First Appointment Psychologist Test Went South!

Yea, He said that I was a binge eater to, I am not. I just told him, I didn't get this fat just eating a second slice of pizza.

After playing "20 questions" at our first meeting, the therapist told me I was depressed and an emotional eater and that I wasn't ready for surgery. I was furious and when I calmed down, I decided that I wasn't going to let this person keep me from getting the surgery that I so desperately wanted/needed.

So I started working on me to change the things I needed to do in order to be a surgical candidate. At my next & subsequent meetings, I discussed the changes that I was making, like working with the nutritionist and keeping a food diary (and showing that I could follow a program) & how I was able to re-direct my compulsion to eat when I was upset or frustrated, etc. I also let the therapist know that I was attending Bariatric Support Group meetings in order to learn more about WLS and what I needed to do in order to prepare for a new lifestyle. And I always emphasized that I was willing & able to do whatever was necessary because WLS was a tool that I needed in order to get to a healthy weight.

Good for you. Great attitude.

That's exactly the right approach  

You can't fight city hall on this.  Find a way to meet their criteria if you're serious about having the surgery done.  Unless you want to opt for self-pay, you gotta play by their rules.

You handled it perfectly. I hope the OP follows suit.

I know this has been a significant blow.  I too was told that I am a binge eater and not a good candidate for WLS,  The psychologist first told me I was fine and did not review the test results until insurance paid (1 month later).  Then she said she would work with me.  I was near completion of my 4-month program and hoping to have surgery before my insurance changed Jan 1st.  Bottom line is that the psychologist worked with me and she approved me for surgery.  I am now 3 weeks post-op with gastric bypass.  Doing very well.  You need to show the psychologist you will work to be ready.  Ask him what he recommends you do to get ready.  They will work with you.  Do not give up!!  You deserve WLS!!  Given that you have already overcome alcoholism I know you can handle WLS.  I am pulling for you!

Thank you Phyllispil, for those encouraging words. I will do everything it my power to meet the challenge!!

He sounds like a jerk. 

Technically, recovering alcoholics are more likely than others to relapse, but my dad has been sober 34 years (since before I was born) and I'm pretty sure the chances of him relapsing are

I would agree totally if I was only a couple of years sober or started drinking to replace food, not realizing what was going on. But having been sober so long, and working with other alcoholics in relaspe and early recovery, I think the chances are very very slim. I has dozens of friends in recovery that I talk to every single day. My worry is that "one test fits all" attitude of this Psychologist and the way he interrupted what I said id wrong. When he wrote I was an alcoholic in recover, he said it did not matter how long I was sober. That is crap!!!  He also said I was a binge eater. What I told him was, that when I quite smoking in 2012, I ate everything in sight to keep from lighting up the first couple of weeks. I gained a lot of weight those 2 weeks, and continued to eat more than I should. How else would I gain 140 lbs 2 years? But I am not a  a binge eater.  He did not differentiate.  . I would hate to think they would throw me out after one consultation.

As someone who actually does pre-op psych evals, I would differ with you on a couple of things you have said.  First, though, I will readily admit that some Psychologists who are doing these evaluations are pretty clueless, and some are just in it for the money (since some places charge a small fortune for evaluations). Some, however, take their jobs very seriously and know what they are doing and do it well.  His age is irrelevant in this scenario, as is his lack of experience in being overweight.  I know you are just venting a but, but if you are going to formally contest his assessment, don't use those arguments. They aren't credible and will likely work against you.

Ok, first of all, as far as you not being at higher risk for drinking again... Statistically -- and not by a small margin -- you are at a much higher risk, no matter how long you have been sober. What he stated is fact, and is supported by a number of peer reviewed studies.  No, he doesn't know you -- and I don't know you either -- and you may very well be right that you won't relapse, but we have to make our recommendations based on whatever little information we can obtain in an hour or two, and no matter how well trained we are for this kind of evaluation, we are forced to rely partially on what the statistics tell us.  The odds are against you staying sober.  The odds, however, don't know how determined you are, what kind of support system you have, or what kind of coping you skills you have.  Hopefully these are things that he asked you about as well.  If he did not, then he has no business doing this job.  Those are the things, along with personal history, that we have to balance against the statistics.

Second, the binge eating: Although many people think only of binge eating as someone up at 1am stuffing themselves with everything in the refrigerator and/or pantry until they physically cannot eat any more, that is too narrow a definition.  Eating "everything in sight" -- whether from a trauma (as was the case for me) or to quit smoking/drinking/using -- for an extended period of time IS binge eating.  Below is the official clinical criteria, and even what you have briefly described here likely qualifies since you didn't just continue to eat those large amounts just in the first couple of weeks when you were quitting smoking (a few weeks of overeating, no matter how significant, does not amount to a gain of 140 pounds over 2 years): 1) recurrent episodes of binge eating which is characterized by both of the following: eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat in a similar period of time under similar cir****tances; a sense of lack of control over eating during the episode.  2) The eating is associated with at least two of the following: eating much more rapidly than normal; eating until uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of feeling embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or guilty afterward. 3) distress regarding binge eating is present; the eating pattern occurs, on average, at least once a week for three months; the binge eating isn't associated with purging and does not occur exclusively during the course of other food disorders (such as Anorexia Nervosa).

Finally, as far as the depression goes, sometimes people also misunderstand the clinical definition of depression, or sometimes don't recognize depression in themselves (which is where the written assessments can be useful).  They can, however, also be pretty useless, especially if they are using a "home grown" questionnaire or other tool.  Do you know what assessment he gave you, by chance?

I understand that it can be very dis treating to have a Psychologist, Psychiatrist, or Counselor express what appears to be a negative opinion about our core being (especially when we have so much emotionally invested in getting the surgery and getting the weight off).  You did not, however, say that he had told you that he would recommend against your surgery (or, if you did, I missed it).  As someone else mentioned, part of our job is to identify areas that may be a stumbling block AFTER surgery so that you can be proactive about preventing those things from derailing you. Just because he has identified a couple of areas of concern does NOT mean that you cannot gget approved for surgery!

If you had already been working with a counselor or a psychiatrist, they would likely accept an evaluation (or at least feedback) from them.  Some surgeon's offices require that you  get the psych clearance from someone on an approved list (and they won't accept an evaluations from someone whose credentials they have not already vetted). IF the person you already saw does not approve you for surgery, you have every right to talk to him about why (and to discuss the reason that you disagree with him) or to ask for someone else to provide a second evaluation.  Until that point, though, I would just take some deep breaths and calm down.  I think you are probably anticipating something that isn't going to be an issue.

It is actually pretty rare to have someone denied surgery based on the psych eval. Even if he has significant concerns about your suitability for surgery, he is far more likely to recommend that you do some pre-op counseling before surgery or -- what seems more likely to me -- perhaps just suggest the value of post-op counseling. FWIW (and this is just an observation, NOT an assessment by any stretch of the imagination), based on what little you have posted here, I see a couple of yellow flags, but I don't see any red ones.

Lora