Bariatric Psychological Evaluation: What to expect?

I was able to go to my private therapist, and she just wrote a letter to my doctor's team telling them I was fit for surgery...

It was a joke, to be honest, as the doctor's office actually gave me a letter for her to use as a guide so my insurance would accept it.

My appointment was at my center, it was a 45 minutes talking session. At the end and after telling me I was approved, I asked what they are specifically looking for. She told me they wanted to make sure I was educated about the procedure and what to expect, that I had a stable life, a good support system and no out of control eating disorders that needed special attention prior to surgery.

I had to fill out a very long questionnaire asking everything from simple mood stuff to do I hear voices others can't hear. Then I met with the person doing the evaluation and basically she wanted to know if I understood what I was getting into and had realistic expectations.

Frankly, given some of the people I've come across on WLS forums, more people ought to "fail" the evaluation than do. I suspect those turned away after the evaluation are very few and far between.

First I had to take a personality test, at least 200 or more questions. After that I met with the hospital Psychiatrist, he asked me about my mental health history, my relationship with food and why I felt I needed WLS. Pretty easy and basic questions. As I was walking out the door he said "Oh by the way your personality test revealed that you are a non-traditional female." I'm sure I looked puzzled because he then said "don't worry, that's not a bad thing."

My practice has a psych on staff who does all the evaluations. It was an hour long and we spent most of the time talking about where we grew up (close to each other), his kid's interview for pre-school, my work and a few other topics that don't stand out to me. At the end of the hour he told me that "I was a smart girl" and that "I'd figure it out." My surgeon made me go back to him when I was diagnosed with a post surgery eating disorder at my 1 year appointment. That "session" was more involved, but at the end, he told me he limits his practice to pre-op evaluations, and he told me how to find a therapist to treat my newly diagnosed condition. I've since told my surgeon that his psych sucks, that he's lazy as hell and not worth the money he's being paid. I told him that truthfully, he should hire me, because at this point I'm probably a better judge on who can be successful and who will struggle. (for clarification, I don't mean to say that I'm in a position to judge true mental health issues, but that I highly doubt the staff psych can either unless my evaluation was not the norm for him.)

Can you give me the Dx criteria for post-surgery eating disorder?

BTW, good job telling him the truth about his lack of skill. He sounds like a real douche.

I can't give you the exact Dx criteria, but I can tell you the questions he asked me. They were concerned that I was "exercise bulimic." This all came about because my 1 year blood test results were horrible. I went from cholesterol of 142 to 315. Upon re-check 6 weeks later my cholesterol had increased to 342. My surgeon was concerned and asked at his weekly practice meeting and other colleagues if anyone had seen results like that. The answer was yes, with anorexic patients. He responded that he knew I wasn't anorexic, because he made me send him my food logs, so he knew I was eating. the response was, that with the exercise I was doing, my caloric intake was "anorexic equivalent." Anyway, his psych asked me the following questions.

1. Do you find yourself restricting calories more than usual if you can't exercise
2. Does an inability to exercise affect your mood? How?
3. Do you find yourself exercising at "off" times during the day, i.e, extremely early in the morning or late at night. A time other than your norm.
4. If you consume what you feel to be excessive calories, do you exercise to try and "purge" them?
5. Does exercise interfere with other daily activities?
6. Describe your feelings right now
7. Do you think you have body dysmorphia?

There may have been more questions, but these were the main ones. At the end of the "session" he handed me a mirror and told me to say hello to my eating disorder.

Thank you.

We basically talked about my life, growing up, eating habits, mental reasons behind eating habits, current home life/support system, why I wanted the surgery, what my plan was for being successful post-op

I read the report later, and it was interesting to read someone's take on me. She said I was engaging, I made good eye contact, and that she thought I had sound reasoning, and plan to make this successful.

it's a bit subjective (I think), but as long as you're not completely off the wall with your answers, you'll do fine. Best of luck!