Navigating bariatric surgery risks: Psychological risk factors

A surgeon looks down, concentrating on his work

As a therapist specialising in eating disorders, I embrace a weight-neutral approach that recognises that good health transcends the numbers on a scale. That being said, increasing numbers of people are opting for weight loss surgery and I believe that it is crucial to offer psychological support throughout the process. Bariatric surgery risks include potentially having to seek out psychological support post-op. I don’t turn away clients who have chosen this path, as my goal is to help everyone forge a healthier relationship with food. I fear without such support, the risk of post surgery sabotage is increased.

Bariatric surgery: Is it the solution?

Weight loss surgery, also known as bariatric surgery, has become an increasingly popular option for individuals seeking significant weight loss and improved health. While the physical benefits of this life-changing procedure are often well-documented, the psychological aspects of bariatric surgery are often overlooked.

The journey to a healthier lifestyle doesn’t end in the operating room; it is essential to address the emotional and mental challenges that may arise during the pre- and post-operative phases.

In this blog, we will delve into the various psychological risk factors, potential consequences, and the importance of psychological intervention to ensure a successful and holistic approach to your weight loss journey.

Whether you are considering bariatric surgery or have already undergone the procedure, understanding and navigating these psychological aspects is crucial for long-term success and personal well-being. 

What is Bariatric Surgery and Who is Eligible?

Bariatric surgery refers to various surgical procedures performed on the stomach or intestines to induce weight loss. These procedures include gastric bypass, sleeve gastrectomy, and adjustable gastric banding. The current criteria for bariatric surgery eligibility are:

1. A Body Mass Index (BMI) of 40 or higher, or 2. A BMI of 35 or higher with at least one co-morbid health condition, such as type 2 diabetes, high blood pressure, or sleep apnea.

NICE Guidelines for Assessment and Screening

The National Institute for Health and Care Excellence (NICE) recommends specific guidelines for assessing and screening individuals for bariatric surgery. These guidelines include:

1. A comprehensive assessment of the individual’s physical and mental health

2. Discussion of the bariatric surgery risks and benefits

3. Evaluation of the individual’s readiness for surgery and postoperative lifestyle changes

4. Providing information about available surgical options and their outcomes

Concerns About Lack of Psychological Support

Not all clinics follow best practices, and there is a concern that people with eating disorders may undergo surgery without adequate psychological support. Surgery alone will not resolve underlying issues with food, making it crucial for individuals to seek support before considering surgery.

The prevalence of people pursuing weight loss surgery having undiagnosed eating disorders is a significant concern. Research has shown that a considerable percentage of individuals seeking bariatric surgery may have an undiagnosed eating disorder or disordered eating behaviours. The exact prevalence can vary across studies, but it has been reported that up to 50% of bariatric surgery candidates may have some form of disordered eating.

Eating disorders and disordered eating behaviours can significantly impact the success of bariatric surgery and postoperative outcomes. Undiagnosed eating disorders can lead to complications, including inadequate weight loss, weight regain, and even worsened mental health conditions.

Some common eating disorders among bariatric surgery candidates include binge eating disorder, night eating syndrome, and emotional eating. These disorders can be difficult to identify and diagnose, as they often present with symptoms similar to those of obesity.

It is essential for healthcare professionals to screen for eating disorders during the preoperative evaluation process. Identifying and addressing these issues before surgery can help improve surgical outcomes and support individuals in developing healthier relationships with food.

Moreover, integrating psychological intervention throughout the bariatric surgery process is crucial. This includes providing therapy, support groups, and educational resources to help individuals better understand their relationship with food and manage any underlying eating disorders or disordered eating behaviours. By addressing these psychological factors, patients can maximise their chances of achieving long-term success after weight loss surgery.Writing More…Expanding Content…

Psychological Risk Factors for Poor Outcomes Post Surgery

Several psychological risk factors may contribute to a poor outcome following bariatric surgery. These include:

1. Unrealistic expectations: Individuals who expect surgery to “cure” their obesity without making lifestyle changes may be disappointed with the results.

2. Emotional eating: If emotional eating is not addressed before surgery, it can continue postoperatively and hinder weight loss progress.

3. Mental health conditions: Pre-existing mental health conditions, such as depression or anxiety, may worsen after surgery if left untreated.

Psychological Consequences Post-Surgery

After bariatric surgery, individuals may experience various psychological consequences, including:

  • 1. Relationship stress: Changes in appearance and lifestyle may strain relationships with friends, family, and romantic partners.
  • 2. Body image concerns: Rapid weight loss can lead to loose skin and other body changes, potentially causing dissatisfaction with one’s appearance.
  • 3. Identity struggles: Adjusting to a new body size and shape can create confusion about one’s identity and self-image.

The Importance of Psychological Intervention

Considering the potential psychological challenges associated with bariatric surgery, it is crucial to prioritise psychological intervention throughout the process. Addressing these issues before and after surgery can significantly improve outcomes and support individuals in developing a healthier relationship with food.

If you are concerned about bariatric surgery risks or have already undergone the procedure, please do not hesitate to reach out for psychological support. As an eating disorder therapist, I am here to help you navigate the complexities of this journey from a non-judgemental and confidential approach. Together, we can work towards fostering a better relationship with food and understanding the psychological aspects of your weight loss journey.

Read more hereBLOG: What it’s like to be a binge eating therapist, 5 Steps to overcome emotional eating

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