Bariatric Surgery and Mental Health: What You Need To Know

You’ve made the decision to have bariatric surgery and are excited about how your body will change. But have you thought about how the physical transformation will affect you mentally? You should.

Understanding the mental-health piece of the procedure is a vital part of your weight-loss journey.

Screening Before Surgery

Addressing obesity is a complex process that requires a deeper dive than a simple “calories in, calories out” approach. This holistic view includes relearning longstanding habits and addressing any underlying mental health challenges.

At clinics with a multidisciplinary team, full-time psychologists screen bariatric patients for mental-health issues that may affect their success.  Patients dealing with obesity are often predisposed to mental health issues such as:

• Depression
• Anxiety
• Body dysmorphia
• Eating disorders

During the mental health screening process, these and other issues are noted — and in some cases, diagnosed for the first time. From there, a mental health treatment plan is put in place that works in conjunction with the surgery and recovery timeline. This includes prescribing medications, if needed, and a conversation between the psychology team and surgery team – and any other healthcare providers who will interact with you – about your mental health conditions or sensitivities.

Mentally Prepare

Like any other life-changing decision, you have to think about your own mindset and intentions before having bariatric surgery. To prepare mentally for bariatric surgery, you should consider:

• Motivation. Are you undergoing bariatric surgery because you want to improve your health – or are you just concerned with how you look? If you’re serious about weight-loss surgery to address health and quality-of-life issues, your chances of feeling satisfied with the result are high. But if your motivation for bariatric surgery is based on aesthetics or external pressure to have the procedure, you are more likely to feel “let down” during the process. Should you get excited about the positive physical changes? Of course! But those changes should be viewed as a bonus to the health benefits of bariatric surgery.
• Weight fluctuations. Think about different life events – marriage, deaths, job changes – and how those may have affected your weight. Your family history and any short-term successful diet or exercise programs are important, too. Recognizing patterns and triggers in weight gain, or disordered weight thinking, will help you better prepare for those challenges after bariatric surgery.
• Psychiatric history. If you have any known psychiatric conditions, even if they do not seem related to weight-loss surgery, tell your doctor. This helps ensure your mental safety before, during and after the surgery.

What To Expect Post-Surgery

For the first two weeks after surgery, you likely will experience a flood of hormonal changes that can cause mood swings. Doctors will explain the difference between a mood swing that will pass and one that needs professional psychological attention.

Once you get past that, the long-term mental health effects of bariatric surgery can be extremely positive, and you likely will see a significant boost in your mood. Being able to exercise and move more easily also will help you feel more energetic. 

In fact, research shows that bariatric surgery patients who participate in regular cardiopulmonary fitness are at less risk of developing depression.

Life still has its ups and downs, though, and you should expect some bumps in the road on your journey — and mentally prepare for them. A common pitfall is relying on food for comfort when you experience a tough day or phase. There’s a reason for this — sugar and carbohydrates boost endorphins short-term. Understanding that is the first step to overcoming those cravings.  Psychological and nutritional counseling will help you learn to get past these feelings.

Although setbacks can feel overwhelming, anticipating them and developing new techniques for coping will help you work through them.

Key To Success: Motivation

You will lose a lot of weight the first six to eight months after surgery, but when you aren’t shedding pounds as quickly is when your motivation needs to kick in. It’s also important to understand that seeing the numbers on your scale edge up and down is normal and no need for alarm.

Establishing a healthy weight-loss and weight maintenance mindset before and in the days immediately following bariatric surgery can help patients face any emotional lows down the road.

You may feel discouraged or worried when the weight loss slows down. Establishing exercise routines, new ways of eating and other healthy habits from the start can be the difference between a temporary feeling and a major setback.

Keep an Eye on ‘Food Fear’

Occasionally patients can develop new mental-health challenges related to bariatric surgery and the corresponding changes to their body. They may experience “food fear” and not want to eat because they worry about regaining weight. This can lead to physical problems such as malnutrition and vitamin deficiencies.

Stay in tune with your thoughts and see your doctor if you are suffering from new mental health challenges after surgery.