Why should I have counseling before and after weight loss surgery?

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Learn about the counselors and the other members of the healthcare team that guide patients through weight loss treatment. Watch this video with surgeon Dmytro Havaleshko, MD from Portsmouth Regional Hospital.
With bariatric surgery comes change, change people don’t need to face alone. In this video, John Pilcher, MD, of Methodist Specialty and Transplant Hospital explains the benefits of counseling before and after weight loss surgery.  
Steven C. Simper, MD
Vascular Surgery
Having a support system around you during your weight loss journey is critical to your long-term success. Experts are available to meet with you individually to help you with your surgery and to successfully make healthier lifestyle habits. Surgery helps you change a lot of aspects of your life. Choosing to participate in counseling or, at a minimum, support groups will help you learn ways to transition into these changes and answer any questions or concerns you might have.
 
Support groups allow you to:
  • meet other people who had shared your journey
  • learn from each other’s successes
  • find people who understand just what you are experiencing
Brooke Randolph
Marriage & Family Therapy
The National Institute of Health requires some psychological counseling prior to any bariatric surgery (weight loss surgery). One reason behind this requirement is that gastric bypass surgery cannot be reversed. It also requires major behavioral change to be successful; if a patient is not compliant with all behavior changes he or she can become very ill -- I have even been told about the possibility of death. These are severe consequences for not following doctor's orders implicitly.

Yet, the behavior change required is also severe. As a therapist, I see asking that kind of change from someone as setting them up for failure or disappointment because so much change is extremely stressful and mentally and emotionally taxing. I would caution any of my clients attempting such overnight life change, and counsel them on forgiving themselves when they do not stick to their plan. Eating more than planned one day may be a disappointment for someone committed to weight loss, but it can have devastating effects for someone who has had gastric bypass surgery.

Over and over what is written about weight loss surgery states that those with the greatest success are those with the strongest support systems. This life change cannot be done alone. I believe a caring, experienced therapist is an essential part of this change for at least the first year and likely longer. In addition to the stress of behavior and lifestyle change, there can be much emotion and adjustment surrounding body image, clothing choices, and social interactions, which will need to be processed in a safe environment.

Another reason that counseling is essential for weight loss surgery to be effective is addressing the reasons behind the original weight gain. Excessive eating can be a symptom of difficulty with impulse control and/or eating to deal with emotions including sadness, loneliness, self-loathing, boredom, joy, anxiety, excitement, etc. Similarly, excessive eating can be a way for someone to deal with trauma by avoiding thoughts of trauma and trying to avoid (sexual) attention from other people. Whatever motivated excessive eating in the past cannot be removed through surgery; it can only be removed through therapeutic processing. Those who do not address those issues will either be unable to maintain the behavior change necessary for the surgery to be a success or they will replace compulsive eating with another "addiction."

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.