Questions about Psych evaluation

I tried to post this earlier and it seems to have not saved.. so here I try again. I understand that I have to have a Psych evaluation as part of the approval process and there are two issues that concern me. I was hoping that you might have some insight or experience that would help with these concerns... First off.. I had read in other post that the Psych would be concerned about approving me if I have admitted to having an eating disorder. Which, honestly, is what I have. I overeat.. dangeriously, when I'm upset, bored, frustrated.. or whatever. I don't understand why this would cause me not to be approved because honestly, don't we all have eating disorders? Secondly.. I have a history of self abuse. (Cutting, with very visable scars on my arms) I have been in treatment with both a Psych and a therapist for this but I'm wondering if this would cause me not to get approved either. I'm not sure how to best relay this information to the doctor *and* get approved. Do you have any advice or suggestions? Thanks in advance for your help.. and hopefully this doesn't end up being posted twice. Courtney

Hi Courtney, I had my psych consult with Dr. Florina Haimovici who at least last fall was the psychiatrist assigned to do the psych screens for bariatric surgery at B&W. My appt was 20 mins tops and couldn't have been easier. Basically she asked a standard form with questions about family history, previous weight loss attempts, current medications, etc. I suffer from depression and anxiety and take several medications for both. I had no problem with the consult. Basically her job is to make sure you have a realistic understanding of what the surgery entails, are emotionally stable to handle the surgery and follow through with the aftercare and can give proper consent. We all have an eating disorder or we wouldn't be choosing WLS. I had a history of bulimia though which esp. with the band is a concern (were I too self-induce vomitting I could risk serious complications incl. band slippage). Honestly I can't even recall if Dr. Haimovici asked me about eating disorders outright and while I wouldn't lie had she asked me I do not recall volunteering the info about my bulimia (I am recovering and haven't purged in several years). Similarly I wouldn't wear short sleeves if I were you but if she asks about self-mutilation be upfront about it. Are your therapist and/or psychiatrist supportive of you getting banded? If so, it might help to get a letter from either/both of them stating this and bring it with you to the consult - again, in case the issue arises. Best of luck, Caeli

I have to agree with Caeli. She was the woman I had my pysch appt with also. My appt could not have gone smoother had I planned it myself. I was in for maybe 15 minutes. The paper work took longer than the appt itself. I was very honest and sincere when speaking to her. I am having lap RNY. Her report didn't have any negative feedback. I just went there and told her what I wanted and why I wanted it and poof, done. I wouldn't worry at all. I wish you luck, Michele

My psych consult was horrible. I do not have any mental health issues (but obviously I have problems with food). The only person in Manchester who does psych consults is a woman who had the surgery herself (and failed, it seems). She was negative and condescending, thought my goal of 200 was unreasonable and that I would likely only lose 100 pounds. She asked a lot of personal questions about my libido, relationship history, and kept repeating my weight loudly and with much contempt in front of the 93 pound nursing student who was observing. When we talked about foods and I said I did not like sweets, she said I was either lying or eating them subconsciously. NOT TRUE! She thought I had to stop fooling myself or I would be a failure as well. Don't most obese people overeat. I am not a counselor and I understand that. Also, she was concerned about my affinity for numbers (I am somewhat of a rainman, doing comlicated math in my head, adding and subtracting numbers, etc.). The math does not interfere with my life and I am sure does not contribute to my weight. Oh, well, sorry for venting. Anyway, I arrived for my psych consult at 8:30 am, filled out paperwork, went in at 9, and did not leave until almost noon. That being said, I think the purpose of the psych consult is to make sure you understand what is done during surgery and what it is like after. They want to make sure you have the mental wherewithall (sp) to follow the diet and show up for post-op appointments. They want to make sure you understand the risks of the surgery. They are not supposed to diagnose and cure all of your problems. Additionally, I would just like to say that if you live in Massachusetts you are very lucky because the health care system in Massachusetts is outstanding. It was one thing I definitely underappreciated when I lived there. You have great access and great rates, and the medicaid system is fair and comprehensive. I live in Manchester, NH, now. I pay $171 a week for medical coverage and $42 a week for dental. It is ridiculous, and copays are $20 and $40 for name brand prescriptions. And I make a lot less money than I did in Massachusetts. I would love to move back, but I want to do it after this surgery is out of the way. Thanks for letting me vent!