Newbie Q's wrt psychological readiness and potential reasons for disqualification for WLS

Hi there, Newbie here and just starting to consider WLS.

The trouble is that my general practitioner feels that it is too early to consider something as drastic as surgery, and she feels that since I have a history of mental health issues (currently being treated for mild depression/anxiety), that WLS may exacerbate these issues.  I don't typically have much trouble with the 'amount' of food I eat, but rather my food choices - which tend to favour fats and sweets ie.,  I have no issue bingeing on sweets for the reward/addiction factor.

I've seen many instances on various websites where people have said that they were turned down for surgeries, but haven't said why.  So my questions are, what reasons could someone be denied surgery for?  Can someone with a history of depression be denied?  Can someone with a mild binge-eating disorder be denied? Can someone with cardiovascular or sleep apnea issues be denied etc.

Thanks!

(Stats on me: 42y/o, BMI:40, not medicated for co-morbidities other than GERD but insulin-resistant, borderline hypertensive, borderline high cholesterol, not sleeping well but not sleep-tested yet - taking antidepressants that help with sleep and having some cardiovascular issues right now that may or may not be related to the antidepressants - I will get results from cardiac stress test in 2 wks).

I can only speak for myself and my own experience. My insurance required a psychological exam to be done. It is tougher then I thought it would be I am only two weeks post op RNY and it is psychologically tasking. Your mind does not change just because your appetite does. I think your insurance can deny you for any reason they deem reasonable. Your plan has alot to do with it, my husbands insurance covered all but $800 of my surgery and did not give me any issues at all it took me 3 months from start to finish to be approved. My only co-morbidities was sleep apnea and GERD and a 40BMI. Everyone is different. I hope that you are able to do what is best for you. I have to tell you this surgery has been more challenging then I ever thought it would be, I am realizing I have issues with food that I did not realize before it has been taken away.

Before you get any procedure for wls, you want to make sure your psych issues are under control and you're under care of a doc for that.  Most require a psych clearance for the surgery, and the psych may, in extreme cases, deny, but many will require regular visits to make sure your meds are keeping you at a good level, etc.  Another thing to watch for is transfer addictions when food is no longer an item of comfort.  Being monitored will ensure you will keep successful.

Your surgeon will probably require a psych eval before doing surgery on you so a mental health professional would be in a better position to make that determination than your PCP, I think.  Does your insurance require you to have your PCP's approval to have WLS?

Where I am at, the PCP must make the referral and the costs are covered by our provincial insurance.  A psych eval is definitely a requirement.  I did find an article entitled "Psychological Assessment of the Patient Undergoing Bariatric Surgery" that talked extensively about what would be evaluated and how contraindications would be determined. It seems like (according to this article anyways), I'd have a pretty good chance of approval from the psych perspective - baring in mind that I know that I will risk 'transfer of addictions' and will have to think about how to replace that eating - and my depression may increase simply from the lack of 'stim-ing' (ie., not activating that neural reward system with sugar all the time).  I guess this will be a good place to seek other's opinions on those challenges....  Thanks for your input!

I have had my psych eval and I am bipolar. I take my meds, see my NP, etc so I do what needs to be done to mitigate the disorder. The psychiatrist that evaluated me for the surgery passed me because of those factors but warned me that I had a 5% greater chance of depression after the surgery than the norm. I think it depends on a lot of factors not just your mental issues. (I was asked about my support system, my family, friends, etc.)