Bariatric Psychology

For more information on Bariatric Surgery / Weight Loss Surgery (GBS) 

Bariatric Psychology (for Bariatric surgery, also called Gastric Bypass Surgery – GBS) refers to the psychological interventions prior to and after Gastric Bypass Surgery.

A psychological evaluation is a routine procedure prior to Bariatric Surgery, including patients with metabolic disease who intend to have Gastric Bypass Surgery. Below are some general questions and answers (Q&A) about the psychological assessment and preparation for such surgery:

Q: Why do I have to see a psychologist?

•A: This kind of surgery requires a very important decision that involves many emotional and behavioural lifestyle changes.  This operation might be one of the most important, if not the most important, investment you will ever make in your life.  In order to offer you the best possible chance to benefit from this surgery, we have to assess your psychological readiness and strengths to cope with this life-changing decision.   For some, this comes with a feeling of loss (such as food), isolation and some other concerns.  Others may have unrealistic expectations about the results of surgery.  Radical relationship changes (some good and some bad) can be a result of this life-changing situation.  You, your partner / family or support system will need the guidance of a therapist in dealing with the “new” you.  Counselling prior to and after surgery will assist in developing better coping mechanisms, building (psychological) strengths and ensuring that a strong support system is in place.

Q: What happens during the evaluation?

•A: The introduction to the program and the rationale behind the psychological intervention will be explained during your first visit as part of psycho-medical education.   This introductory session forms the basis of the complete program and rationale behind the psychological assessment and preparation.  During the first group consultation you will also complete a psychometric assessments.  These assessments takes about 70 minutes to complete and are simple true or false responses.  The assessments will help determine how prepared you are for surgery and assist the treatment team in preparing you for the procedure.  This preparation will also enhance the likelihood of your long-term success in the program.

Q: Will I have to see Dr Liebenberg more than once? 

•A: Yes, a planned intervention program is scheduled.  Some patients may need more intensive support to prepare for the procedure, after which Dr Liebenberg will make the appropriate recommendations for counselling and / or possible psychiatric interventions.  The initial group consultation (basically three sessions in one) has already been discussed; following this, one more session before your planned surgery is compulsory.  Please bring a member of your support system (partner / parent / friend) with during the first group information session.  During the individual session prior to surgery your adjustment to the surgery will be assessed.  Your emotional status will also be discussed with you and if needed therapeutic interventions might be suggested to assist with your emotions as well as other behavioural components.  After surgery you have to see Dr Liebenberg between week 2 and 4 (not later than week four) to prepare you for the journey ahead.  The idea is to guide you and help you prevent potential pitfalls in the attempt to have long-term sustainability on the program.  This is a particular helpful and needed session.

Q: Who will get the psychologist’s report?

•A: Your confidential report will only be sent to your Surgeon, Prof Heine van der Walt, and is a generic report indicating your compliancy, commitment and psychological readiness regarding the planned Bariatric Surgery.

Q: How do I make an appointment? 

•A:  You can only make an appointment to see Dr Hermann Liebenberg for the first group consultation once you attended Prof Heine van der Walt’s Seminar on Gastric Bypass Surgery and usually after your first visit to Hanlie Sweers (Dietician).  To contact Hermann’s rooms, call (012) 6431594 Monday – Friday between the hours of 8 am and 2 pm (Fridays only until 11 am) and ask for an appointment with him for the Bariatric Information Session and assessment.

Q: What happens if I don’t attend all my sessions?

•A:  The success of the program depends on your full participation and cooperation.  Should you choose not to attend a session/s, Dr Liebenberg will be unable to provide the necessary details of your suitability, preparedness and readiness for the surgery.  This will be taken into consideration by the surgeon as to your commitment and further participation on the program. As part of the psychology practice policy, you will be charged the full amount of the booked session if you don’t cancel your appointment at least 12 hours prior to your session.

Psychological Preparation DVD for Bariatric Surgery Patients (You Tube)

During your Bariatric journey you will also have to familiarise yourself with the preparation prior to and the post-operative care.  The attached video guides patients into the start of the medical and psychological preparation prior to and after Bariatric Surgery.

In addition to Gastric Bypass Surgery (Bariatric Surgery), Plastic and Reconstructive Surgery is often indicated.  This kind of surgery requires a psychological assessments and preparations as part of mental “self-image reconstruction therapy”:

Some patients need to get rid of e.g. excess skin and or need a “tummy tuck” (Abdominoplasty).  These patients needs to be prepared for Reconstructive Surgery.  For some bariatric patients other body image issues might need attention to be “corrected” or improved after weight loss surgery.  This however is not a rule and the minority of patients need to and undergo Plastic and Reconstructive Surgery after Bariatric Surgery.  

•For many prospective plastic and/or reconstructive surgery patients, the fantasy of walking out of hospital a complete new person, unfortunately crumbles once they realise that this kind of surgery can be significantly more invasive than what they ever expected or anticipated.

•The role of the psychological assessment and support prior to and after this kind of surgery is crucial in order for the results and expectations to be in line with reality.  There are some patients that are not emotionally and psychologically suitable candidates or who are not yet optimally prepared for such invasive surgery, and the role of the psychologist in dealing with these patients is far more important than anticipated.  If patients are informed and realistic prior to plastic or reconstructive surgery, they are usually happier and more content patient afterwards.

•For many years the role of the “psyche” was undervalued as part of the preparation for these patients.  Recently, Plastic and Reconstructive Surgeons increasingly acknowledge the benefits of patients who are properly assessed, informed and supported through the process of changing their appearances.  For some it is a life-changing experience and for others it turns into a nightmare.  For that reason the psychologist uses an assessment protocol and support plan to assist in making those changes which the body and mind needs to go through.  The outcome reflects a better and more realistic acceptance of what some people think is a true “Hollywood fix”, indeed creating a realistic reflection of what a surgeon can do to enhance, change or alter your body to give you a better self-image.  Unfortunately, for some patients, the bodily change is not sufficient to influence the mind in changing preconceived perceptions. Therefore, the role of the psychologist in the body and mind alteration is increasingly valued by surgeons all over the world.