• Bariatric Mental Health Evaluations

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    Bariatric Mental Health Evaluation

    Before making the decision to have weight loss surgery, patients have typically tried many other ways to lose weight, with little to no success. There are several steps patients have to take before they are ready to have surgery. Taking these steps and arriving here is a huge accomplishment!

    Addressing the mental health and behavioral contributors to obesity and ensuring that you are prepared to undergo surgery is an important step in treatment. Having specialized in bariatrics, I am able to conduct pre-bariatric surgical mental health evaluations that meet all insurance and surgeon requirements.

    Why have a pre-surgical bariatric mental health evaluation?

    Most who decide to have weight loss surgery will need an evaluation prior to the procedure. Most insurance companies require a mental health evaluation as part of the criteria that must be met in order to be approved for bariatric surgery. A pre-operative evaluation or mental health screening is also required by many bariatric surgeons. It also helps to learn more about your own unique triggers and challenges to eating, reasons for your habits, barriers that prevent you from staying on track and come up with the best plan to help get you on your way for post-surgical success. You want to openly and honestly discuss the impact (emotional, behavioral, relationship, etc.) that surgery may have on you.

    Success after weight loss surgery depends, in large part, on the patient’s ability to follow post-operative recommendations and implement lifestyle changes appropriately. Certain types of mental and emotional disorders can negatively impact your ability to take care of yourself. It is important to assess, before surgery, that you fully understand the implications of having weight loss surgery and are able to provide informed consent. The vast majority of patients are ready to have surgery. Those who may need treatment or other services prior to proceeding with surgery will be given clear recommendations and referrals, as appropriate. In most cases, these are NOT reasons to delay or deny surgery.

    What does a pre-bariatric surgery mental health evaluation entail?

    While this sounds intimidating, I assure you, it is not.

    You will meet with me for an interview/evaluation for approximately 60 minutes to discuss:

    The evaluation is an exchange of information about your eating habits, health, emotional health and social history, current attitudes, expectations for surgery, and postoperative plans. Many people have unhealthy eating habits and this is NOT a reason to deny someone surgery! I will discuss these habits with you so we can make recommendations for a more successful transition into your new lifestyle.

    Your mood and emotional stability and mental health history. It is normal for people to have ups and downs at times as well as normal bouts of sadness or anxiety. This is not a reason to deny someone surgery!

    Your understanding of the weight loss surgery procedure, any risks involved, and the necessary long-term behavioral changes that you will have to make so that you are most prepared for success. Having surgery is serious – I want to make sure that you have done your homework, are prepared for surgery, and understand what to expect!

    It is also your chance to ask questions and express concerns concerning the procedure and your new lifestyle. I will provide information about coping with challenges you may have and will address your questions or concerns.

    You will take three written tests that are short and concise; they are regarding mood and eating habits.

    After the evaluation, I will prepare a report and send it directly to your surgeon.

    The evaluation is NOT a pass or fail test. It is more of a discussion to help you identify potential issues that might lead to difficulty after surgery. Since many individuals with significant weight issues may suffer from depression, anxiety, binge eating, and other problems, these are typically NOT reasons to delay or deny surgery.

    If there is anything concerning, I will share it with you during the visit and work with you to develop a plan to better prepare you for surgery. Those who may need treatment prior to surgery will be given specific recommendations and referrals. Ultimately, your surgeon will make a decision as to whether he or she will proceed with the surgery.

    This evaluation is nothing to worry over, “study,” for, or feel you are “doomed to fail.” Most importantly you will learn more about food and the role it plays in your life; emotionally and physically. As your evaluation continues, we will discuss challenges I have faced, you are concerned about and how these things can be worked out and that coming back for an additional visit is always an option!

    Will I know the outcome of the evaluation?

    Many patients want to know immediately if they “passed” the evaluation. Please realize that a mental health evaluation is not a pass/fail test. It is an opportunity for you to better understand your behavioral patterns, personality traits, and emotional functioning. That said, you will be informed about your assessment results and recommendations regarding surgery. I see my role as a patient advocate and educator to help you achieve your weight loss and health goals.

    How Much Does the Evaluation Cost and Will My Insurance Pay For It?

    Currently, my bariatric evaluations are self-pay $350.00. These reports will be sent back to the surgeon within 7-10 days.

    Many patients elect to meet with me for the mental health evaluation rather than use someone else on their insurance plan because they prefer to receive a mental health examination from a highly experienced and professionally trained bariatric specialist. By now, you have likely invested a lot of thought, time, and money on your decision to pursue weight loss surgery. The mental health evaluation is an important qualifier for your insurance company and for your surgeon. I understand surgeon requirements, and the pre-and post-operative process much more than clinicians who do not specialize in bariatrics. I can relate to you one on one; this is an advantage most cannot provide.

    Why should I see Katie McIntosh, MSW, LCSW for my bariatric mental health evaluation?

    Bariatrics is important and specific; I have lived life knowing the shame and guilt weight can carry. The time during your visit will not just be to conduct an evaluation. You have put a lot of time, thought, and money into this surgery and you want the evaluation performed by a clinician who thoroughly understands bariatric surgery. I am compassionate about the daily battles and struggles (emotionally, physically, etc) surrounding obesity. In addition to the evaluation required by insurance companies and surgeons, I will offer education and behavior modification tips unique to your own needs to better prepare you for success.

    I will offer you an appointment typically within 1-2 weeks of your phone call and your report will be done in a timely manner.

    I am available for pre and post-weight loss surgery support, therapy, and/or behavior modification. I will be available throughout your journey; you have come so far getting to this part of the process. I have been there, I know how you feel and I will support you all the way.

    Behavioral Therapy and Behavior Modification

    As a bariatric specialist, I help people address issues about themselves or their behavior that they would like to better understand or change. Many individuals choose to work with an experienced bariatric specialist following bariatric surgery. As you know, having weight loss surgery is a life-changing experience. Any change, even change for the better, can be stressful, especially when it’s a lifestyle change.

    While the majority of patients who undergo weight loss surgery find it to be a positive experience that improves their quality of life, some struggle with the adjustment. Some experience postoperative depression, anxiety, sadness, and anger. Often, we have to grieve food after surgery like a death. Food is no longer there for us like it used to be; feeling abandoned by food is something we have never expected. If you notice some habits start forming again, or you notice some of your previous thinking returning, therapy can help.

    Therapy can help you understand why you are returning to those behaviors, perhaps more importantly, overcome dysfunctional patterns and reduce emotional distress. Instead of putting yourself through that emotional stress, come see me; therapy helps! You are not alone in your weight loss journey. Consider therapy and behavior modification sessions to continue your success.