Adult Pre-Bariatric Surgery Psychological Assessment

What is a Pre-Bariatric Surgery Psychological Evaluation?

You have made the decision to pursue bariatric/gastric weight loss surgery!

A good first step in the process, if you have not already done so, is to watch the free informational video about bariatric surgery likely located on your surgeon’s homepage online.  Otherwise, if there is not an online seminar or video available, many surgical teams have a free informational meeting that you can attend in person, or a question-and-answer opportunity with professionals on the surgical team.  There, you can learn more about the common types of bariatric surgery, such as a Gastric Bypass Surgery (Roux-en-Y), a Sleeve Gastrectomy or Endoscopic Sleeve Gastroplasty, a Biliopancreatic Diversion with Duodenal Switch (BPD/DS) surgery, or an Intragastric Balloon surgery.

At some point, you are going to be told that you need to get a Psychological Evaluation prior to surgery, in addition to other various medical check-ups.  This pre-surgical psychological evaluation is used by bariatric surgical teams to help determine your readiness for surgery and to rule-out any mental health or behavioral difficulties that could impede your immediate recovery from surgery or psychosocial problems that could get in the way of you successfully utilizing the long-term benefits from bariatric surgery.

How do I get a Weight Loss Surgery Psychological Assessment?

Some surgeons and surgical teams have a list of psychologists from whom they would like you to choose.  Other surgical teams might suggest that you find your own evaluating psychologist through your insurance company or through other means.  

Collectively, at Soul Work Counseling, we have been conducting Pre-Bariatric Surgery Psychological Evaluations for 20 years. Contact us; we can help!

It is normal to be nervous about this step during your pursuit of weight loss surgery, but knowing what to expect can help.

Different psychologists will approach these health and behavior psychological assessments in various ways, some with more appointments, some with less appointments.  However, it is important that you confirm that your evaluating psychologist is licensed and is trained in completing these types of evaluations.

Most of us who regularly conduct Pre-Bariatric Surgery Psychological Evaluations combine psychological testing measures with interview data and a review of your history to come up with your psychological “clearance” status for surgery and to provide recommendations prior to bariatric surgery.  Psychological tests you may take for this evaluation can range from personality test instruments to psychological tests designed to categorize mental health symptoms.  Some professionals will want to measure your overall life satisfaction or give you psychological tests designed to screen for eating disorders or chemical abuse or chemical dependency symptoms.  Tests chosen will vary across providers.  We typically give 3-4 tests for this assessment, which on average, take about an hour-and-a half total time for most people to complete (1-2 hour range depending on your reading speed).

What will this evaluation say about me, and how will it affect my Bariatric Surgery?

Most of the time, psychological evaluation recommendations are based on your health behaviors and habits that need to change and improve prior to surgery.  Often, recommendations psychologists give will not interrupt your pre-surgery process for weight loss surgery; these types of recommendations are informational or instructive to help you maximize your future benefit from bariatric gastric surgery.  

We work to make these psychological evaluations as helpful and as informative as possible!

Some recommendations an evaluating psychologist could make might delay your pre-surgery process if there are more serious difficulties or significant changes that need to be addressed prior to bariatric surgery.  In rare circumstances, the pre-bariatric surgery process could stop due to conclusions from the psychological assessment, unless the surgical team deems your medical issues severe enough to proceed with bariatric surgery regardless of the psychological evaluation recommendations.

Commonly, two separate referral questions are being asked and answered by this pre-surgical psychological evaluation:

• Are there any mental health concerns for you, which are not already identified and treated, that could get in the way of bariatric surgery recovery and impede your long-term benefits from bariatric surgery?
• What is your psychosocial and behavioral readiness for surgery and do any improvements need to be addressed (social support network adequacy, ability and willingness to access help, practice of self-care, interpersonal relationship boundaries, stress management and use of non-eating stress management coping skills, recent chemical use history, etc.).

More serious issues that may lead to evaluation recommendations that could delay or stop a pre-bariatric surgery process include the following:

1. Undiagnosed mental health problems that need a referral for treatment (or undertreated mental health problems that need to be better treated for mental health stability).
2. Chemical abuse or dependency symptoms/history within 6-12 months prior to surgery.
3. Pattern of suicidal thoughts and an attempt of suicide, and/or self-harm behaviors, within 1 year prior to surgery.
4. Serious and persistent mental health problems that significantly impede emotional stability and behavioral consistency, and/or Personality Disorders that are not well treated and have behaviors that get in the way of healthy interpersonal interactions and negatively influence your ability to follow treatment expectations over time.  [For example, it is helpful if individuals with Borderline Personality Disorder have gone through, and graduated from, a Dialectical Behavioral Therapy (DBT) program prior to pursuing bariatric surgery.]  Borderline Personality Disorder and treatment
5. Current difficulties with diagnosable Binge Eating Disorder, which, if left untreated, can create serious and dangerous problems for you after a bariatric surgery.  If outpatient psychotherapy alone has not helped to manage your Binge Eating Disorder into remission, receiving treatment at an eating disorders program prior to any type of weight loss surgery is helpful and often necessary.  There are several programs and providers in Minnesota including Melrose Center through Park Nicollet & HealthPartners; The Emily Program affiliated with the University of Minnesota; and this informational website called Eating Disorders might help you find the right treatment team or support group.

The Mayo Clinic in Minnesota has some good online resources to learn more about Bariatric Surgery and other mental and physical health topics.

Ultimately, you and your surgical team determine your fit for bariatric surgery.  The psychological evaluation is designed to help identify readiness for surgery and to assess for potential problems that could occur for you after bariatric surgery and to try to prevent those problems from occurring.

What if my bariatric surgery has already been delayed or stopped by a past Psychological Evaluation?

We can help you work to achieve the goals, and address the recommendations, that a psychologist has already given you in a past psychological evaluation.  We can help review your written psychological evaluation and, if possible, determine an action plan and a course of psychotherapy to help you work on those recommendations and prepare for reassessment with that evaluating psychologist.

What else is helpful for Bariatric Surgery Patients?

Besides conducting these health and behavior pre-surgical psychological evaluations, some of our practitioners at Soul Work Counseling also provide psychotherapy, as needed, for patients before and after bariatric surgery to help with surgery preparation and also to address any emotional and behavioral bariatric surgery adjustment needs.  

Telehealth Evaluations

We can also conduct online telehealth interviews (HIPAA compliant videoconferencing) and remote online psychological testing under most circumstances for Minnesota residents.  It is important that you check with your insurance that they will cover telehealth psychological evaluations.

Dr. Benson is also a PSYPACT telehealth provider (APIT # 10303) and is authorized to provide interjurisdictional telehealth psychological services for clients residing in other participating PSYPACT states, via telehealth. If your state is highlighted in blue on the map in the link below, then Dr. Benson can work with you. (If Dr. Benson is out of network for your insurance, you may pay upfront for services and a Superbill can be provided to you after services are completed, which you may then submit to your insurance company for reimbursement.) https://psypact.site-ym.com/page/psypactmap

Contact Us!

Please do not hesitate to contact us if you have any questions or concerns about the Pre-Bariatric Surgery Psychological Evaluation or questions about other services that might be helpful to you either before or after Bariatric Surgery.  We can talk over the phone or through e-mail and, if desired, get you scheduled for an Intake Appointment to take the next step.  

We would be happy to help!

(When checking your insurance, pre-licensed providers conducting these evaluations are supervised under Shawna M. Benson, PsyD, LP and Jennifer Lees, PsyD, LP at Soul Work Counseling, Blaine location.)