Hello! I am new to the forums and currently planning my gastric sleeve journey. Right now I am considering surgery in Mexico at Endobariatric with Dr. Alvarez or possibly another self-pay program in Florida. Self-pay programs don’t have the pre-op therapy (or dietician meetings, etc) or post op support groups. From what I can tell, most surgery centers only allow their own patients to attend any monthly support meetings. Since the mental component is so important, how have others that did not use insurance address this? I want to make sure I have a plan in place to address my own mental health - especially since I live alone and have just moved to a new state by myself. Would this be better in the post-op forum for people that have already gone through it? Thanks for reading.

Hi Devi, and welcome! I was self-pay (VSG at Cleveland Clinic). Their “package price” included a year of nutritionist and psychologist appointments.

You should call local hospitals and ask them. The one I went to before Covid had people that had surgery elsewhere. Now it's been virtual for a while.

I actually thought about this a whole lot.

I was self pay in Canada, and while there was nutritional counselling, there wasn't any psychological counselling as part of the package. I worried about the emotional and psychological adjustments that I'd have to make after surgery, changes in interpersonal relationships, possible dysmorphia, etc. etc.

Your mileage probably will vary, but what I found is that none of that has been an issue. I am skinner and healthier than I was, but otherwise I am exactly the same person as I was before. Maybe that's because I didn't really have as much weight to lose as some (I'm only down 65 lb) but for what's it's worth, my experience was that the psychological impact of surgery was vastly overemphasized.

I think your planning for potential problems is wise, but for what it's worth, I spent a lot of time worrying over nothing.

You can always seek out a bariatric therapist and a nutritionist on your own and see them as needed. Of course you will have to pay but at least you know that is an option.