For weight loss surgery patients, dropping pounds isn’t only a physical transformation. There is a significant mental component to life after the surgery to be considered as well.
“We’re looking for if they have any kind of disorder that affects their ability to think and reason,” says Traci Fraley, PhD, a clinical psychologist at Harbor. “The whole bariatric process—preparing for surgery and everything afterward —does require a lot of them and you need to have a certain level of organizational skills and be able to keep track of what you’re eating. You also need to have a certain level of motivation to do those things consistently that definitely can be impacted by a mental illness.”
Going through such a life-changing procedure such as bariatric surgery can exacerbate mental health conditions such as severe depression, Fraley states. That’s why Harbor staff work closely with the patient’s psychiatric provider to monitor symptoms in the weeks leading up to the procedure.
For many weight loss surgery candidates, obesity is something they’ve lived with their entire adult lives. “I think that they’ve developed, to some degree, an identity around being overweight,” Fraley says. “Some people really underestimate what that’s going to be like, that shift in their identity.”
The psychologist, who evaluates about a half dozen weight loss surgery patients each week, says she has often heard overweight people say that they’ve been putting off various life decisions or activities until they’re thinner.
“All of a sudden now, if they don’t have that weight, they’re like, ‘Oh yeah, I said I was going to do this in my life—I was going to make progress with my relationships or I was going to start a career or whatever it may be’—now they have to actually do those things. If they haven’t been gently pushing themselves through life to meet those demands, some of them may not have a good ability to cope with these kinds of ups and downs.”
Romantic relationships can be a significant source of tension for those undergoing bariatric surgery, Fraley says, noting the divorce rate is a bit higher for weight loss surgery patients.
“In my opinion, it’s not just the weight loss that causes it. It’s probably relationships that had issues that should have been dealt with long ago and for whatever reason, the person didn’t have the confidence to deal with them,” she said.
Fraley stresses that it’s important to realize the surgery isn’t a cure-all. “I really, strongly believe that people need to start dealing with whatever issues in their life they’re not happy with and the weight issues will be easier to deal with after that.” She continues, “That’s a really hard thing to convince people of.”
Learn more about the connection between mental health and weight loss surgery in this column by Dr. Daniel McCullough: Addressing Emotional Issues Before Weight Loss Surgery.