Cognitive and Psychological Assessment Before And After The Bariatric Surgery

1. COGNITIVE AND
PSYCHOLOGICAL ASSESSMENT
BEFORE AND AFTER THE
BARIATRIC SURGERY
prepared By: Dalal Alroais
NeuroPsychologist

2. Many people believe that going through a
Bariatric surgery is enough for losing the
unnecessary weight
The Bariatric surgery is the beginning
because the person should add important
changes to their lifestyle including habits
and exercising

3. OBESITY AND DEPRESSION
Emotions such as :Psychological Stress, sadness
feelings, tenseness can lead people to eat too
much
Obesity is often accompanied by depression and
the two can trigger and affect each other
Depression can both cause and result from
stress, which, in turn, may cause the person to
change his eating and activity behaviors

4. Some people who have difficulty recovering
from unexpected or emotionally exhausting
events loss of a family member or close friend
losing a job or facing a medical problem
relationship difficulties begin eating too much of
unhealthy foods or forgoing exercise, and these
become habits and take long time to change

5. EATING DISORDER
Binge eating is a behavior associated with obesity
and other disorders such as bulimia and anorexia
nervosa, and it is also a symptom of depression
A study of obese people with binge eating disorder
found that 51 percent had a history of depression
Other research shows that obese women with
binge eating disorders developed body
dissatisfaction and depression

6. Many research suggests that obesity may be
significantly associated with mood disorders
Eating disorders have been shown to be more
common among adolescent girls and young
adult women with type 1 diabetes than among
their nondiabetic peers
The successful weight loss is associated with
decreased depression, and the depression
predicts poorer success in weight loss

7. PSYCHOLOGICAL ASSESSMENT
Psychological assessment is important for
obese patients to determine their
appropriateness for surgery
The psychological assessment involves two
parts: a clinical interview and psychological
tests

8. The clinical interview includes reasons for
seeking Bariatric surgery, current eating
behaviors, weight history, psychiatric symptoms
current and past
It may also include
understanding of the surgery, lifestyle changes
and social support

9. The psychological testing provides an
objective measure of the patient
presentation style, psychological
adjustment, and readiness for surgery

10. PSYCHOLOGICAL ASSESSMENT
Assessment of eating habits and behaviors
Motivation and attitude about a lifestyle
change

11. PSHYCHOLOGICAL CHANGES
Mental health conditions or emotional
problems
Unhealthy habits of eating, such as binge
eating, that could cause problems after
surgery
Realistic expectations of what life will be
like after the surgery

12. Patients are at risk for possible
mood disorders and for
noncompliance after the weight
loss surgery
The study, published in September
2014 in the journal Obesity Surgery,
examined the possible causes and
frequency of depression in patients
after bariatric surgery. The study
concluded that most of the patients’
emotional well-being improved in the
months following the surgery

13. The researchers also discovered that a
subgroup of the 107 study participants
experienced a relative increase in depression
six months after the procedure
The majority of patients with discernible
worsening in mood experienced these mood
changes between six and 12 months post
surgery

15. Bariatric patients seeking surgery have a higher
prevalence of psychological distress compared to other
obese patients who do not seek surgery They are often
driven to pursue surgery due to a distressing event
A high prevalence of psychological comorbidities
exists in obese patients, particularly mood disorders,
anxiety, and low self-esteem. Extremely obese
individuals are almost 5 times more likely than their
average weight counterparts to have suffered from a
major depressive episode in the past year

16. Cognitive therapy and cognitive behavioral therapy CBT
have become an important aspect of the treatment of
obesity
Cognition influence both feelings and behaviors
CBT in the treatment of obesity is to help patients
change their negative eating behaviors and their
lifestyle
These CBT interventions are self-monitoring techniques,
stress management, social support, problem solving,
and cognitive restructuring helping patients have more
realistic weight loss goals, avoidance and challenging of
self defeating beliefs

17. The psychologist functions as an assessor
collecting data, an educator - providing
information, and a therapist - reinforcing
motivation and managing the emotions that
often appear during the Psychological
evaluation

18. UNDERSTANDING OF THE SURGERY AND ITS
ASSOCIATED LIFESTYLE CHANGES
As part of the psychological assessment, patients
are asked to describe what the surgery requires
the risks and possibility outcomes associated with
it, and the behavioral changes that are required
for success
The patients specific procedure laparoscopic
gastric banding or gastric bypass determines the
details of this discussion

19. If patients are unable to demonstrate a clear
understanding of these factors, they are referred
back to the surgeon and/or nutritionist for additional
counseling
The need for intellectual testing has been apparent to
determine the ability for consent
It's useful for patients to attend a group therapy and
seminars and talked with people who have had the
surgery: this enhances their understanding of the
surgery

20. During this discussion, the role of the surgery as
a tool, and not as a magical cure
is emphasized
The idea that the surgery “stops” them from
overeating is challenged
They are reminded that the surgery allows them
to feel satisfied with a small amount of food but
that they are responsible for stopping when that
point has been reached

21. It is important that the patient realize if they
fail to stop, they will face consequences such
as dumping after the surgery and possible
weight gain after the surgery
This point undermines the notion that the
surgery absolves patients of responsibility for
their eating choices
Patients are encouraged to view the surgery as a
tool that they can use to improve their health
if they make the appropriate choices

22. Psychological evaluation after
bariatric surgery should focus on an
assessment of depression, eating
disorder ,behaviors, self-esteem and
social functioning