Nutritionist Consult

So I finished almost all of my testing/med clearances the last 2 I have to do it psychiatric and nutritionist. My PCP has been monitoring my weight for the last 6mnths per my ins. company. I saw the nutritionist the other day an she was not what I expected. She was looking through my food logs and pretty much said I dont see you trying to lose weight an goes i will not lie to your surgeon about our meeting. Ok? I didnt ask you to lie? But isnt that why I am here? so you can educate me on how I am going to be eating after I have this surgery? An to get me on some type of meal plan in the mean time? I technically do not have to see her again my ins. company requires 1 session. She tells me again she will not lie to the surgeon about me being "prepared" for this surgery an that she wants me back in 6wks. I was a little disappointed when I left that if I get denied for this surgery its going to be because of what she writes :/ ughh . Also can anyone tell me what to expect from my psychiatric eval? A co-worker of mine was denied RNY because of her psychiatric eval! well thanks for reading my vent!

That really sinks! I know it can be tough and make you want to scream...just make sure you take to heart what your nut is telling you. It's defiantly different once the surgery is over and your able to eat food. It's like your head tells you one thing and your stomach tells you something different. As for the psy eval they want to know that you understand how to eat, what to eat and if your understand your restrictions...should you have any. I've know many people including myself that feel if you can get past the head hunger then it should be a lot easier for you. Good luck on your journey!!

I never had to give my NUT food logs for my consult and I dont' understand why anyone would.  You are going to meet her and find out what the surgery is about and learn how you are going to need to eat and what the supplements you will need to take.  For many, the diet starts then.  I never had to go on a diet at all since I was a lightweight and losing anyweight would have disqualified me for surgery.  So, if that were the case, I never would have qualified since I never tried to lose weight. 

Just do your best over the next 6 weeks.  Follow everything she told you and list everything you eat.  Don't write down anything that you aren't supposed to eat.  She will hold it against you.

My psych eval was a joke.  It was a psycologist that basically asked me questions simply so she could write a letter.  They were mainly yes and no questions, stated so she could write the letter. It was in no way an evaluation.  A few of the questions I actually got to explain myself but to me it served no purpose.

One can never know what the insurance company is looking for in terms of that pre-approval diet. It would seem that they want to prove you can commit to a program and be disciplined, but I've heard stories about people who were denied because they lost weight on it. It "proved" they could "do it on their own" and didn't need the surgery. So there is no right answer.

Your nutritionist was inappropriate with you, and if it were me, I'd tell her so. As you said, you didn't ask her to lie! Why did she assume that was your point? My guess is that she is a thin person and has never struggled with her weight, and that fat people are lazy and don't want to do the hard work to lose the weight.  I would have told her: "This is the way I eat, for whatever reasons, and that is why I think the surgery is right for me."

And yes, she should have been explaining what your post-op life will be like. This process should be about informing you of the reality of your new diet, and helping you figure out if you can live with it and do what it takes to be successful and healthy.

The psych evaluation will be the same thing. There are no standards, so everyone handles it differently, and I think alot of therapists see it as a quick, mindless way to make a little money. A good therapist, who has your best interests at heart, will help you determine if your expectations are realistic and your resolve strong.

Good luck. Sometimes the approval process is long and frustrating. But don't be deterred; fight for it if you think its what you want and need. It is all worth it.

SJMomof2boys,

First question, did the Doctor tell you prior to seeing the Nutritionists and/or operation you need to lose weight? If not, WTF?!?!?!?!?

As other said, call the Nutritionists on the carpet about her professionalism. And then go to another.

Here is a list of NJ Nutritionists www.obesityhelp.com/forums/NJ/a,list/type,1/

As for psych eval, I tout one who frequents this board - Doctor Mike. While he is probably far from you, and your insurance may not pay for it, he's definitely work the trip and cost. Let me know if you need his info too.

Good luck, and know we're here for you

Thanks for all the replies!Very helpful..No I called my surg. nurse an she said my ins. company does NOT require weight loss before approval. I also told this to the nutritionist and she again rolled her eyes at me an made a snooty comment. I did get snippy right back with her and tell her I willingly came to see her my ins. told me that I didnt have to see a nut because my PCP was doing it mnthly but I wanted to see one anyway! What can I do now yanno? I dont know if I should see her again in 6wks or see another one to only hear the same thing! Did anyone else see a nut more then once before they were even approved for the surg.? I am trying to find a psych. none of them take my ins. so I am prepared to pay. None of the ones I have called have returned my call to sched me an appt or let me know if the Dr does evals for wls. I wanna pull my hair out haha because I am at the end of my 6mnths and now she wants me to wait 6wks to see her again before she will write a letter to my surg.!

This nutritionist sounds like she has some axe to grind. If it was I, I would avoid her and seek another.

While the concept of being diligent and dedicated to following rules for a successful weight loss is applauded and encouraged, being chastised in the beginning isn’t and shouldn’t. I would strongly suggest seeing another one – someone who is willing to guide you before during and after the entire process. Again, depending where you are, I can recommend a few – or go to the link I provided.  

 

Unless you have a particular history that dictates a Psychiatrist, a Psychologist will be accepted (watch the wording when looking)

 

Here is some helpful links

 

Psychiatrists              http://www.obesityhelp.com/forums/NJ/a,list/type,35/

Psychologists            http://www.obesityhelp.com/forums/NJ/a,list/type,2/

As mentioned, I suggest contacting Michael L. Sakowitz, Ph.D. is a psychologist (NJ 35SI00148700) and member of ObesityHelp's Mental Health Board. He’s located in Wayne NJ. No matter where you are, I highly recommended going.

 

You may also want to check with the hospital you’re having the operation in. If the hospital takes your insurance, they may be able to direct you to either a nutritionist or psychiatrist/psychologist who accepts your insurance.