Weight Loss Surgery: To Be a Surgical Candidate

Hello, everyone my name is Dr. Catherine Applegate. I am one of the psychologists that work with the weight loss surgery program. I also work with Dr. Kelly Friedman who is with our program full time as well and I just want to tell you about the psychological and behavioral portion of our program. Our main goals with the patient coming through the weight loss surgery program is to help them enhance the amount of weight that they lose with the procedure and also to maintain that weight loss over time. So we are going to be working with you on behaviors that are often very helpful and associated with long term weight loss and weight loss maintenance.

The first thing that we do with patients that coming through the program, we meet with you on the first day of year assessment. So on that day you are going to meet with the member of the medical staff and also with Patrick our nutritionist and then myself for Dr. Kelly Friedman and we will meet with you individually during that visit. What we like to talk with you about is kind of what is bringing in for surgery? How your friends and family might react to you having surgery? Kind of understand your relationship with food and help behaviors that you have that may need to be modified in preparation for surgery so sometimes people need to eat more frequently or to increase their level of exercise or change the beverages that they are drinking or if they need to quit smoking and those kind of things. We can talk with you about.

And encourage you start phasing in changes in your behaviors that will be helpful and similar to what we need you to do after surgery but so you do not have to wait until after surgery and try to change everything at once. We do encourage people to try to faze some of those changes in. We will also talk to you about your psychological history or any medications that you are taking and give you suggestions about things that are often helpful for people as they go through this process. Then if you improved and have surgery with our program the second main way we work with patients is in small groups. So we meet with patients in their preop session which is usually the week before surgery and then also at four sessions after surgery.

Three weeks after three months, six months, and one year. And those visits will be on the same day that you are coming to the clinic for your medical and nutritional follow ups. There are no extra visits for you. You will meet with other patients that are at the same faze that you are at and improves. We have the opportunity to really talk with people about how well they are doing in terms of implementing all of the changes that the team has asked you to make. Giving you suggestions about how to incorporate these changes into your busy schedule, we are talking about some relaxation ideas right before the surgery and also afterwards sort of having keep yourself motivated to do your exercise to remember to at frequently and to keep yourself hydrated.

We also talk about some of the social changes that we see. When you lose weight very rapidly it is noticeable to people. You often get a lot of attention whether you like that or not. Questions from people, comments, are you aloud to eat that? They are very curious about what you are eating and how you eat and can ask you about your weight loss and how much weight you have lost and things like that, which some people do not mind and other people find quite personal. We talk about some the ways that you can deal with the social attention with rapid weight loss.

One of the other things that we are going to ask you to do is to complete some paperwork the first round will be in preparation for your first appointment with us and some of the questions in your paperwork will ask you about things related to your quality of life. This is results from a study that I did that looked at how weight impacts quality of life before and after surgery. In this draft the first purple bars show the responses of patients before surgery and on this scale high is more impairment. People who are reporting a lot of impairment in various areas of their life because of their weight from how well they were able to physically function in their life to their self esteem, their sexual life how they felt in public, and how they were able to work.

Then when we asked them again at one year postop to complete the same questionnaire we saw improvements in al of these areas. This was really helpful for us because we are interested in documenting not only changes in your physical health but also in your psychological health and your general quality of life as well. We will be asking you to complete some questionnaires. The first group of which you would get in your new patient packet we would ask that you please complete that yourself personally and bring it with you completed to your first visit and we will go over that with you. So I am going to stick around if anybody has additional questions about the psychological portion of the program. I will be glad to answer those.