Question:
Psych Eval

My case was under insurance review for about 4 weeks when they requested a lipid/cholesterol blood profile and a psych eval from a psych who has experience in eating disorders.This was 3 weeks ago,,seven weeks total.I had been seeing a psych for meds and a psycologist for counselling for several years due to depression. My regular psych does not believe in WLS so I had to seek someone else. I had few choices here where I live. He said according to my 567 question test and the sexual/physical abuse from my childhood that my profile is one of being a "CONDITIONED FAILURE" at anything I may do or emotionally feel in life.That I would not make a good candidate for surgery because of his findings.He also added that my documented co-morbidies were 80% in my head and "possibly" 20% physical in nature.That I allowed myself to become morbidly-obese because somewhere in my subconscious mind,,I did not want to do something physical in nature.(been morbidly-obese for 5 yrs) When I asked him what he was recommending, He told me of a client, 12 yrs into her therapy who had regained ALL her weight back,,yet this was a psych who did not know ANY of the surgeries I wanted to talk to him about. In the two visits,,there were but two sentences spoken regarding WL and WLS.This was the last info my insurance needed to go back into review..All my surgeon needed next was a pulmonary consult. With this negative profile report being sent to my insurance I guess a denial is inevitable....and perhaps ANY WL programs that insurance may have covered if I had'nt been looking at WLS......ANY ADVICE? PLEASE RESPOND~~~~    — Violet K. (posted on August 17, 2000)

August 17, 2000
When I read about doctors treating us,who are in search of a healthier way of life, this way it makes me so angry. For some on this site this surgery is literally life saving. I feel each of us should be commended for wanting to undergo a positive lifestyle change. Well here is a real "positive" fellow. I thought going to a psych was supposed to be self improving not another way to be beat up and feel worse about yourself. This charachter will talk this way to the wrong patient and they may try suicide. Run, do not walk from this fool who is in more trouble than the patients he treats. I would lodge formal complaints every possible place you can, including his professional associations. But first I would seek another psych no matter how far away you must go. It sounds as if your chance at this surgery depends upon this. Doesn't he have a superior? The opinions expressed in your letter sound personal not professional. I personally feel this written test so many psychs are using is not much of an indicator of how one will do with the lifestyle changes, and adjustments after surgery. It would be nice to get some psychs to come out and suggest some realistic guidelines for these psych evaluations. Seems they bring everything but the kitchen sink into it. Any psych problems I might have I would rather face as a more normal sized person with as few co-morbidities as possible. That's one thing the surgery realistically, really can do.
   — JennyLynn A.

August 17, 2000
Hi. These answer are all wonderful! But let me tell you something that will make you even feel better. I too suffer from depression and also compulsive eating disorder. I was also clinically dx with these findings. My surgeon did not require a psych consult. He believes what these good people here are saying as well. I was so bad that practically every minute of my life was planned around food! Polishing off an entire pizza or two-three BIG MACs or bag fulls of cookies or entire cheese cakes was completely normal for me! After the surgery, I am getting so much negative feedback from food that my life is drastically changing...my life can no longer revolve around food. I am 14 weeks post op and have lost 86lbs! My dosage of Zoloft did increase to help me with the cravings, but believe me, every ounce of pain, uncomfort and sacrifice you have to endure with the surgery almost becomes comforting with each pound you lose! Good Luck!
   — Lisa N.

August 18, 2000
I heartily endorse everyone here before me. My psych eval testing was done before my diagnosis with sleep apnea, but the "chat" part was done the day I was diagnosed with apnea. In a very brief lesson, apnea is the disease by which one stops breathing while they sleep. Very annoying, but also extreme dangerous in cases like mine. I was stopping 125 times per hour. To shorten the story even more, the more I tried to sleep, the less oxygen I got, the more sleep I did not get. End result was oxygen levels dropping to as low as 60% (they like 95+) for as many hours as I tried to sleep. Know what prolonged oxygen deprivation does to EVERYTHING? Bad, bad things. No memory, no ambition, no hope--endless list. OK, so there we are with that situation. Having just left the sleep clinic, I was SO excited to know what was wrong with me after 3 years of being tested for some of the most bizarre things you ever...Well, again, that's not the point. The point is that my psyche eval stated that I "blamed" most of my physical ailments on my apnea (*I* blamed?) Upon telling him that I had a happy marraige, he said that wasn't possible in the written report. I only THOUGHT I did, which hid deep problems. He said I was a MARGINAL candidate for surgery and would not attend support groups. My husband ALSO imagined his ailments due to sleep apnea (after diagnosis), he also imagined he was in a happy marriage (good thing we're both having the same dream, huh?) and that he was barely a good candidate and again, would not attend support groups. We attend AT LEAST 6 groups a month, sometimes more. Again, the final point, and that is that this guy could hardly have been more clueless about trying to guess the future than if he'd never spoken to us AT ALL. He never even laid EYES on me, as my interview was done by phone due to snow. Please do seek another opinion. Psychology is not an exact science and where there is prejudice, there will be gross error.
   — vitalady

August 22, 2000
Hi Everyone, Thankyou so much for your posts. Well yesterday I recieved my COPY of the eval. The diagnosis terms are "Undifferentiated Somatoform Disorder". For those of you who are taken aback by this as I was,,the definition is as follows:"Somatoform is a psychological disorder (listing 300.81 in the DSM-IV,the Diagnostic and Statistical Manual of Mental Disorders). It is a variety of Somatoform disorder,a condition in which a patient reports physical symptoms which are not explained by known general medical disorder. These symptoms must be significant enough to cause distress and impair the person's functioning". From PLANET PSYCH.COM-Undifferentiated Somatoform Disorder is a milder form of of Somatization Disorder lasting at least 6 months.- Now,,this is what I find APPAULING,,ALL OF MY CO-MORBIDIES are documented either by tests or x-ray.If this shrink can get by with using this "TYPE" of diagnosis on me,,I can only imagine how many more morbidly-obese people he will suceed in prompting a denial from insurance for WLS.
   — Violet K.

August 23, 2000
The only thing I can think of to say WHAT AN ASS!!!
   — JennyLynn A.

November 5, 2000
Geez, Vilet, are you sure you didn't just THINK he was a doctor, and he was ill himself? It sounds like he thinks he is GOD, for all the things he thinks he knows about you--they go way beyond what it is possible to be sure of, even with extensive tests and interview. There is a strong flavor of anger here on his part, if he actually said those things that way, and there ARE misogynistic (woman-hating) obesity-prejudiced docotrs, too! One clue is his pretense at omnipotent knowledge, when he seems to have known zero about WLS and only one former patient--who didn't do well! (Twelve years ago there was a lot less wholistic support beyond the surgery, too.) Don't give up! Travel if you have to to get somemoe else--this guy is damaging to your psyche, it sounds like. And I don't say that casually or easily.
   — Jesse M.

November 23, 2000
Thats how it went with the first psychiatrist I went to, we talked for 15 minutes, she said "you don't need surgery, you need to see me once a week' 15 minutes! I gave up seeing for a year.. then went to my pcp in tears and asked him to help me with this.. he referred me to the head of clinical psychiatry who talked with me for over an hours... said he stronly recommeded the surgery and advised me to continue the prozac.. "you have plenty to be depressed about" We both cracked up over that. He was great, I didn't have to take some huge test, we just talked. I did that before I met with the surgeon, so he was glad that was taken care of.
   — Jo H.