The importance of psychological follow-up after a bariatric surgery

Psychological follow-up after bariatric surgery is essential for several reasons, as the surgery not only transforms the body but also affects emotional and mental health. Weight loss surgery is a life-altering procedure that can trigger complex emotional, social, and psychological challenges. Here’s why psychological support is crucial in the post-surgery journey:

1. Addressing Emotional Eating and Behavioral Patterns

• Pre-surgery Eating Habits: Many individuals who undergo bariatric surgery such as gastric band, gastric sleeve… have a history of emotional eating, stress eating, or using food as a coping mechanism. After surgery, the body’s capacity to consume large quantities of food is reduced, but the psychological triggers for eating may remain.
• Developing Healthy Coping Strategies: Psychological follow-up helps individuals identify emotional triggers and replace unhealthy coping mechanisms with more adaptive strategies, such as mindful eating, relaxation techniques, or other forms of emotional regulation.

2. Preventing Post-Surgery Depression and Anxiety

• Mood Fluctuations: Rapid weight loss and the drastic physical changes that follow bariatric surgery can lead to significant mood swings. Some patients may experience depression, anxiety, or a sense of loss, especially if they relied on food for comfort or emotional regulation.
• Body Image Issues: Even after significant weight loss, some patients struggle with their new appearance, body dysmorphia, or dissatisfaction with excess skin. Psychological support can help manage these complex feelings and improve body image satisfaction over time.
• Suicidal Thoughts: Research shows that individuals who have undergone bariatric surgery may be at an increased risk of suicidal thoughts and behaviors, particularly if underlying mental health conditions were present before surgery. Ongoing psychological care helps address these issues early.

3. Adjustment to a New Lifestyle and Identity

• Lifestyle Changes: Bariatric surgery requires patients to make lifelong changes to their eating habits, exercise routines, and daily routines. Adapting to this new lifestyle can be overwhelming, and some may feel frustrated or resentful about the restrictions.
• Support for Identity Changes: Rapid weight loss can lead to an identity shift. Some patients may struggle to reconcile their “new self” with the “old self,” which can affect relationships and self-perception. Psychological follow-up can help guide individuals through this transformation and help them establish a healthy and balanced identity.

4. Preventing Weight Regain

• Behavioral Management: Surgery is a tool for weight loss, but maintaining the results requires long-term behavioral changes. Psychological follow-up helps patients develop strategies to prevent weight regain by reinforcing healthy habits and addressing emotional or compulsive eating patterns.
• Motivation and Accountability: Regular sessions with a psychologist or counselor can provide motivation and accountability, helping patients stay committed to their dietary and exercise routines during challenging times.

5. Improving Relationships and Social Interactions

• Changing Social Dynamics: As individuals lose weight, their relationships with friends, family, and romantic partners may shift. Some people experience jealousy, resentment, or changes in their social circles. Psychological support helps individuals navigate these changing dynamics and develop healthier interpersonal relationships.
• Self-Esteem and Confidence: Weight loss can improve self-esteem and confidence, but it may also bring about new challenges in how individuals relate to others. Counseling helps individuals build healthy self-esteem and manage any anxiety or discomfort in social situations.

6. Dealing with Unrealistic Expectations

• Expectations vs. Reality: Many individuals have high expectations for their weight loss journey, assuming it will solve all their problems. When the results don’t immediately lead to happiness or fulfillment, they may feel disillusioned or disappointed.
• Adjusting Expectations: Psychological follow-up helps patients set realistic expectations and prepare for the emotional and physical challenges that may arise after surgery. It ensures they understand that while surgery can improve health and quality of life, it is not a cure-all.

7. Supporting Long-Term Mental Health

• Chronic Mental Health Conditions: Many individuals undergoing bariatric surgery have a history of mental health conditions such as depression, anxiety, or bipolar disorder. Psychological follow-up helps manage these conditions post-surgery, especially as hormonal and physical changes may impact mood stability.
• Preventing Substance Abuse: Some patients are at risk of substituting food addiction with other behaviors, such as alcohol or substance abuse, especially if they don’t develop healthy coping strategies. Ongoing therapy helps identify these risks early and prevent unhealthy behavior substitution.

8. Reinforcing Personal Empowerment and Self-Efficacy

• Confidence in Change: Psychological follow-up helps build confidence in one’s ability to maintain the changes brought about by surgery, reinforcing the belief that long-term success is within the patient’s control.
• Goal Setting and Achievement: Counseling helps patients set achievable, realistic goals beyond weight loss, such as improving overall health, fitness, or emotional well-being, empowering them to take control of their journey.

9. Managing Setbacks and Plateaus

• Coping with Plateaus: Many patients experience weight-loss plateaus or setbacks in their journey. Psychological support can help individuals manage feelings of frustration or failure during these periods, preventing them from giving up on their goals.
• Positive Reinforcement: A therapist can offer positive reinforcement, helping patients focus on non-scale victories, such as improved health markers, increased energy, or better mental well-being, rather than just the numbers on the scale.

10. Addressing Relationship with Food and Body

• Disordered Eating: Some patients may continue to struggle with disordered eating patterns, such as binge eating or restrictive eating, even after surgery. Ongoing therapy is vital for addressing these behaviors and fostering a healthy, balanced relationship with food.
• Body Acceptance: Counseling can help patients accept their new body, adjust to the changes, and develop a positive body image, even if they struggle with excess skin or residual weight.

11. Preventing and Addressing Transfer Addictions

• Risk of New Addictions: Some individuals may develop transfer addictions post-surgery, where they replace food with other addictive behaviors, such as alcohol, shopping, gambling, or even exercise. This occurs because the original emotional need (previously satisfied by food) remains unaddressed. Psychological follow-up helps identify these tendencies early and provides coping mechanisms to prevent unhealthy behaviors.
• Support in Developing Healthy Coping Strategies: Therapy can offer patients healthier alternatives for managing stress, boredom, or emotional pain without resorting to destructive behaviors.

12. Helping with the Social and Cultural Impacts

• Cultural and Social Pressure: In some cultures, body image ideals or attitudes toward food and weight can affect a person’s emotional well-being before and after surgery. Some people may face challenges related to changing social identities, cultural expectations, or family dynamics. Psychological support can help individuals navigate these complex social dynamics and cultivate positive relationships with themselves and others.
• Social Isolation: Individuals who undergo bariatric surgery may feel isolated if their social circle doesn’t understand the emotional challenges associated with weight loss surgery. Counseling can help them reconnect with their support system and find new communities or peer groups who share their experience.

13. Building Resilience for Long-Term Success

• Preventing Self-Sabotage: Some patients, especially those with a history of self-doubt or low self-esteem, may unconsciously engage in self-sabotaging behaviors, such as returning to old eating patterns or avoiding follow-up care. Therapy can help patients recognize and break these destructive cycles.
• Building Mental Toughness: Psychological support encourages resilience, helping individuals bounce back from setbacks, stay committed to long-term goals, and continue making progress in maintaining their weight loss and mental health.

14. Improving Sexual Health and Intimacy

• Impact on Relationships: Significant weight loss can improve physical health and self-esteem, potentially enhancing intimacy and sexual relationships. However, it may also bring challenges, such as changes in how individuals perceive themselves or how their partners view them.
• Navigating Body Image and Confidence: Therapy can help individuals explore how they feel about their body in the context of intimacy and develop the confidence to foster healthy, satisfying sexual relationships.
• Communication with Partners: Psychological counseling can facilitate open and honest communication with partners, helping both parties navigate the physical and emotional changes that come with weight loss.

15. Addressing Trauma and Past Experiences

• Link Between Trauma and Obesity: Some individuals struggle with obesity due to unresolved trauma, such as childhood abuse, neglect, or bullying. Bariatric surgery can bring up these past issues, as losing weight might trigger emotions that were previously suppressed by emotional eating. Psychological follow-up helps patients address and process these traumas in a healthy way.
• Healing Emotional Wounds: Therapy provides a safe space to work through emotional scars and develop new, healthier ways of dealing with pain, anxiety, or distress that may have previously been linked to eating habits.

16. Supporting the Entire Family

• Family Dynamics: Bariatric surgery affects not just the patient, but also their family. Partners or family members may need to adapt to the patient’s new lifestyle, eating habits, and emotional needs.
• Family Therapy: Including family members in counseling sessions can help them understand the psychological aspects of weight loss surgery, allowing for more effective support and improved communication within the household.
• Creating a Supportive Environment: A healthy post-surgery environment includes loved ones who are aware of the patient’s journey and can offer encouragement rather than sabotage or misunderstanding.

17. Developing Realistic Long-Term Expectations

• Managing Weight Loss Expectations: Many patients expect rapid or dramatic transformations after bariatric surgery. While the surgery can lead to significant weight loss, psychological follow-up helps ensure that patients have realistic expectations about the speed and amount of weight loss.
• Body Image Acceptance: Psychological support helps individuals accept the changes in their body shape and size, especially if excess skin or other cosmetic issues arise, and manage any dissatisfaction with aspects that may not meet their initial expectations.
• Setting New Goals: Therapy helps patients set long-term goals for health, self-care, and emotional well-being, ensuring they stay focused beyond just the number on the scale.

18. Preventing Relapse into Old Habits

• Long-Term Accountability: Regular psychological follow-up provides ongoing support and accountability, helping patients stay on track and avoid slipping back into old habits like overeating, skipping meals, or avoiding exercise.
• Dealing with Stress and Setbacks: Life stressors, such as job loss, family issues, or health challenges, can tempt patients to return to unhealthy habits. Psychological care provides tools to manage these situations without resorting to food for comfort.

19. Supporting Career and Workplace Challenges

• Workplace Dynamics: Rapid weight loss can lead to changes in how individuals are perceived in the workplace, sometimes causing unexpected attention or bias. Psychological follow-up can help patients navigate these situations confidently and professionally.
• Confidence and Assertiveness: Therapy can improve self-confidence and assertiveness, equipping individuals with the skills to handle any career-related challenges that arise due to their weight loss or improved self-image.

20. Enhancing Overall Quality of Life

• Holistic Well-Being: Weight loss surgery impacts not just physical health but emotional, mental, and social well-being. Psychological follow-up ensures that patients maintain balance in all aspects of their lives, fostering happiness, satisfaction, and fulfillment.
• Sustaining Positive Change: The ultimate goal of psychological care is to ensure that the changes achieved through bariatric surgery—both physically and emotionally—are sustained over the long term, improving overall quality of life.

Conclusion

Psychological follow-up after bariatric surgery is essential for promoting emotional well-being, ensuring long-term weight management, and helping individuals adjust to the physical and psychological changes they experience. With the proper support, patients can address emotional eating, improve body image, and enhance relationships, ultimately leading to a healthier, more fulfilling life. This support empowers individuals to make lasting changes, not only in their physical health but also in their mental and emotional well-being, which is crucial for long-term success.