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What would disqualify me in a Psych exam?



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Hi everyone,

I have an upcoming Psych eval ( over Zoom) for WLS. What would disqualify me or not clear me for surgery? I have heard a few people say that they didn't pass their Psych exam, why?

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Hi, this is what held my surgery up going through the psychology process, they start from the very beginning of you being a child and what family life was like, then they go through relationships, losing people, alcohol and drugs. Personally mine was abusive relationships in the past and my partner passing away. But they want to know everything about everything.

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1 hour ago, CLC1981 said:

But they want to know everything about everything.

Oh wow. Mine wasn’t like that at all. Mine asked why I was there, why I thought I needed surgery, what I thought the surgery would do for me, and if I knew the possibility of risks involved. Then there was the 200 yes/no questionnaire I had to fill out afterwards.

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Yes mine asked all those questions also but was more like I was turning to food because of what happened over the years the way they were putting it and it just seemed to drag on for over a year.

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I'm sure almost everyone has a few "issues" - but they want to see if your particular issues might hinder your weight loss, and/or if you understand what you're getting yourself into and if your expectations are realistic. Most people do pass it...

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They definitely dont want to hear your reason for wanting to lose weight is to wear a bikini. The reason should be for health. Also many people, myself included have a need for food for comfort. I need to learn what I can replace that need with other than food or other bad addictions.

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I didn't have to do a questionnaire. They wanted to know about my history with food behaviors (like whether I had any history of eating disorders/food addiction), any other mental illness (I have bipolar disorder and they just wanted to know it is being treated and they said they want to get sign off from my psychiatrist), family/friend support, etc.

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My psych exam was great actually. She asked me which surgery I was having, and asked what my surgeon had told me about the risks and benefits, and why I wanted the surgery.

Then, she went on to explain the surgery, dumping syndrome, liver shrinking diet, etc. I was very impressed with her knowledge and I enjoyed the discussion.

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I think it’s important that you are just honest. The psychiatrist I seen did not ask a lot of questions and I literally just left a message today to try to schedule an appointment with a specialist because I feel I have issues with food that I need to work on. Having already had the surgery I am racing against the clock to figure them out before I waste this tool. We all have been there dying to get the surgery even one week sooner at all costs but you will not get flat out denied if anything it will just be delayed but that time will be well spent preparing you to be In the best place after your surgery. So what seems devastating having to wait could mean the difference between the surgery helping you to the full extent.

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Mine was really unhelpful in the sense that it was mostly just answering questions about stress on a scale system, etc. She didn’t really impress me as someone who had a lot to offer me so far as counseling and advice.

I’m gonna be honest, it was clear that she was just trying to make sure that I had a home environment that wouldn’t undermine my success, that I wasn’t mentally ill to the point that I would be a surgical risk, and that I understood the surgery/had reasonable goals and expectations so I tailored my answers to that. I had my psych exam in the middle of covid however during one of the most stressful times personally and professionally and no way in heck was I going to start discussing that with someone who I didn’t even know when my end goal was just to check off this requirement for my insurance.

At some point I want to potentially meet with someone to discuss my issues with food, family, etc but I’ll do that with someone of my own choosing at a time of my choosing. My goal was to get cleared for surgery so that is what I did.

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So I "failed" my psyche exam. The psychiatrist asked questions about my eating habits, how much I eat in a sitting, how long it had been going on and stuff like that. I was honest in my answers and let her know that while I had been eating better within the past few weeks, that wasn't representative of how I was eating that caused me to gain weight. Those were just some changes I had made after starting the process for surgery. I also had to fill out a questionnaire about binge eating.

My eating habits pre-surgery decision, and when not on a diet, included a Protein Shake for Breakfast, and then eating a lunch that was so large it was physically uncomfortable, and not really eating anymore for the rest of the day as a result. We're talking a Giant Jersey Mike sub order with two bags of Doritos (from the store, not like family sized chip bags), all in one sitting. I also had little to no control with sweets in the house. If they were present, I'd eat them. Due to my eating habits, she thought I may have a disordered relationship with food and just wanted to give me some additional time to address that before surgery. She also wanted me to get back on depression medications, as she was afraid I was coping with food and that I'd spiral horribly if that was taken away.

This means I've been following up with a different psychiatrist for the past few weeks to talk through things and work on behaviors, and will hopefully be getting approved for surgery within the next month (everything looks good right now). The psychologist now doesn't seem to want me perfect, but to show I'm willing to make changes and be in a good enough place to give me a running start and set myself up for success.

I'd highly recommend being honest about what you eat. Even if you get delayed, the additional therapy will help set you up for success long term.

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I had my Psych Eval yesterday - we did it via telehealth.

It lasted one hour, she asked mainly about my history with dieting, my life history in general, what I typically ate in a day and a lot about my mental health progress with my therapist. She wanted me to be 100% sure that I was ready for all of the changes.

She told me that she believed I was a good candidate for the surgery BECAUSE I had obviously had previous trauma and things that needed sorting and that I rose to the occasion to sort them out.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      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.

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

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