Beyond Feeling Blue: Depression Before & After Bariatric Surgery
March 18, 2021Depression and Bariatric Surgery
Evidence is strong that mental health and obesity are interrelated. Depression is the most commonly diagnosed mental illness in bariatric patients, with a recent report stating that 19% of pre-surgery patients meet clinical criteria for depression. This is more than twice the percentage of the general US population, which is 8%. Addressing depression pre-and post-operatively has a profound impact on achieving optimal outcomes. If you have depression and bariatric surgery, you are not alone!
How Do I Know If I’m Depressed?
Depression does not look the same in everyone. It can manifest as feeling tired, irritable, not motivated, tearful, hopeless, hungry, or avoidant. You may not even recognize that what you are experiencing is depression.
Most bariatric programs require you to meet with a clinical psychologist before surgery. These mental health providers have specialized training to meet the needs of weight loss surgery patients. They can help you to identify if any of these symptoms are severe enough to require treatment before having surgery or begin treatment to address symptoms that occur after surgery.
Prior to surgery, depression often interferes with meeting your diet and exercise goals, reduces motivation to change, and makes it harder to change your emotional relationship with food. It may lead you back to the comforting, yet destructive, patterns of emotional eating and inactivity.
- Have you felt "Down", Depressed or Hopeless?
- Have you had little pleasure or interest in doing things?
- Do you find yourself withdrawing from family, friends, or co-workers?
If you have answered yes to one or more of these questions, it’s time to reach out for help.
It can be difficult to talk about your feelings because of shame, fear, or even worry that you will not be able to have surgery. Remember, the psychologist is there to help set you up for success, not to be a barrier or gatekeeper in your weight loss journey.
Research shows that if depression is not addressed at any point in your weight loss journey, it can lead to suboptimal outcomes (ie: losing very little weight, weight regain, transfer addiction to other substances, and complications).
Depression and Bariatric Surgery
After surgery, depression can interfere in the same ways. You may not have felt depressed before surgery, but the sudden and significant changes in surgery can cause these symptoms to emerge. This is very common, you are not alone!
Recovering from major surgery and making associated behavior changes related to food can be very emotionally taxing. Patients sometimes “miss” the comfort of their eating habits, or struggle to keep up with the treatment recommendations.
Some patients even feel that the experience did not meet their expectations (ie: I feel worse than I thought I would, this is not as easy as I thought it might be). Family and friends may offer their support, but they often do not understand the full experience of weight loss surgery. It may feel a bit isolating.
Seeking Treatment
So what can you do? The first step is recognizing that these symptoms are more than just feeling down. Clinically, we look if it is interfering with your daily functioning beyond the recovery period. By daily functioning, we mean activities such as daily tasks, going to work, getting out of bed, or even personal hygiene.
Many bariatric programs have psychologists on the treatment team who are there to support and treat patients just like you! It can feel intimidating to call in and ask for help. Remember, that is what we are here for. We want to see you be successful, there is no timeline except your own.
How Do I Feel Better?
More than likely, you just want to feel better, more like yourself, and enjoy the journey. Weight loss is physical and mental.
Tips to Jumpstart Emotional Recovery During the WLS Process
Talk to friends and family
- “This has been a lot for me and I need some support right now”
- “I am struggling to feel motivated to take care of myself right now”
Simplify
- Set boundaries. Sometimes saying yes to everything or allowing others to freely voice their opinions about your weight can take an emotional toll. Responding with “This has been a lot for me, and right now I feel like I need to take a break from discussing my weight.”
- Small goals each day will help you feel a sense of accomplishment. Go for a five-minute walk, start the day with a protein shake, or call a friend.
Positive Activity Planning
- I recommend that my patients get out their calendar and write ONE thing every day that they can do for themselves. Having something to look forward to and engage in really boosts mood. A short five minute walk can work wonders! Sitting down and concentrating on a project can be very calming. Planning a walk with a furry friend may be the motivation you need.
Join a SUPPORTIVE support group
- There are a number of support groups online. Some are not so supportive. A great resource on ObesityHelp and other social media groups are just a few clicks away.
Reach out to your bariatric team
- They are there to help you. They will not judge you, shame you, or be upset. In fact, they will be glad you called and are invested in your well-being. Your bariatric surgery journey begins before you have surgery, it certainly does not end on your surgery date, and continues long-term.
 | ABOUT THE AUTHOR Jennifer M. Duncan is a clinical psychologist in the Weight Management Institute at Summa Health. She provides mental health services to surgical and non-surgical weight management patients. Services include psychological evaluation, psychological testing, and supportive psychotherapy to patients with eating and weight issues.Read more articles from Dr. Duncan! |
