. The bariatric psychologist also stated she doesn't think my current medications are working as well as I think, and that based on what I described as "normal" eating for myself, I am self-medicating with food in addition to the medications, and she'd like to make sure that I won't spiral once that food aspect is no longer a possibility. So I am now scheduled to see a therapist who specializes in bariatric surgery and disordered eating (she doesn't think I have Binge Eating Disorder, but she does think that my eating is disordered), and we'll check in 90 days later. The psychologist did repeatedly thank me for being honest though, so there's that 😕

I had a bit of a cry session yesterday when I found out. I am continuing to remind myself that the behavior and mental support part is why I chose to go with the hospital I did over other places. This is essentially what I wanted. I don't want to fail at this. I know it'll pass and a few months (hell even a year or two) is a drop in the bucket compared to the rest of my life. It just doesn't seem that way in the moment and I'm just super bummed out.

Edited March 16, 2021 by SunnyinSC

[Jaelzion 1,123]

I'm really sorry. I know the delay stings. Hopefully the time will pass quickly and yield great benefits!

[ChubRub 1,696]

I'm so sorry! It's so frustrating, b/c I feel like most WLS patients (myself included!) have an unhealthy relationship with food (it's not "normal" to be 100lbs overweight, etc). I also feel like it's luck of the draw with some psych evals.

Sending lots of hugs and hoping you can get to the root of your issue, so that when you do finally have WLS you have all of the tools (both mental and physical) to make it a success. Lots of HUGS and good luck!

[SunnyinSC 137]

25 minutes ago, ChubRub said:

I'm so sorry! It's so frustrating, b/c I feel like most WLS patients (myself included!) have an unhealthy relationship with food (it's not "normal" to be 100lbs overweight, etc). I also feel like it's luck of the draw with some psych evals.

Sending lots of hugs and hoping you can get to the root of your issue, so that when you do finally have WLS you have all of the tools (both mental and physical) to make it a success. Lots of HUGS and good luck!

Thank you both. I definitely do feel it's a bit luck of the draw, but in a way I am happy to have had one that listened and actually seems to want me to succeed. A friend who also went through the process recently is going through a different place, and her evaluation was just a multiple choice questionnaire, while mine was a questionnaire, but then an hour sit down with the psychologist to discuss eating habits themselves.

Really trying to look and find silver lining to fight off the blues, cause logically I know it's better to address this stuff now, and obviously I wasn't addressing it as well as I thought because the right topics weren't being discussed previously. I do very much appreciate the support this forum offers and knowing I am not completely alone in this journey. My husband is super supportive, but he's never had to deal with weight issues and he honestly doesn't really understand a lot of what I'm going through. He listens and he'll offer comfort and hugs (which do help!), but he doesn't identify with it cause his relationship with food is healthy and he's never struggled with weight.

[SunnyinSC 137]

@OAGBPal Thank you for the links. I will definitely be adding to and reading all the discussion in the eating disorder thread. I did read @Creekimp13 food addiction post and it really did hit home in a lot of ways. I didn't respond to it cause I wasn't sure what I could really add there. I love her posts in general though. Always well worded, relatable, and on point!

I don't know that I'm handling things particularly well, but I'm trying! Part of the reason of wanting to write up something, and why I continue to mention that I know this is ultimately better, is I need to remind myself. I know all the folks reading this stuff don't need to read about how mental health is important and therapy for it is an important part of the recovery process.. but typing it out like that helps me remind myself. Fake it until you make it, or something similar, because the emotional side of me is not being logical today, haha. So I apologize if I sound like a broken record. It definitely is a scary, and anxiety inducing process, but I know in the end I'll be grateful I held on.

[SunnyinSC 137]

1 hour ago, OAGBPal said:

Btw ... skip the squabbles in the middle of the ED thread, it does get back on track, I promise Feel free to add your thoughts and share your own things. The more we talk, the more we win against the monster that is disordered eating.

I didn't! Haha. I got in a bit of a squabble myself in another thread. They tend to happen, but I'm glad the thread was able to get back on track. It really is an important discussion to be had and you're right in that I'm surprised there isn't a forum for the mental health side. Seems like putting together a place to share resources to find help, and perhaps find suggestions on good bariatric therapists who are knowledgeable about overeating would be a good fit for a WLS forum.

[JustJazzy 67]

8 hours ago, SunnyinSC said:

I'm throwing this here cause it's more of a rant than a question. Just wanna complain to some people who may get it. To get it out of the way, I am not mad at the psychologist, or the clinic or anything like that. I understand why I need more therapy prior to getting surgery and I fully agree that addressing problematic behaviors is important for long term success. The support of bariatric psychologists and support groups is why I decided to go with a hospital close to me that offers that stuff as part of the program instead of going to Mexico where it'd be much much cheaper as a self pay patient.

All that being said, I can't help but feel a bit down trodden and frustrated. I go to therapy frequently, and have for years. The past few years I've felt like I was doing really well. I hadn't had any major bouts of depression or anxiety that lasted for notable periods of time. There had been a few hiccups but they were promptly addressed and such. I thought I was gonna pass this thing with flying colors. Alas, nope. My psychologist that was evaluating me asked if any of the doctors or surgeons I had visited over the years had asked about my relationship with food cause she was seeing some concerning things, and honestly they haven't. That isn't to say I haven't talked with my therapist about my weight, it's just that eating patterns and behaviors themselves weren't ever really discussed. It was more just acknowledgement that depression and anxiety had contributed to weight gain. The bariatric psychologist also stated she doesn't think my current medications are working as well as I think, and that based on what I described as "normal" eating for myself, I am self-medicating with food in addition to the medications, and she'd like to make sure that I won't spiral once that food aspect is no longer a possibility. So I am now scheduled to see a therapist who specializes in bariatric surgery and disordered eating (she doesn't think I have Binge Eating Disorder, but she does think that my eating is disordered), and we'll check in 90 days later. The psychologist did repeatedly thank me for being honest though, so there's that 😕

I had a bit of a cry session yesterday when I found out. I am continuing to remind myself that the behavior and mental support part is why I chose to go with the hospital I did over other places. This is essentially what I wanted. I don't want to fail at this. I know it'll pass and a few months (hell even a year or two) is a drop in the bucket compared to the rest of my life. It just doesn't seem that way in the moment and I'm just super bummed out.

Delayed not Denied! Everything happens for a reason I know that’s not what you want to hear but it’s not the end. In 90 days you’ll see her again and pass and be on to a better you. Sending you positive vibes

[suburbaneck 6]

Okay, this might ruffle some feathers, but I think that’s a load of BS and I’m REALLY sorry that happened to you. We all self-medicate with food. Literally every single one of us uses food inappropriately in one way or another or we wouldn’t be seeking WLS. You’ve already been in therapy and isn’t that what would happen anyway? More therapy. She could tweak your meds without “failing” you. I’m sorry but I feel like you should be assertive and get another opinion. Seems like the psychologist might’ve been on a power trip and/or looking to increase income by ensuring future visits.

[Creekimp13 5,838]

Hugs. Hang in there and do the work. I've seen a few folks get delayed sorting out some different issues on the psychology side....and many of them eventually get approved and do well. It's a journey, not a sprint. You'll get there. Crossing fingers and toes for you.

[SunnyinSC 137]

1 hour ago, suburbaneck said:

Okay, this might ruffle some feathers, but I think that’s a load of BS and I’m REALLY sorry that happened to you. We all self-medicate with food. Literally every single one of us uses food inappropriately in one way or another or we wouldn’t be seeking WLS. You’ve already been in therapy and isn’t that what would happen anyway? More therapy. She could tweak your meds without “failing” you. I’m sorry but I feel like you should be assertive and get another opinion. Seems like the psychologist might’ve been on a power trip and/or looking to increase income by ensuring future visits.

I appreciate your concern. That said, I honestly don't believe she was on a power trip or anything, and my follow ups will be with a completely different therapist/office/practice so I don't think it was money. This psychiatrist is used by the hospital for surgery approval quite frequently and the nurses and dietician I have spoken to did not give the impression that patients are often delayed by the psychological evaluation. I think I'm probably the exception, not the rule.

While it is true I've been in and out of therapy for years (21 to be precise), that has always been for depression and anxiety, and has never really addressed my eating habits or eating behaviors. Which does explain why even when I have my depression and anxiety under control (or what I feel like is under control), I was still gaining weight over time. Given some of the questions she asked regarding how long certain behaviors had been going on, and the responses I gave after some thought, what she was saying made sense and does apply to my situation. I very much appreciate that she was honest with me, and while I may not like the outcome, I do think that addressing some of the behavioral eating problems, in the same way I've addressed depression and anxiety, will be better for me long term. I don't expect they'll want me perfect prior to surgery, just in a better place since it's not uncommon for depression and anxiety to get worse after surgery for patients with both those chronic illnesses and disordered eating habits.

[chiquitatummy 326]

This happened to me too. I had my psych visit a few months into covid lockdown and I kind of melted down when the psych asked me about stress and how I cope. Like you, I also got super honest and talked about a fairly new realization of how much I have used food to resolve anxiousness. I don't have a clinical eating disorder but absolutely have had unhealthy eating patterns that include use of food as a coping mechanism for stress and anxiousness. The psych ended up scheduling one more visit with me and referring me out to a therapist who I still seeing once a month. I was cleared once I started therapy and completed a 2nd psych visit.

Honestly, it's been really nice for me to be back in therapy again during this time. I was worried that being off work and recovering from surgery at home might be rough enough that I would have a depressive slump (I didn't, yay!) so it was really nice to be able to schedule an appointment for one week after surgery as a lifeline just in case that happened.

Edited March 17, 2021 by chiquitatummy

[Creekimp13 5,838]

I think that a LOT of people have the reacation "All fat people self medicate with food...why should anyone be delayed from weight loss surgery because they do? Are the therapists on a power trip, are they just making money?"

There is some truth in this...that nearly all of us medicate with food.

But why is that an issue?

There's a very common phenominon that occurs with bariatric surgery called cross or transfer addiction. It is said to affect about 30% of people who have surgery.

When people find they can't eat to self medicate, they can switch to other addictions for relief.

Not just alcohol and drugs.

They can also become sex/intimacy addicts. They can start spending too much, gambling, there are a lot of ways for this to manifest. Exercise addiction. Controlling behaviors with family/children. Annorexia. Most of us think of annorexia as something absurd that could never happen to us....but it happens! Same disordered eating...just a different expression of it.

Also, there's a reason they call it divorce surgery. It can and does add strain to a relationships to have dynamics change profoundly. Eating is a big part of socializing, relaxing, relating to family, friends, coworkers. Eating dysfunction can be familial and codependent. There are some big changes that go with this whole process. Sometimes, they're easy changes, and sometimes they're not.

Sometimes they cause all hell to break loose for the person inside them.

Also, there is tremendous risk of remission...where you lose weight for a little while, then the food addiction and disordered eating come roaring back and you can physically injure yourself if you don't have other coping mechanisms in place.

I am not saying that ANY of these situations describe any particular posters here any more than they could potentially describe all of us.

Just sayin....if at your psych eval your therapist recommends more support, more preparation....that can be a good and responsible thing to do for yourself. That can help guarantee your best chances. It can make this time of change more joyful and less stressful. It can make you more successful in the long run. Figuring this stuff out is a great investment in yourself.

Best wishes to all.

[moonbean85 35]

Wow I just made a mental health post. I'm sorry your process is delayed a bit. I had a 20 min phone psych eval for my clearance. To be honest I wasnt ready. Here I am 3 weeks after surgery and mentally in a very dark place. I didn't think I was going to actually have the surgery. This was my second time starting to look into it and up until I was strapped on the operating table I didnt believe it was going to happen. I thought something is going to delay or deny me like last time. Dealing with the cold turkey stopping of food is hard, especially with not alot of support. I can see how easy it would be to swap out eating for Any other self destructive habit and I'm trying so hard to not do that. Best of luck to you on your journey. It may not feel like you need it but hopefully you'll get the tools to deal with the psychological effects of the surgery and have such a better time adjusting post op than if you wouldn't have.

Sent from my SM-G950U using BariatricPal mobile app

[SunnyinSC 137]

5 hours ago, moonbean85 said:

Wow I just made a mental health post. I'm sorry your process is delayed a bit. I had a 20 min phone psych eval for my clearance. To be honest I wasnt ready. Here I am 3 weeks after surgery and mentally in a very dark place. I didn't think I was going to actually have the surgery. This was my second time starting to look into it and up until I was strapped on the operating table I didnt believe it was going to happen. I thought something is going to delay or deny me like last time. Dealing with the cold turkey stopping of food is hard, especially with not alot of support. I can see how easy it would be to swap out eating for Any other self destructive habit and I'm trying so hard to not do that. Best of luck to you on your journey. It may not feel like you need it but hopefully you'll get the tools to deal with the psychological effects of the surgery and have such a better time adjusting post op than if you wouldn't have.

Sent from my SM-G950U using BariatricPal mobile app

I honestly don't know if I'll every truly feel totally ready. It is a large change. But I am hopeful that I can feel more ready than I do and that the additional therapy ahead of time will pave the pathway to success. I am -still- bummed about pushing it back. Delaying 90 days (assuming I get approved then) means I'll need to cancel the vacation we had planned in September cause I won't be able to request time off so close to the time off I'm taking for surgery. But we can also push the vacation back a bit too. It's just a lot and I needed the safe place to rant to people who get it. I appreciate all the supportive comments and I hope you also get the help you need for dealing with the big life change. I know I posted that in your thread too, but figured I'd add it here. It sounds like you're at least taking the steps you can to address it, which is wonderful!

[Elahnen 183]

You should proud because you were honest with the psychologist and yourself! You are setting yourself up for success by being open and honest. I know right now it definitely does not seem like a positive and it is frustrating, but you will get there! So many people aren’t honest and pass the psych, but later fail bc they weren’t truthful with themselves! Your not alone! Good luck!